RT Journal Article SR Electronic T1 Carbon footprint impact of the choice of inhalers for asthma and COPD JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 82 OP 84 DO 10.1136/thoraxjnl-2019-213744 VO 75 IS 1 A1 Janson, Christer A1 Henderson, Richard A1 Löfdahl, Magnus A1 Hedberg, Martin A1 Sharma, Raj A1 Wilkinson, Alexander J K YR 2020 UL http://thorax.bmj.com/content/75/1/82.abstract AB In the 1990s, metered dose inhalers (MDIs) containing chlorofluorocarbons were replaced with dry-powder inhalers (DPIs) and MDIs containing hydrofluorocarbons (HFCs). While HFCs are not ozone depleting, they are potent greenhouse gases. Annual carbon footprint (CO2e), per patient were 17 kg for Relvar-Ellipta/Ventolin-Accuhaler; and 439 kg for Seretide-Evohaler/Ventolin-Evohaler. In 2017, 70% of all inhalers sold in England were MDI, versus 13% in Sweden. Applying the Swedish DPI and MDI distribution to England would result in an annual reduction of 550 kt CO2e. The lower carbon footprint of DPIs should be considered alongside other factors when choosing inhalation devices.