Treating without harming: An urgent call to action for sustainable inhaler disposal in India

ABSTRACT Asthma and chronic obstructive pulmonary disease remain leading causes of chronic respiratory morbidity and mortality worldwide, with India having a significant share of the global burden. Inhalers are the cornerstone of treatment for these patients. However, their environmental impact is a growing concern. Pressurised metred-dose inhalers, widely prescribed in India, use hydrofluoroalkane propellants with global warming potentials up to 3000 times higher than carbon dioxide (CO 2 ). Improper disposal further increases emissions and introduces non-degradable components into ecosystems. Surveys suggest that nearly 79% of Indian patients discard used inhalers in regular household waste. This highlights huge gaps in awareness and infrastructure. While the United Kingdom’s “Take AIR” programme has demonstrated success, India also has some promising initiatives such as Kerala’s IMAGE and nPROUD. These, alongside industry-led efforts, offer scalable solutions. This article reviews India’s inhaler disposal scenario and proposes strategies to reduce environmental impact while ensuring responsible inhaler use.