Green Impact Inhaler Project


Reducing the Carbon Footprint at The Westerham Practice through Appropriate Dry Powder Inhaler Prescribing in Asthma

The Westerham Practice is committed to helping the NHS reach their target of being totally carbon-neutral by 2040. We are currently reviewing our own practices to look for changes we can make to help shape an environmentally friendly and sustainable future by reducing our carbon footprint.

One change that we have identified is converting patients from Metered Dose Inhalers (MDIs) to Dry Powder Inhalers (DPIs) where appropriate. This conversion is something that the healthcare team here at The Westerham Practice feel passionately about. To make a real change we will need the help of our patients.


What are metered dose inhalers and dry powder inhalers?

Metered Dose Inhalers (MDIs) use a pressurised propellant within the aerosol chamber to help administer the medicine. The propellants used in these inhalers are potent greenhouse gases which cause damage to the ozone layer.

Dry Powder Inhalers (DPIs) are newer inhalers, where the medicine is released when the patient breathes in on the inhaler. This means that there is no need for the pressurised propellant.


Why are these inhaler changes important?

Inhalers contribute to roughly 3.5% of the NHS’ total carbon footprint. MDIs use greenhouse gases as their propellants. This means that, on average, 100 doses of an MDI release carbon emissions equivalent to that released during a 180-mile drive in a car. On the other hand, DPIs release 18 times less carbon emissions that MDIs.

Climate change is also an important determinant of social and physical health5. In other words, reducing climate change will not only have a positive impact on the environment, but it will also improve our health in general.


How will we be implementing these inhaler conversions?

We have identified several groups of patients in which we could make a significant impact and we will be sending out text messages to these patients in regard to converting to the environmentally friendly DPI inhalers.

We welcome patients interested in changing from an MDI inhaler to a DPI inhaler, to contact us online. Please use "Other" for your query with "FAO Clinical Pharmacist".

Should this intervention prove successful, we will then look to other patient groups on other inhalers to make similar conversions in the future.


How will changing to a DPI affect me?

The medication and dose that you receive will remain the same, so it should not have any impact on your health. The only aspect that will change is the device that delivers the medication.

Some people find the DPIs are easier to use as they do not require the hand-breath coordination that is required by MDIs. Although some people may find that they prefer their original MDI. Of course, should you decide that you prefer your original MDI after trying the DPI, you can always be switched straight back.


Inhaler Technique

When changing over inhalers it is important that patients know the correct technique for their new inhaler, Asthma UK provides very helpful video guides on the correct technique and you can also come in and make an appointment with our Asthma nurse for any questions that you may have.

How to use your inhaler


What to do with your empty or unwanted inhalers?

Return your empty or unwanted inhalers to a community pharmacy or dispensary for environmentally safe disposal or recycling.

Did you know that inhalers, like other medicines, should not be put in your household waste bin or recycling bin? Even when your metered dose inhaler is empty, it still contains some of the greenhouse gas.


Why choose a more environmentally friendly inhaler?

You use a metered dose inhaler (MDI) for your lung condition. These are the most common type of inhaler used in the UK. MDIs contain a gas (propellant) in a metal canister that you press down into a plastic case to release the medicine into your lungs. Inhalers are a vital part of your treatment. It’s really important that you continue to take your inhalers as prescribed, to keep your lungs healthy.

The gas in your current inhaler is a powerful greenhouse gas. This means that when the gas is released, it stays in the air and traps the sun’s heat, like glass in a greenhouse. This warms the planet which is a problem for the climate. Climate change increases air pollution which can worsen lung conditions.

Surveys have shown that most patients with inhalers want to try to reduce greenhouse gas emissions from their inhalers. There are many ways to achieve this, including changing the way you use and dispose of your inhalers, or switching to a different more environmentally friendly inhaler.

The NHS supports the change to environmentally friendly inhalers if this is the right choice for you. NHS research has shown that people are willing to change to environmentally friendly inhalers.

Environmentally friendly inhalers which do not contain a greenhouse gas are dry powder inhalers (DPI) or soft mist inhalers (SMIs). Not all patients can use these sorts of inhalers, although many patients find them easier to use. They all come with dose counters, making it easier to keep a track of your medicines. With DPIs you don’t need to coordinate pressing and breathing in at the same time. Some DPIs have the benefit of being once-daily inhalers that work for 24 hours.

Some MDIs contain a smaller amount of greenhouse gas than other MDIs, making them more environmentally friendly. Some MDIs contain a powerful greenhouse gas. Other MDIs contain a less powerful greenhouse gas and so are more environmentally friendly. Ask your doctor, nurse or pharmacist if there is an environmentally friendly inhaler which might be right for you.

Even if your MDI has a high carbon footprint and you are concerned about climate change, it is very important that you continue to use your inhaler to keep your lungs healthy.

There are additional ways you can help yourself and the environment when using inhalers:

  • Make sure you use your preventer (treatment) inhaler every day, as this should lessen how much you need to use your reliever inhaler. Look at your inhaler dose counter, if it has one, or think about ways to help you remember to use your inhaler.
  • Check that you are using your MDI correctly so that you get all the benefits from using your inhaler. You can read a leaflet or watch a video on how to use your inhaler on Asthma UK.
  • Follow your asthma action plan, or self management plan for COPD, which tells you what to do when your symptoms are getting worse.
  • Most inhalers are disposed of before all the doses have been used up. If your inhaler has a dose counter, use that to see when it is empty. If not, make sure you know how many doses your inhaler has when it’s new to help you keep track.
  • Return your empty or unwanted inhalers to a community pharmacy or dispensary for environmentally safe disposal or recycling. Did you know that inhalers, like other medicines, should not be put in your household waste bin or recycling bin? Even when your metered dose inhaler is empty, it still contains some of the greenhouse gas.

More helpful information below

  1. NHS England. Delivering a ‘Net Zero’ National Health Service
  2. NICE National Institute for Healthcare and Excellence: asthma patient decision aid
  3. British Thoracic Society - Position Statement: Environment and Lung Health