posted 18th November 2025
Newer treatment options for asthma - which are better for patients AND better for the environment.
What is asthma?
Asthma is a long-term lung condition. It affects the airways (breathing tubes) that carry air in and out of your lungs. causing them to become swollen (inflamed). This makes the airways narrower so less air gets into and out of the lungs. (asthma and lung uk)
About 8 in 100 people have asthma.
Treatment:
Updated asthma guidelines from NICE (National Institute for Health and Care Excellence) recommend that:
• everyone with asthma needs treatment with inhaled steroids
• no one with asthma should only have a blue reliever inhaler
Why is salbutamol NOT a treatment for asthma on its own?
Because it is not treating the underlying inflammation that is the root cause of the disease.
For adults and children over 12 years (sometimes 6 years) diagnosed with asthma, the latest medical guidelines recommend using a special type of combination inhaler
Your GP or nurse may ask you to use this combination inhaler:
• only as needed if you get symptoms. This is because you have no, or very few, symptoms. Using your inhaler like this is known as an AIR treatment plan.
Air treatment plan
• every morning and evening as prescribed, as well as when you get symptoms. This is because you have regular symptoms which are affecting your daily life or waking you up at night. Using your inhaler like this is known as a MART treatment plan.
MART treatment plan
This type of combination inhaler contains:
• an inhaled corticosteroid (ICS) to treat inflammation in your airways
• a long-acting bronchodilator called formoterol, which can also open your airways quickly if you get symptoms or an asthma attack.
You do not need a separate blue reliever inhaler if you’re using this type of combination inhaler. This is because your inhaler contains formoterol, which works quickly as a reliever if you get symptoms.
A combination inhaler without formoterol cannot be used as a MART or AIR inhaler.
NHS Scotland's inhaler propellants (2/3 = MDI salbutamol) have same environmental impact as 81,000 people flying from London to New York!
AIR and MART regime is better for the environment if using DPI (dry powder inhalers) including:
- Symbicort Turbohaler® (budesonide/formoterol)
- Fobumix® Easyhaler (budesonide/formoterol)
- Duoresp® Spiromax (budesonide/formoterol)
- WockAIR® (budesonide/formoterol)
- Fostair® NEXThaler (beclometasone/formoterol)
The pressurised MDI inhalers (like ventolin and salamol) use propellants which are powerful greenhouse gases and harm the environment
Not all patients can use the DPI and avoid using the pMDI inhalers. Some patients might still need to use MDI inhalers especially if they are using them with spacers.
Please speak to our GPs or Nurses if you wish to discuss your asthma treatment further, especially if you do not have good asthma control, or if you wish to look into the newer regimes for both better asthma control and help the environment.
Please complete form below for asthma review or book asthma review appointment at the practice
eConsult asthma review