Inhaler user awareness of climate implications: a Canadian survey

<bold>Background:</bold> People with lung diseases are vulnerable to climate change; yet the most common inhaler device, metered dose inhalers (MDIs), have significant climate impacts. <bold>Aim:</bold> To understand inhaler users’ perspectives on climate change and awareness of inhaler climate implications. <bold>Methods:</bold> Canadians (aged ≥ 16) who reported using an inhaler in the previous 6 months were invited via health organizations' newsletters to complete a cross-sectional e-survey. Multivariate regression models assessed the association between sociodemographic factors and climate change risk perception index scores, inhaler disposal methods, awareness of inhaler climate impacts, and willingness of MDI users to switch to low carbon footprint devices. <bold>Results:</bold> There were 255 respondents (mean age 68 ± 12 years, 64% female, 80% MDI users). Most individuals were concerned about climate change (84%) but only 20% were aware that MDIs have high carbon footprints. Older individuals and women were less likely to be aware of the carbon footprint of MDIs, while higher education was associated with greater awareness (p<0.05). People who already experienced health changes due to climate events (31%) had higher climate change risk perception scores (p < 0.001). Most respondents reported disposing of their inhalers in garbage bins (58%) and when provincial pharmacy return programs were available (n=216) they were underutilized (26%). Nearly all MDI users (92%) were willing to switch to a lower carbon footprint device. <bold>Conclusions:</bold> Inhaler users are concerned about climate change but lack awareness of inhaler climate impacts. Interventions that promote education, use of low carbon devices, and sustainable disposal could reduce inhaler-related climate impacts.