The mainstream press was quick to report this week on a startling new study out of UCLA: inhalers used to treat asthma and chronic obstructive pulmonary disease (COPD) produce greenhouse gas emissions equivalent to 530,000 cars on the road each year. Published on October 6, 2025, the study quantified that inhalers approved for asthma and COPD generated an estimated 24.9 million metric tons of carbon dioxide equivalent (CO₂e) from 2014 to 2024, a misleadingly frightening number.

Yet before anyone stops using their inhaler, let’s be clear: don’t. These are life saving medical devices. Millions of Americans, and tens of millions more across the globe, depend on them daily for the simple, essential act of breathing.

The Numbers Behind the Emissions

According to the university researchers, 1.6 billion inhalers were dispensed in the U.S. over the past decade, producing nearly 25 million metric tons of CO₂e. The study found that 98% of those emissions came from metered dose inhalers,the familiar devices that use hydrofluoroalkane propellants to deliver medicine directly to the lungs.

From 2014 to 2024, annual inhaler related emissions rose by 24%, from 1.9 million to 2.3 million metric tons of CO₂e. Just three inhaler types, those containing albuterol, budesonide-formoterol, and fluticasone propionate, accounted for a remarkable 87% of those emissions.

The Climate Context

These findings matter because hydrofluoroalkanes, while safe for the ozone layer, are potent greenhouse gases. Ironically, the federal government has been phasing down hydrofluorocarbons under the American Innovation and Manufacturing Act as part of its broader climate policy, yet this data reveals an overlooked emissions source right in the nation’s medicine cabinets. With no good U.S. data, it is worth noting that, based on U.K. data from across the pond, inhalers account for only 0.14% of all carbon emissions in Britain.

The Trump Administration has not yet indicated how it will address this issue, and to date, there has been no coordinated federal effort to regulate or mitigate inhaler related greenhouse gas emissions.

Balancing Health and Sustainability

There’s no denying the environmental impact (.. assuming the assumptions made by the UCLA researchers are correct?). But there’s also no denying the medical necessity. Asthma and COPD affect tens of millions of Americans and hundreds of millions worldwide. Any transition away from current inhalers must not sacrifice public health.

Some environmental groups have suggested shifting prescribing patterns toward dry powder inhalers or soft mist inhalers, both of which deliver medication without using greenhouse gas propellants. But these alternatives come with challenges: they are not suitable for all patients (.. many children and elderly with limited lung capacity cannot generate enough force to effectively use a dry powder inhaler), they can be significantly more expensive, and globally, they may be out of reach for lower income populations.

With the global inhaler market valued at over $33 billion in 2024, affordability and access are not abstract concerns. In many parts of the world, the cost of switching to “green inhalers” could mean the difference between treatment and no treatment at all. And is it too cynical to believe any such push to switch is driven by the pharmaceutical companies?

A Legal and Policy Path Forward

As an environmental lawyer, I support reducing our environmental impact wherever practical, but not at the expense of human life. The path forward should be pragmatic:

• Encourage innovation in propellant technology to create lower GWP (global warming potential) inhalers.
• Support research into manufacturing and lifecycle emissions from all inhaler types.
• Ensure equitable access to new medical technologies developed in response to environmental matters.
• Incentivize proper disposal and recycling of inhalers. 
• Inhaler technique education to prevent excessive emissions.

The purpose of environmental law is not simply to prohibit; it’s to balance, to harmonize natural environment protection with human welfare.  This understanding highlights that environmental laws do not exist solely to forbid harmful activities but to manage the relationship between humans and the rest of the natural world in a sustainable way.

This is not dissimilar from what we discussed in a blog post last year, Eyeglasses versus Emissions: Are We Losing Sight of the Bigger Picture?

It should be lost on no one that last year, even with current inhaler use, more than 3,600 Americans died from asthma.

Breathing Easier

It’s commendable that we’re now scrutinizing every source of emissions, even those from essential medical devices. But we must remember: sustainability is not an absolute value, it’s a shared one. The goal of environmental policy should be to ensure that the planet’s air is clean and breathable for everyone, not to make breathing itself harder for those already struggling. Improving air quality will make a big difference in reducing asthma rates, which means less inhaler use.

Efforts to reduce inhaler emissions are worthwhile, but they must proceed with compassion and science. Environmental progress should not come at the cost of human breath.

Inhalers save lives. The challenge before us is not to stop using them, but maybe to start thinking smarter about how to make them, and how to make the air they protect us from cleaner for all.

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