The healthcare sector produces great amounts of waste and negative impact on the environment. In 2021 the media reported on the fact that pressurized Metered Dose Inhalers (pMDI) have a measurable contribution to greenhouse gases emissions (ghg) through the propellants used, hydrofluorocarbons. The Montreal Protocol, which came into force in 1989, removed chlorofluorocarbons as a propellant, yet global warming has continued and has a profound effect on public health, healthcare and the economy. This presentation will describe issues with current pMDIs and alternatives, and help pharmacists talk comfortably with patients to help make device changes if appropriate or improve technique with tools to reduce emissions. We’ll cover a few simple tools and resources pharmacists can use to help improve outcomes and long term issues where possible. This presentation will provide a template for initial and follow up interventions.