8/8
Want to find out more?
For clinical guidance and carbon data, see the Environmental impact of inhalers section of the Scottish Government’s Quality Prescribing Strategy: www.gov.scot/publications...
Want to find out more?
For clinical guidance and carbon data, see the Environmental impact of inhalers section of the Scottish Government’s Quality Prescribing Strategy: www.gov.scot/publications...
Respiratory conditions - quality prescribing strategy: improvement guide 2024 to 2027
Respiratory conditions are a major contributor to ill health, disability, and premature death – the most common conditions being asthma and COPD. This Scottish Government quality prescribing guide is ...
www.gov.scot
February 7, 2026 at 9:10 PM
8/8
Want to find out more?
For clinical guidance and carbon data, see the Environmental impact of inhalers section of the Scottish Government’s Quality Prescribing Strategy: www.gov.scot/publications...
Want to find out more?
For clinical guidance and carbon data, see the Environmental impact of inhalers section of the Scottish Government’s Quality Prescribing Strategy: www.gov.scot/publications...
7/8
The Golden Rule
The most "green" inhaler is the one a patient can, will, and does use correctly.
Switching a stable patient to a device they can’t use (e.g. low inspiratory flow for a DPI) leads to poor control and a higher net carbon cost. Patient-first is planet-first. 🤝
The Golden Rule
The most "green" inhaler is the one a patient can, will, and does use correctly.
Switching a stable patient to a device they can’t use (e.g. low inspiratory flow for a DPI) leads to poor control and a higher net carbon cost. Patient-first is planet-first. 🤝
February 7, 2026 at 9:08 PM
7/8
The Golden Rule
The most "green" inhaler is the one a patient can, will, and does use correctly.
Switching a stable patient to a device they can’t use (e.g. low inspiratory flow for a DPI) leads to poor control and a higher net carbon cost. Patient-first is planet-first. 🤝
The Golden Rule
The most "green" inhaler is the one a patient can, will, and does use correctly.
Switching a stable patient to a device they can’t use (e.g. low inspiratory flow for a DPI) leads to poor control and a higher net carbon cost. Patient-first is planet-first. 🤝
6/8
Why AIR/MART matters for the planet:
1. Volume: Reduces total devices per patient/year.
2. Avoidance: Every prevented hospital admission saves ~0.5 tonnes CO2e.
3. SABA Reduction: Naturally phases out the highest-carbon prescribing element.
Why AIR/MART matters for the planet:
1. Volume: Reduces total devices per patient/year.
2. Avoidance: Every prevented hospital admission saves ~0.5 tonnes CO2e.
3. SABA Reduction: Naturally phases out the highest-carbon prescribing element.
February 7, 2026 at 9:08 PM
6/8
Why AIR/MART matters for the planet:
1. Volume: Reduces total devices per patient/year.
2. Avoidance: Every prevented hospital admission saves ~0.5 tonnes CO2e.
3. SABA Reduction: Naturally phases out the highest-carbon prescribing element.
Why AIR/MART matters for the planet:
1. Volume: Reduces total devices per patient/year.
2. Avoidance: Every prevented hospital admission saves ~0.5 tonnes CO2e.
3. SABA Reduction: Naturally phases out the highest-carbon prescribing element.
5/8
The SIGN 245 Joint Guideline now formally recommends SABA-free pathways to mitigate risks:
• AIR: Anti-inflammatory reliever as needed.
• MART: Maintenance and Reliever Therapy.
Guideline: www.sign.ac.uk/guidelines/a...
The SIGN 245 Joint Guideline now formally recommends SABA-free pathways to mitigate risks:
• AIR: Anti-inflammatory reliever as needed.
• MART: Maintenance and Reliever Therapy.
Guideline: www.sign.ac.uk/guidelines/a...
Asthma: diagnosis, monitoring and chronic asthma management
A new collaborative guideline developed jointly by British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN).
www.sign.ac.uk
February 7, 2026 at 9:07 PM
5/8
The SIGN 245 Joint Guideline now formally recommends SABA-free pathways to mitigate risks:
• AIR: Anti-inflammatory reliever as needed.
