OBJECTIVES: The carbon footprint is an environmental indicator that aims to reflect the total amount of greenhouse gases emitted directly or indirectly by an individual, organization, event or product. In order to implement an emission reduction strategy, it is important to know this carbon footprint. The aim of this study was to estimate the carbon footprint of asthma and chronic obstructive pulmonary disease (COPD) inhalers in Spain.

METHODS: The total carbon footprint of asthma and COPD inhalers in Spain was estimated using monthly pharmacy dispensing sales data for 24 months (May 2022 to April 2024), provided by IQVIA, and the carbon footprint of each device marketed in Spain. The carbon footprint of each inhaler was obtained from PrescQipp (a not-for-profit organization of the UK National Health System). Inhaler type, region and time period were considered.

RESULTS: A total carbon footprint of 869,592,590 kg CO₂ was estimated for 68,692,347 inhalers over a two-years period. According to the type of inhaler, metered dose inhalers (MDI, 54.0% of sales) and dry-powder inhalers (DPI, 40.6% of sales) were responsible for 97.4% and 2.3% of the total carbon footprint, respectively. Switching from MDI to DPI results in a carbon footprint reduction of more than 90%. Catalonia was the region with the largest carbon footprint impact (17.2% of sales; 20.0% of carbon footprint) as it is also one of the regions with the largest proportion of MDI sales, while Andalusia was the region with most units sold (19.5% of sales; 19.3% of carbon footprint). Sales and carbon footprint were lower during summer months.

CONCLUSIONS: Inhalers contribute notably to the healthcare related carbon footprint. Advocating for the use of inhalers with a lower carbon footprint, such as DPIs, is a vital step towards reducing emissions.