Summary: The new GINA 2021 guidelines introduced several important changes in asthma treatment. From a practical point of view, we concentrate on adolescents and adults in this review. Current GINA 2021 guidelines prefer the use of single-inhaler maintenance and reliever therapy (SMART) over the SABA reliever add-on to GCS or GCS plus LABA treatment. In this age group it is important to individually tailor the therapy to patientsʼ needs and to make it practical. It seems to us that breath-activated in-halers might be the right solution for the majority of patients. This approach has been widely accepted and well tolerated in several clinical trials. Therefore, the combination of SMART and a breath-activated inhaler might improve overall asthma control in the adolescent and adult population.