{
  "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.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Respirology, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada",
    "Division of Respirology and Sleep Medicine, Queen’s University, Kingston, Ontario, Canada",
    "Canadian Association of Pharmacy for the Environment, Regina, Saskatchewan, Canada",
    "Division of Respiratory Medicine, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada",
    "Canadian Association of Pharmacy for the Environment, Ottawa, Ontario, Canada",
    "Lung Saskatchewan, Saskatoon, Saskatchewan, Canada",
    "Canadian Society of Respiratory Therapists, Ottawa, Ontario, Canada",
    "Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada",
    "Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada",
    "Family Physicians Airways Group of Canada, Aurora, Ontario, Canada",
    "Sinai Health System, Toronto, Ontario, Canada",
    "Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada",
    "College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada",
    "Division of Respirology, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Corresponding author at: Respirologist & Clinician-Scientist, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Stacey J Butler"
    },
    {
      "affs": [
        1
      ],
      "name": "Geneviève C Digby"
    },
    {
      "affs": [
        2
      ],
      "name": "Caitlin Roy"
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    {
      "affs": [
        3
      ],
      "name": "Sze Man Tse"
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    {
      "affs": [
        4
      ],
      "name": "Shellyza Sajwani"
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    {
      "affs": [
        5
      ],
      "name": "Jill Hubick"
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    {
      "affs": [
        6
      ],
      "name": "Carolyn McCoy"
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    {
      "affs": [
        7
      ],
      "name": "Ivy Lam"
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    {
      "affs": [
        8
      ],
      "name": "Alexander Singer"
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    {
      "affs": [
        9
      ],
      "name": "Alan Kaplan"
    },
    {
      "affs": [
        0
      ],
      "name": "Eva Leek"
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    {
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      ],
      "name": "Sakina Walji"
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    {
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        11
      ],
      "name": "Valeria Stoynova"
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    {
      "affs": [
        12
      ],
      "name": "Erika Penz"
    },
    {
      "affs": [
        13
      ],
      "name": "Samir Gupta"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8erp6srj15pxr.bib",
  "cited_by": 0,
  "doi": "10.1016/j.joclim.2026.100761",
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  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
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  "pmcid": "PMC13721926",
  "pmid": "42965155",
  "published": "2026-10-24",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/8erp6srj15pxr.ris",
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      "field": "medicine",
      "origin": "openalex:2307|Climate Change and Health Impacts",
      "subfield": "pharmacology-toxicology"
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  "title": "Canadian healthcare professionals’ attitudes towards climate change and the environmental impact of inhalers",
  "title_text": "Canadian healthcare professionals’ attitudes towards climate change and the environmental impact of inhalers",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:32Z",
  "url": "https://research.draconitic.com/paper/8erp6srj15pxr",
  "venue": "The Journal of Climate Change and Health",
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