More than 25% of asthmatics worldwide are current or former smokers. Smoking in asthma leads to suboptimal control, lower quality of life and frequent exacerbations. Despite that there is lack of evidence concerning the treatment of smoking asthmatics, this large population is usually excluded from studies. All RCTs with triple therapy in asthma exvluded smokers more than 10p/y.The aim of our study was to determine if current or former smokers (>10p/y) with uncontrolled asthma (good inhalation technique and adherence, treated co morbidities) could benefit from the addition of LAMA to their treatment with (medium or high dose)ICS/LABA. We excluded patients with COPD, bronchiectasis, severe heart failure and other severe comorbidities. and conducted a single arm trial, adding LAMA for 3 months. Our primary end point was FEV1. Secondary end points were ACT, AQOL and HADS scale.We included 22 smokers and conducted a single arm trial, adding LAMA for 3 m.  Results are shown in Fig 2 We conclude that even asthmatic that smoke more than 10py benefit from the addition of LAMA. More research with RCTS is needed in order to prove efficasy of adding LAMA in smoking asthmatics stage 4-5.