Our prescription for climate change: reduce and recycle inhalers!

I applaud the authors for their timely insights into the environmental impact of the myriad of inhalers we prescribe.¹ I am sure if we are honest each of us has a handful of patients using more than 42 salbutamol metered dose inhalers (MDIs) per year — a figure that equates to the greenhouse gas from one car per year.¹ Perhaps we should cycle to work until we have completed a salbutamol overuse audit?

Joking apart, it does seem that reducing and recycling MDIs ought to be a priority given our current climate emergency. So on taking the authors’ advice I was dismayed to discover that the Complete the Cycle recycling scheme was no longer accepting new referrals due to lack of funding. GSK, who run the scheme, confirmed this, but today I met with their Government Affairs Director and made the following suggestions:

• Reduce MDIs — include a leaflet in all MDI packaging with a QR code linking to a YouTube video on how to use the MDI, thus improving technique and reducing waste. Facilitate the switch to DPIs by funding clinician time for the necessary reviews.

• Recycle MDIs — re-open the Complete the Cycle scheme with government backing. The flip side of the above leaflet in MDI packaging should have instructions on how to recycle the MDI at your local surgery or pharmacy via the Complete the Cycle scheme.

And for us clinicians? Perhaps prescribing targets should direct us to DPIs, but best of all — raise awareness with MDI users.