How inhalers affect the environment

Asthma + Lung UK is working in collaboration with NHS England, NHS Scotland, NHS Wales and Department of Health (Northern Ireland) to support you to make changes so you can live better with your lung condition and help the environment at the same time.

This project has been supported through a funded partnership with NHS England. 

If you have asthma, COPD or another lung condition, inhalers contain essential medicines to help you stay well.

The best inhaler is the one that works well for you. Looking after your lung condition well is better for you and the environment.

Some inhalers use a gas, known as propellants, to create a puff of medicine, which is then inhaled by the person using them. These types of inhalers are called pressurised metered dose inhalers (pMDIs).

The propellants in pMDIs are powerful greenhouse gases and are thousands of times more powerful than carbon dioxide. They are safe to the person using them, but contribute to climate change.

Many people in the UK use pMDIs, also known as aerosol inhalers or “puffers”. They usually have a plastic case and a metal canister. pMDIs make up 70% of inhalers prescribed in the UK, causing 3% of the NHS’s overall carbon emissions. This makes them the single largest contributor to the NHS’s carbon emissions of any medicine.

For this reason, the NHS is encouraging healthcare professionals to give people over the age of 12 the option of changing to a lower-carbon inhaler. Find out about changing to a lower-carbon inhaler.

Not all pMDIs have the same carbon footprint. For instance, Ventolin Evohaler has a higher carbon footprint than Salamol. Both of these pMDIs work just as well as each other and contain the same medicine. The difference is that Salamol has a lower carbon footprint, although it still contains greenhouse gases.

The good news is, there are inhalers with a much lower carbon footprint than pMDIs. These come in two different types: dry powder inhalers (DPIs) and soft mist inhalers (SMIs). These inhalers have a lower carbon footprint because they don’t contain greenhouse gases.

Most people can use a DPI or SMI and many people prefer them, as you don’t need to use a spacer. Most DPIs and SMIs also have a dose counter, to help you track how much medication you have left.

Not everyone will be able to change to a DPI or SMI. Together with your healthcare professional, you can decide on the best type of lower-carbon inhaler for you and your lung condition. If you can’t change to a lower-carbon preventer inhaler, the important thing is to make it work as well as possible. This means taking it every day, as prescribed, and with the right inhaler technique.

Remember, looking after your lung condition well is better for you and the environment. This is done best when you use an inhaler that works well for you. Find out more about the simple things you can do to make sure you’re taking your inhalers in the best way for you and the environment.

Different inhalers have different carbon footprints.

You might not know what specific type of inhaler you use. The National Institute for Health and Care Excellence (NICE) has developed a patient decision aid about inhalers, which can help you find out the type of inhaler you use.

Most pMDIs are taken twice a day. However, it is possible with some pMDIs to use one puff at a higher dose, rather than two puffs at a lower dose.

Fewer puffs mean less propellant is being released. Your GP, respiratory nurse or pharmacist might suggest changing to an inhaler that means you take fewer puffs, even if the overall dose you take stays the same.

However, it is very important not to change how often you take your inhaler without talking to your healthcare professional.

There are other simple ways reduce the carbon footprint of your inhalers, even if you need to use a pMDI. To find out what these are, keep reading.

Managing your asthma, COPD or other lung condition well is better for your health and the environment.

If you use a pMDI, you might also want to think about using a spacer. Using a spacer helps the right amount of medicine get to your lungs, where it’s needed. This helps to reduce side effects and means you don’t waste medicine. You may also find it easier to take your medicine with a spacer.

If you’re using a DPI or an SMI, you don’t need to use a spacer.

Read more about spacers, including how to use one.

If you have asthma, taking your preventer inhaler every day, as prescribed, means you shouldn’t need to take your reliever inhaler as much to deal with asthma symptoms. This means you’ll use fewer inhalers overall, which is better for you and the environment.

If you find you need to use your reliever inhaler three times a week or more, speak to your healthcare professional. This could be an early warning sign of an asthma attack, so it’s important to get an asthma review as soon as you can.

If you have COPD or another lung condition and you’re given an inhaler to take regularly, it’s important you take it as prescribed. Do this even if you feel well, as this can help you control your symptoms and reduce the risk of a flare-up.

Using the right inhaler technique is also really important. This is a simple way to:

• help keep your lung symptoms under control
• reduce your risk of side effects from your medicines
• waste less medicine - good inhaler technique ensures the right quantity of medicine gets into your airways.

If you use the right inhaler technique when you use your preventer inhaler, you’re less likely to need your reliever inhaler to deal with symptoms.

For people with asthma, if your asthma is well managed, you should not need to use more than two reliever inhalers a year. Using three or more reliever inhalers a year is a sign that your asthma is poorly controlled, increasing your risk of an asthma attack.

Managing your lung condition well also means you’ll use fewer inhalers overall, which will help to reduce the carbon footprint of inhalers.

Ask your pharmacist, nurse or doctor to show you how to use each type of inhaler you have. You should also get your inhaler technique checked at your annual asthma review or lung condition check-up.

A quick and easy way to check you’re using the right inhaler technique is by watching our short inhaler technique videos.

If you need more support on your inhalers, you can call our Helpline on 0300 222 5800 (Monday to Friday, 9am to 5pm). Our friendly nurses and healthcare advisors can offer support with any aspect of your lung condition, including changing inhalers.

Inhalers can’t be recycled with household rubbish. When inhalers are put in the bin at home, they may end up in landfill and any remaining greenhouse gases from pMDIs are released into the atmosphere.

The best way to dispose of inhalers is to take them to your local pharmacy. Your pharmacy can send your inhalers to be incinerated with other medical waste. This type of disposal reduces the impact of the leftover greenhouse gases. This is better for the environment, compared to putting inhalers in landfill.

In some cases, pharmacies have access to inhaler recycling, which means the plastic and gases can be recycled.