• The NHS long-term plan, NICE patient decision aid and the Greener NHS agenda have emphasised the importance of finding lower carbon inhalers. This is because inhalers alone represent around 3% of emissions in the NHS.
• Dry powder inhalers (DPIs) do not contain hydrofluoroalkane propellants, so from this perspective have less of a carbon footprint in comparison to traditional inhalers. However, DPIs require children and young people (CYP) to adapt to a new way of using an inhaler (from tidal breathing via a spacer) and will require training in the appropriate technique. 
• To ensure that any changes to inhalers used by CYP are appropriate, the London CYP Asthma Pharmacy group have developed a top tips guide for healthcare professionals in greener respiratory prescribing in A3 and A4 format and leaflets for parents and carers.
• The guide applies to decision makers i.e. commissioners, primary, secondary and tertiary care and all healthcare professionals involved in the care of CYP with asthma.

London’s CYP asthma pharmacy group, a subgroup of the London Asthma Leadership and Implementation Group, have developed two leaflets on inhalers and the green agenda.

Launched in November 2022, these detail what young asthma patients and their families can do to protect the environment and how professionals can inform themselves and advise their patients in relation to the environmental impact of inhalers:

• Patient leaflet for printing
• Patient leaflet for digital use
• Top tips for professionals in greener respiratory prescribing in A3 and A4 format
• Greener Respiratory Prescribing in Children & Young People - Supporting ICBs to safely introduce greener inhalers for CYP. (These slides have been produced to support the use of the Top Tips document and appropriate inhaler prescribing for CYP more widely)
• Communications toolkit for Inhalers and the Green Agenda

These are available for download to the right of this page.