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Asthma and the environment

Choosing an inhaler which is good for you and good for the planet (PDF, 248KB)


Asthma and the environment 

South East London CCG has introduced more environmentally friendly inhalers, prescribed for conditions like asthma and COPD, and your clinician may discuss switching your inhaler at your next respiratory review.

The benefits of green inhalers:

  • For most people they are easier to use
  • Many don't require spacer devices
  • Include a counter, so you know how much is remaining, meaning less waste
  • Contain up to 30 times less CO2, so better for the environment

What do inhalers do?

Inhalers are used in a variety of respiratory (lung) conditions, such as asthma and chronic obstructive pulmonary disease (COPD).

Some inhalers use propellants to create a spray of medication droplets which the person inhales. These are called pressurised metred dose inhalers (pMDIs). The propellants in pMDIs are a powerful greenhouse gas. They are safe for the person using them but they have a much bigger impact on the environment than dry powder inhalers (DPIs) or low carbon inhalers delivering the same medicine. That’s because dry powder inhalers (DPIs) don’t use propellant gases, instead using a person’s breath to deliver the dose. DPIs therefore have a much lower environmental impact. Dry powder inhalers have an estimated carbon footprint equivalent of just 20g per dose compared with 500g in MDIs.  So switching to a DPI from an MDI can help to reduce not only the NHS carbon footprint, but also your own carbon footprint!  This can have a bigger impact than eating less meat or planting a tree. (see greeninhaler.org)

For most people, either type of inhaler is equally effective. In many cases a DPI inhaler can be easier for a patient as they have a counter (so you know when it is running out), it does not need a spacer device, and it can be easier to co-ordinate with your breathing so making sure that the drug gets to your lungs.  Most people, once shown the correct technique, can master a DPI.

What does switching to a greener inhaler mean for me?

Your inhaler type will not be changed without your knowledge and agreement; not all inhalers are suitable for every patient. The best inhaler for you is that one that gives you the best control of your lung condition.

Where someone can use a dry powder inhaler effectively to deliver the same medication, then that is likely to be the preferred option – giving benefit to the patient and the environment too.

If you do decide to switch, you will be given training on how to use it and reviewed after a short period of time to see how you are getting on. This may be by the person who changed your inhalers, or the pharmacist who dispensed them.

If you need a reminder how to use your inhaler properly, Asthma UK have videos reminding you how to do this.

If you do change, you probably won’t notice any difference in your symptoms.  Sometimes there is actually improvement if you are better able to use the new device.  However, if there is any worsening you should contact your doctor or nurse to be reviewed, check how you are getting on, if you are using the inhaler properly or if you need to change back again. If you do need to carry on using a pMDI don’t worry, the most important thing is that people get good control of their lung condition and for this some people need MDI inhalers. 

If this is something that you would like to discuss, please do contact the practice for an asthma review with a Practice Nurse or member of the Clinical Pharmacy team, or feel free to mention at your annual asthma review where a healthcare professional will review your condition, ask about symptoms, check how you are getting on with the inhalers that you already have, and discuss whether a switch to a greener inhaler would be suitable.  You will be able to ask questions and may also be able to look at example inhalers.

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171 King Harold’s Way, Bexleyheath, Kent, DA7 5RB

  • 020 8303 1127
  • bexleymedicalgroup@nhs.net

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