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Making environmentally friendly choices when prescribing for asthma

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There are 5.4 million people with asthma in the UK, which means asthma affects one in five households.2 Recent market research conducted by GSK suggests that only a quarter (25%) of British people are aware that different inhalers have different environmental impacts.1

Across the total UK inhaler market, the ratio of pMDI to DPIs dispensed is 70%:30%.3 The NHS Sustainable Development Unit has estimated that 3.5% of the NHS’ total carbon footprint comes from pMDIs,4 which have a carbon footprint approximately 18 x the carbon emissions of DPIs.5

GSK market research suggests that healthcare practitioners are better informed about the impact inhalers have on the environment. However there is still awareness to be gained, as from 550 healthcare professionals surveyed, covering GPs, practice nurses, respiratory specialists and respiratory nurses, 60% did not know that some inhalers produce more greenhouse gases than others, while 67% were not aware that pMDIs produce more greenhouse gases than DPIs.6

To help address the impact of inhalers on the environment, prescribers and patients are encouraged to consider switching pMDIs to DPIs whenever they are likely to be equally effective.7

The NHS has also now committed to encouraging the use of lower carbon inhalers to help save 4% of health and social care emissions as part of the Climate Change Act target.7 Plus, a NICE asthma ‘shared decision aid’9 which launched in April, aims to help patients with asthma and their healthcare professionals to discuss their options for inhaler devices. The carbon footprint of the inhaler is included as one of many considerations when patients and healthcare professionals discuss inhaler choices.

GP, Dr Steve Holmes, comments:

‘People are becoming more aware of the impact their actions are having on the environment. We are making many more green choices every day – reusable cups, bags, straws and other greener options. This also applies to healthcare, where we are becoming more aware of our carbon footprint. One example is the total impact of respiratory inhalers, which includes the gas emissions, production and transportation costs, as well as the use of reusable plastics, metals and other valuable resources. Halving the amount of emissions from inhalers would be equivalent to approximately 230,000 fewer cars on UK roads.8 It’s time to take action. It is important to stress that there remains an important role for pressured metered dose inhalers where there is a clinical need or where dry powder inhalers may not be suitable for the patient. However, where clinically appropriate, patients should be offered a lower carbon inhaler choice which, together with environmentally safe disposal, will make a positive impact on the environment.’

More information can be found at


1. Market research survey conducted 27th February – 9th March 2019, by medeConnect Healthcare Insight, among 1,034 adults (comprising 1,000 adults nationally representative by region, age and gender, plus an additional 34 preventer inhaler users; the sample in its entirety included 200 preventer inhaler users).

2. Asthma UK: Asthma Facts & Statistics

3. Lavorini F, Corrigan CJ, Barnes PJ, Dekhuijzen PR, Levy ML, Pedersen S, et al. Retail sales of inhalation devices in European countries: so much for a global policy. Respir Med2011;105:1099-103

4. EAC – UK Progress onreducing F-gas Emissions. Fifth Report of Session 2017–19, April 2018

5. Hillman, T. Mortimer, F and Hopkinson, N. (2013). Inhaled drugs and global warming: time to shift to dry powder inhalers. British Medical Journal. DOI: 10.1136/bmj.f3359.

6. Market research survey conducted 5th – 27th March 2019, by medeConnect Healthcare Insight, among 550 healthcare professionals.

7. BTS (2019) Position Statement: Environment and Lung Health

8. Data on file: Carbon Savings from Recycling Inhalers – UK/RESP/0296/18


Content lab number: NP-GB-RS-JRNA-190003

Date of prep: December 2019

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