PCRS support initiatives to improve air quality and minimise short- and long-term damage to the environment, particularly those with an impact on climate change resulting from greenhouse gases. We believe that such initiatives should cover a variety of issues including better patient education to support adherence with preventer use in asthma, routine spacer use if using pressurised metered dose inhalers (pMDIs), recycling schemes for inhaler devices, application of new technologies to reduce the environmental impact of inhalers (reusable devices, longer expiry dates, dose counters, biodegradable plastics, alternative propellants), and switching from pMDIs to dry powder inhalers (DPIs) or soft mist inhalers (SMIs) where the change is clinically appropriate, safe and acceptable to patients. We do not support policies that advocate ‘blanket switching’ of patients from one inhaler type to another in a practice or an area. Nor do we advocate attempts to phase out the use of pMDIs altogether as this would be detrimental to patients needing to use inhalers when their control is poor and in emergencies. We encourage any decisions about inhaler choice to be made on an individual basis between clinicians and patients.