Green Impact Inhaler Project

Reducing the Carbon Footprint at Five Oaks Family Practice through Eco friendly inhalers Prescribing in Asthma

Five Oaks Family Practice is committed to help NHS reach their target of being totally carbon neutral by 20401.

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 less eco-friendly to an inhaler which is more eco-friendly. The options are to change a brand of an inhaler (like Ventolin to salamol) or switch to a different inhaler type (any DPI)

To make a real change we will need the help of our patients and that’s “YOU”

Difference between metered dose inhalers (less eco-friendly) and Dry powdered inhalers (more eco-friendly)?

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 footprint2.

MDIs use greenhouse gases as their propellants. This means that, on average, 100 doses of an MDI releases carbon emissions equivalent to that released during a 180-mile drive in a car3. On the other hand, DPIs release 18 times LESS carbon emissions that MDIs4.

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 a group of people in which we could make a significant impact.

These are:

  1. People with Asthma over the age of 18 currently Ventolin evohaler (MDI)

We will be sending out text messages to these patients soon to gauge their interest in converting to the environmentally friendly DPI inhalers.

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 same, so it should not have any impact on your health. The only aspect that will change is 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 MDIs6. 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.



  1. NHS England. Delivering a ‘Net Zero’ National Health Service. (EXTERNAL LINK).
  2. NHS Sustainable Development Unit. Sustainable Development in the Health and Care System: Health Check;2016. (EXTERNAL LINK).
  3. NICE National Institute for Healthcare and Excellence: asthma patient decision aid.
  4. British Thoracic Society (BTS) (2019) Position Statement: Environment and Lung Health.
  5. Watts N, Amann M, Arnell A, et al. (2018). The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet, 392(10163):2479–2514
  6. Desai, H. & Dala, B. (2012) Management Options in Chronic Obstructive Pulmonary Disease. Clinical Medicine Insights: Therapeutics. 4(4):273-285.