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More than a million people in England now use a combination inhaler for asthma, surpassing for the first time the number of patients who use solely a blue inhaler. The National Institute for Health and Care Excellence (NICE) published new clinical guidelines in November 2024,12 advising doctors to stop prescribing short acting β2 agonists (SABAs) such as salbutamol on their own for new patients with asthma. SABAs are administered through recognisable blue inhalers, but experts3 say that these are flawed for asthma treatment because they help only to alleviate the condition rather than tackling the underlying cause. As such the new guidelines recommend combination inhalers to tackle the inflammation that triggers asthma attacks, as well as relieving symptoms. Overuse of the blue “reliever” inhalers has also been linked to a higher risk of asthma attacks, hospital admission, and …