Introduction:
Asthma exacerbation is a major cause of Emergency Room (ER) visits. Asthma patients who smoke have more frequent ER visits and hospitalizations for an exacerbation than asthma patients who do not smoke. The objective of the study is to determine the prevalence of smoking exposure in adults with an asthma exacerbation visiting ER.

Methods:
Patients with an asthma exacerbation at the ER from August to November 2019 where assessed for a definite asthma diagnosis at the outpatient clinic. Exposure to smoking was assessed.

Results:
A total of 81 patients were enrolled, with 36.2% having an asthma diagnosis for the first time. The majority of patients had mild asthma. Hospital admission occurred in 13.3% of patients, 43% of the enrolled asthmatic patients were current smokers with a median of 19 pack-years (range 3–80), and median 20 cigarettes per day (range 1–50) while 28.5 % were former smokers, and 28.5% never smokers. Among the group of asthmatics with first diagnosis, smokers were 46%. The percentage of smokers in different stages were: Stage I-II (42.8%), Stage III (50%), and Stage IV-V (50%). Of the non-smokers, 25.5% were exposed to passive smoking.

Conclusion:
Although it is generally known that smoking is affecting asthma severity and exacerbation rates, smoking exposure was high among adults visiting ER for an asthma attack regardless of the severity stage of asthma. Smoking exposure is a modifiable risk factor and ER offers an opportunity to identify patients with asthma who could benefit from outpatients preventive care.