Climate change impacts everyone’s health and in particular patients with respiratory disease. Patients can work with clinicians to improve their respiratory symptoms and make treatments more environmentally friendly. If you are worried about your carbon footprint or how well your symptoms are being controlled, then read on and please talk to your surgery for options.
Can a greener inhaler help you fight climate change?
The most important thing you can do for your health and the planet is to get your disease control is as good as it can be.
Poorly controlled asthma or COPD creates its own carbon footprint and is bad for patients in the long run. Using any inhaler device in the right way is the best thing you can do to stay well and minimise the impact on the environment. Remember, “The greenist inhaler is the one you can use properly”.
For example, in asthma – If you need to use your RELIEVER (“blue” inhaler or salbutamol) more than three times a week, this could be a sign that your asthma control is not well controlled. If this is happening, you should contact your surgery for an asthma review. Using your PREVENTER (“brown” inhaler or steroid) regularly even if you have no asthma symptoms can also help keep your asthma under control. Some patients are recommended Maintenance and Reliever Therapy (MART) for extra help with their symptoms and can be a great option for reducing your carbon footprint
If any of the following apply to you then speak to your GP, respiratory nurse, pharmacist or respiratory specialist.
Are you repeatedly experiencing symptoms or needing to use your rescue medicines or blue inhaler too frequently? (e.g. more than twice a week)
Are you using your preventer medication too irregularly? (i.e. not using them daily as prescribed)
Are you struggling to use your inhaler device as you find the technique too difficult to manage?
Have you had an asthma or COPD review in the last year?
Do you need more than 3 to 6 blue inhalers in a year? (well controlled asthma patients shouldn’t need more than one blue inhaler per year in most cases)
The NHS needs to do more to reduce its carbon footprint and prescribing medicines in the greenist way possible really can help. Many people are surprised to learn that many commonly used inhalers (called metered dose inhalers) contain powerful greenhouse gases which are needed as propellants to help deliver the medicine to your lungs. Greener alternative inhalers are available and can help to control your symptoms just as effectively and reduce the carbon footprint of the NHS. These alternatives are called “dry powder inhalers” and have a much lower carbon footprint because they do not need propellants.
Metered Dose Inhalers (MDIs or “puffers”) are very commonly used but greener alternative inhaler devices are available which are much better for the environment because they do not need propellant greenhouse gases to get the drug into your lungs. These alternatives are called “Dry Powder Inhalers” (or DPIs). They help control long term lung diseases such as asthma or COPD just as well as MDIs with a vastly reduced impact on the environment.
Please note: If you are worried about your carbon footprint or how well your symptoms are being controlled, please talk to your surgery for options. Do not stop using any of your prescribed medications including inhalers because you are worried about your carbon footprint and do not feel guilty if your clinician advises you to continue using your Metered Dose Inhaler because alternatives are not necessarily recommended for all patients. Most patients will get on well with DPIs with only a few exceptions. Your GP, pharmacist or respiratory nurse can check if you are suitable for a Dry Powder Inhaler.
Patients can check how green their prescribed inhalers are. Use the quick “green inhaler checklist” to help you to decide.
| Are you prescribed a Metered Dose Inhaler? (pMDI) as eith a reliever or preventer, or both (see pictured below) | Yes or no |
| Are you needing to use your blue inhaler (reliever) more than 3 times a week? | Yes or no |
| Are you prescribed (or normally dispensed) a Ventolin Evohaler®?” | Yes or no |
| Are you prescribed a “Flutiform®?” pMDI or “Symbicort®?” as a pMDI? | Yes or no |
| Are you prescribed a mixture of inhaler devices? (e.g. a dry powder inhaler and a pMDI) | Yes or no |
| Do you struggle to use your inhaler device? | Yes or no |
| Do you use your reliever medication repeatedly in a single day even though you do not feel breathless? (e.g. because that’s what the label instructs you to do) | Yes or no |
| Do you worry you are throwing away inhalers too early or can’t tell when they are empty? | Yes or no |
| Do you throw away your empty or unwanted inhalers in your domestic rubbish or recycling bins? | Yes or no |
If you have answered ‘yes’ to one or more of these questions, then please speak to you GP, respiratory nurse, pharmacist, or respiratory specialist.
Get the most from your inhaler
Poorly controlled asthma or COPD is bad for you in the long run and creates its own higher carbon footprint. Getting the most from your inhaler device (whatever the type) is good for you and good for the planet. If any of the following apply to you then speak to your surgery about booking a respiratory disease review:
- Are you repeatedly experiencing symptoms (such as shortness of breath) or needing to use your rescue medicines or “blue” reliever inhaler too frequently? (e.g. more than once or twice a week)
- Are you using your preventer medication too infrequently? (i.e. not using them daily as prescribed)
- Are you struggling to use your inhaler device because you find the technique too difficult to manage?
- Have you had an asthma or COPD review in the last year?
- Do you need more than 6 blue reliever inhalers per year? (Did you know that well controlled asthma patients shouldn’t need more than one blue reliever inhaler per year in most cases)
Getting the use of “reliver and preventer” inhalers right is vital – YouTube.
The next best thing is to make sure that you are using your inhaler correctly by getting the technique right. Ask your doctor, nurse or pharmacist to check your inhaler technique. You can also find inhaler technique support videos online at the inhaler videos library.
It is possible to manage your symptoms just as well and make treatments more environmentally friendly by either changing the device or getting the most from your existing devices.
Do not feel guilty if your clinician advises you to continue using your Metered Dose Inhaler. Alternatives are not necessarily recommended for all patients.
For many patients, effective and more environmentally friendly alternatives are available. Many patients find them easier to use as they require less coordination to use than a pMDI device and they usually have dose-counter so you know how many doses are left so you can avoid accidentally using an empty device or throwing away a device with doses left to use.
So, ask your clinician – “will a dry powder inhaler be suitable for me?”
Do not feel guilty if your clinician advises you to continue using your Metered Dose Inhaler. Dry powder devices are not necessarily recommended for all patients and your clinician needs to sure that you can effectively breathe in strongly enough to activate the device (they require a hard, fast, deep breath to work properly) Most importantly- do not – stop using any of your prescribed medications including inhalers because you are worried about your carbon footprint.
There are other things you can do (especially if your still require a Metered Dose Inhaler).
Make sure you are using your inhaler correctly. Ask your doctor, nurse or pharmacist to check your inhaler technique. Alternatively you should carefully read the leaflet or watch a training video to help you to improve your inhaler technique.
Make sure you are using your PREVENTER (“brown” or steroid inhaler) regularly and correctly. They are vital to prevent symptoms or prevent asthma from getting worse .
There still may be more environmentally friendly options available even if you must have a pMDI. For example, the most commonly used Ventolin Evohaler® can be changed for a smaller volume inhaler such as “Salamol” with the same medication and number of doses in (your GP practice may already be doing this – but if in doubt ask)
You may be able to get the ‘strength’ or your device changed so you need to inhale fewer doses (e.g., “2 puffs twice daily” is a common dose for a preventer but if you have stable symptoms and well controlled disease changing to a stronger device but used less often as “1 puff twice daily” will mean fewer daily doses, a smaller carbon footprint and less waste
Keep closer track of how many doses are left in your inhaler if it lacks a dose-counter
Return it to your pharmacy after you’ve finished with it. Pharmacies dispose of medicines differently to your domestic or recycled rubbish. The harmful greenhouse gases in MDI devices will be disposed of in a way that is less environmentally damaging.
