Introduction: Asthma medication was increasingly used during the second part of the past century. There are few detailed data from population studies on use of asthma medication. The current study aimed to determine the use and determinants of asthma medication in West Sweden and to assess changes during the last two decades. Methods: From a random population sample participating in a survey on respiratory symptoms, 2000 individuals were randomly selected for clinical examinations and structured interviews, 1172 participated. All subjects reporting asthma (n Z 1524) were also invited, and 834 participated. In total, 964 subjects with asthma participated. Asthma medication use was assessed in the general population and among two severity categories of asthma: multi-symptom asthma (MSA) and “other” asthma (having fewer symptoms). Current data, from 2010, was compared with data from 1992. Results: Asthma medication was used by 11% of the population, 4.4% used ICS with concurrent use of LABA, 3.3% used ICS without LABA, while 3.2% only used SABA. Compared with 1992, the prevalence of asthma medication use had increased with 54%, and use of ICS had increased from 1.5% to 7.7%.Conclusion: Subjects with MSA reported using asthma medication more frequently and at higher doses, and a higher proportion used ICS.A shift in asthma medication use has occurred since 1992, with increased use of ICS and decreased use of SABA only, implying better asthma Control on a population level. Multi-symptom asthma should alert the treating physician to consider under-medication and/or poor treatment adherence.