Local variation in low carbon footprint inhalers in pre-COVID pandemic primary care prescribing guidelines for adult asthma in England and its potential impact.

Aims: Pressurised metered-dose inhalers (MDIs) have a much higher carbon footprint than dry powder inhalers (DPIs). We aimed to describe variations of inhaler options in local adult asthma prescribing guidance.

Methods: We reviewed local clinical commissioning group (CCG) adult asthma prescribing guidance for primary care in England in 2019 and recorded DPI and MDI inclusion.