Published On 6 Oct 2025
According to researchers in a significant new study, the inhalers that people breathe also contribute to warming the planet, producing annual emissions equivalent to that of more than half a million cars in the United States alone.
Researchers at the University of California, Los Angeles, and Harvard University conducted an analysis of global warming pollution from three different inhalers used to treat asthma and chronic obstructive pulmonary disease (COPD) between 2014 and 2024 using a national drug database.
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According to the study, which was published on Monday in the Journal of the American Medical Association (JAMA), US patients who had commercial insurance and were covered by Medicaid and Medicare generated 24.9 million metric tons of carbon dioxide equivalent over the course of ten years.
With 98 percent of emissions coming from metered-dose puffers, puffers were by far the most harmful. To deliver medication, they use pressurized canisters filled with potent greenhouse gases, such as hydrofluoroalkane (HFA) propellants.
In contrast, propellants are not used in dry powder and soft mist inhalers. Both use a patient’s breath to release the medication, and the latter create fine spray, making both far less toxic to the planet.
Lead author William Feldman, a pulmonologist and researcher at UCLA, told AFP: “I think this is a really important topic because it’s fixable. There are easy ways to reduce emissions.
Only a small percentage of patients in medicine require metered-dose inhalers.
Spacers, valved chambers that open the lungs to deliver medicine to the lungs, are something that only metered-dose devices can handle, but they are necessary for very young children. Because they can’t breathe in insufficiently, older, weakly able adults may also require puffers.
However, Feldman noted that countries like Sweden and Japan use alternative inhalers without losing any health outcomes, noting that “the vast majority of people could use dry powder or soft mist inhalers.”
Barriers to insurance
He added that market and insurance barriers are causing the slower US adoption of greener inhalers.
The most popular inhaler drug, albuterol, is available in a dry-powder version, but it is frequently not covered by insurance, increasing the cost. In Europe, budesonide-formoterol, a different drug, is widely available in dry-powder form, which is not available in the US.
Feldman emphasized that the research’s goal is to highlight the need for policy and pricing reform rather than to blame people for their behavior.
He said, “We utterly don’t want to stigmatize patients who have asthma and COPD.”
“I believe that as a society, we must provide those medications to the patients in a responsible manner, and that ultimately falls to the highest levels.”
According to another JAMA commentary, policymakers and insurers must make lower-emission inhalers affordable and accessible for everyone, according to Alexander Rabin of the University of Michigan and others.
