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Canadian healthcare professionals’ attitudes towards climate change and the environmental impact of inhalers

Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Preferential prescribing of inhalers with low carbon footprints over metered-dose inhalers (MDIs) can reduce healthcare's climate impact. We aimed to assess healthcare professionals' (HCPs) attitudes towards climate change, its health impacts, and inhaler prescribing practices. Methods: We invited HCPs via professional societies and non-profit organizations to complete an online survey (November 2024-March 2025). Multivariable regression examined associations between sociodemographic characteristics and climate change risk perception index (CCRPI) scores, inhaler carbon footprint awareness, and prescribing behaviors. Results: In total, 430 HCPs responded (median age: 41 years (IQR: 34-50); 74% women; 94% completion rate). Climate change concern was high [median CCRPI score 34/40 (IQR: 30-37)]. Most respondents (85%) were aware of inhaler carbon footprint variability. Nurses and nurse practitioners were less likely than physicians to be aware of this variability (OR: 0.29, 95% CI: 0.11-0.75). Only 49% of prescribers preferentially prescribed low carbon devices to new inhaler users and just 17% routinely switched current MDI users. Higher CCRPI scores were associated with greater awareness of inhaler carbon footprint variability (OR: 1.34, 95% CI: 1.04-1.72) and preferential prescribing of low carbon devices for new inhaler users (OR: 1.70, 95% CI: 1.32-2.23) and current MDI users (OR: 1.30, 95% CI: 1.03-1.68). Carbon footprint ranked 8th (IQR: 7-10) among 12 attributes influencing device selection. Conclusion: Despite significant concern for climate change and awareness of inhaler-related carbon emissions, preferential prescribing of low carbon inhalers is not part of routine practice. Targeted interventions are needed to support climate-conscious prescribing and reduce inhaler carbon emissions.
DOI: 10.1016/j.joclim.2026.100761
Authors: Stacey J Butler, Geneviève C Digby, Caitlin Roy, Sze Man Tse, Shellyza Sajwani, Jill Hubick, Carolyn McCoy, Ivy Lam, Alexander Singer, Alan Kaplan, Eva Leek, Sakina Walji, Valeria Stoynova, Erika Penz, Samir Gupta
Institutions: St. Michael's Hospital, Unity Health Toronto, Queen's University, Centre Hospitalier Universitaire Sainte-Justine, Canadian Society of Respiratory Therapists, University of Toronto, University of Manitoba, Sinai Health System, University of British Columbia, University of Saskatchewan
Language: English
Open Access status: gold
Estimated APC paid: $2,200
OpenAlex ID: W7223475395
FWCI:
Cites: 50
Cited by:
Related to: 10