• MART: Maintenance and Reliever Therapy.
Guideline: www.sign.ac.uk/guidelines/a...
The SIGN 245 Joint Guideline now formally recommends SABA-free pathways to mitigate risks:
• AIR: Anti-inflammatory reliever as needed.
• MART: Maintenance and Reliever Therapy.
Guideline: www.sign.ac.uk/guidelines/a...
4/8
Next-gen propellants are arriving:
✅ Trixeo Aerosphere HFO-1234ze triple therapy has arrived: www.gov.uk/government/n...
✅ Clenil Modulite HFA-152a submission: www.chiesi.uk.com/media/press-...
🚀 Low-carbon Ventolin: launch expected from 2026 www.gsk.com/en-gb/media/...
Next-gen propellants are arriving:
✅ Trixeo Aerosphere HFO-1234ze triple therapy has arrived: www.gov.uk/government/n...
✅ Clenil Modulite HFA-152a submission: www.chiesi.uk.com/media/press-...
🚀 Low-carbon Ventolin: launch expected from 2026 www.gsk.com/en-gb/media/...
MHRA approves world’s first low-carbon version of COPD inhaler Trixeo Aerosphere
As with all medicines, the MHRA will continue to monitor the safety and effectiveness of Trixeo Aerosphere
www.gov.uk
February 7, 2026 at 9:06 PM
4/8
Next-gen propellants are arriving:
✅ Trixeo Aerosphere HFO-1234ze triple therapy has arrived: www.gov.uk/government/n...
✅ Clenil Modulite HFA-152a submission: www.chiesi.uk.com/media/press-...
🚀 Low-carbon Ventolin: launch expected from 2026 www.gsk.com/en-gb/media/...
Next-gen propellants are arriving:
✅ Trixeo Aerosphere HFO-1234ze triple therapy has arrived: www.gov.uk/government/n...
✅ Clenil Modulite HFA-152a submission: www.chiesi.uk.com/media/press-...
🚀 Low-carbon Ventolin: launch expected from 2026 www.gsk.com/en-gb/media/...
3/8
The Salbutamol Factor
Poor asthma control = over-reliance on relievers. Currently, Salbutamol MDIs alone account for 66% of the total inhaler carbon footprint.
Reducing SABA over-reliance is the most
The Salbutamol Factor
Poor asthma control = over-reliance on relievers. Currently, Salbutamol MDIs alone account for 66% of the total inhaler carbon footprint.
Reducing SABA over-reliance is the most
February 7, 2026 at 8:52 PM
3/8
The Salbutamol Factor
Poor asthma control = over-reliance on relievers. Currently, Salbutamol MDIs alone account for 66% of the total inhaler carbon footprint.
Reducing SABA over-reliance is the most
The Salbutamol Factor
Poor asthma control = over-reliance on relievers. Currently, Salbutamol MDIs alone account for 66% of the total inhaler carbon footprint.
Reducing SABA over-reliance is the most
2/8
The Propellant Problem
Standard pMDIs use HFA gases which are potent greenhouse gases:
• HFA-134a: 1,300x more potent than CO2
• HFA-227ea: 3,350x more potent than CO2
These gases account for ~70% of the carbon footprint of UK respiratory prescribing. 🌍
The Propellant Problem
Standard pMDIs use HFA gases which are potent greenhouse gases:
• HFA-134a: 1,300x more potent than CO2
• HFA-227ea: 3,350x more potent than CO2
These gases account for ~70% of the carbon footprint of UK respiratory prescribing. 🌍
February 7, 2026 at 8:52 PM
2/8
The Propellant Problem
Standard pMDIs use HFA gases which are potent greenhouse gases:
• HFA-134a: 1,300x more potent than CO2
• HFA-227ea: 3,350x more potent than CO2
These gases account for ~70% of the carbon footprint of UK respiratory prescribing. 🌍
The Propellant Problem
Standard pMDIs use HFA gases which are potent greenhouse gases:
• HFA-134a: 1,300x more potent than CO2
• HFA-227ea: 3,350x more potent than CO2
These gases account for ~70% of the carbon footprint of UK respiratory prescribing. 🌍