A Somerset woman, Sue*, who has battled asthma for 42 years, recently endured a severe asthma attack following an unconsulted switch in her medication. Accustomed to using a blue inhaler, Sue was surprised last September when her repeat prescription was replaced without prior notice.
Upon inquiry, her local GP surgery attributed the change to a decision by the Somerset Integrated Care Board (ICB), which was reportedly phasing out blue inhalers citing their high carbon footprint. However, the ICB has denied that environmental concerns are the reason for discontinuing blue inhalers.
Environmental data from the Living Well Partnership reveals that a typical blue inhaler has a carbon footprint of 28 kilograms of CO2 — roughly equivalent to driving 175 miles between London and Sheffield. In contrast, dry powder inhalers like Symbicort have a considerably lower carbon impact. Despite this, months later, Sue finds Symbicort challenging to use and feels it is less effective during her asthma episodes.
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Sue shared with Somerset Live, “This actually makes me so very afraid and very anxious because the blue inhaler is a medicine that has saved my life many times.” When she raised these concerns with her GP, she was told that her anxiety was being addressed as part of broader support efforts for asthma sufferers.
Symbicort requires a deep inhalation for the medication to reach the lungs, which Sue finds difficult during an attack. She recounted a recent incident when she was cleaning a dusty house and suffered a severe asthma attack; the new inhaler provided little relief. Fortunately, she managed to use an old blue inhaler she found in her car, and then an older one at home, before her condition improved.
Asthma and Lung UK, a leading charity, supports the switch to Symbicort, citing evidence that it is safer and more effective than traditional blue inhalers. Clinical Lead Dr. Andy Whittamore explained, “Research shows it reduces the risk of asthma attacks better because it treats underlying inflammation, not just symptoms.”
The charity emphasizes that while blue inhalers provide quick relief, they do not address the root cause—airway inflammation—which, if uncontrolled, can lead to increased symptoms and serious attacks. The newer inhalers combine low-dose steroids with formoterol, a fast-acting long-term bronchodilator like that found in Symbicort.
However, Dr. Whittamore stressed the importance of patient consultation before switching inhalers. “Patients need to be properly instructed and able to use their new devices, especially in emergencies,” he said. “In Sue’s case, there are alternative inhalers that might suit her needs better.”
The Somerset ICB declined to comment on individual cases but highlighted that local GP practices have been collaborating with medicines management teams for more than a decade to improve asthma outcomes. According to the ICB, Somerset boasts some of the best respiratory prescribing indicators and low hospital admission rates.
In 2024, the National Institute for Health and Care Excellence (NICE) issued new asthma guidelines warning against over-reliance on blue inhalers, linking it to worse patient outcomes. The Somerset ICB supports these guidelines and is implementing them across the region.
(*Name changed for privacy)