Nebulizers and automatic cars have something in common. They are both designed to facilitate the smooth operation of something essential. A 2022 article in the Wall Street Journal indicated that only 1% of cars sold in the U.S. have manual transmissions, and that only 18% of adults know how to drive a stick shift. Those that know how mastered the ‘friction point’ of the clutch, having practiced exactly when to release the clutch and apply the gas for a smooth transition between gears. It’s a bit tricky, but with practice and application, along with a good instructor, it can be done. Yet most Americans appreciate driving automatic cars that do the gear shifting for them.
Sticking with this analogy, there have been a multitude of studies that show people living with chronic lung disease, such as asthma or COPD, fail to use their inhalers the right way and therefore are not getting the optimal dose of medicine to treat their disease. Inhaler technique is complicated. You must breathe out completely first, making sure when you do inhale it’s not too fast or too slow, activate the inhaler at just the right time and hold your breath for 5-10 seconds after each dose. Yet patients absolutely can learn, with practice and application, along with a good instructor, how to maximize each dose of medicine through proper technique. The Lung Association has resources available to help patients and their caregivers learn and practice inhaler techniques.
When you use a nebulizer, the directions are simple – breathe normally. It’s true that there are steps before and after you’ll need to account for, but when it comes to actually administering the medicine, the nebulizer does the heavy lifting for you. You sit back, relax and breathe normally until the medicine is completely delivered. Perhaps Sade was really thinking about nebulizers when she recorded Smooth Operator in 1984.
So, when does it make sense to use a nebulizer vs an inhaler? We sat down with Kaveh Bagheri, MD, who practices at Sharp Grossmont Hospital in La Mesa, California to learn his thoughts about nebulized therapy.
“The first thing patients need to know is how a nebulizer works,” says Dr. Bagheri. “A nebulizer converts liquid medicine into a mist that you inhale to get the medicine into the lungs. It can be used if you have a disease such as asthma, COPD, bronchiectasis or cystic fibrosis.” Dr. Bagheri continued to share the importance of knowing How to Use a Nebulizer and How to Clean a Nebulizer.
Nebulizers come in stationary or portable varieties. Both require power sources to work, with stationary nebulizers plugging into an outlet and portable nebulizers with options to plug into an outlet, car adaptor or utilizing a battery pack. “Nebulizers are becoming cheap. You can go online and buy it yourself...but I don’t necessarily recommend that.” says Dr. Bagheri. “It’s best to order a nebulizer through your healthcare provider or a durable medical equipment company. I’ve had patients tell me that their old nebulizer broke and the new one they bought online doesn’t work well. People who have used nebulizers before are quick to notice when a new nebulizer takes 15-20 minutes to deliver medicine and their old one only took five minutes.” Indeed, some nebulizers available online are not Food and Drug Administration (FDA) approved, meaning they haven’t met safety and efficacy standards. In the case of a device that delivers your medicine, you want to make sure you are using a quality product. Most insurance companies provide nebulizers, and some of them offer both stationary and portable devices.
Patients in all stages of chronic lung disease may use a nebulizer for a variety of reasons, but not everyone chooses a nebulizer. So how do you decide the best option for you? “A patient with mild lung disease may walk through a department store with perfume and experience sudden bronchospasm with chest tightness and shortness of breath that is relieved by using an inhaler,” explains Dr. Bagheri. “But when patients wake up at 2 a.m., and they can’t breathe, the first thing the paramedics do when they arrive is give nebulized treatment as they are taken to the hospital.” In fact, he has had patients tell him, “When I ended up in the hospital with pneumonia, I used a nebulizer, and it really helped me. Do you think a nebulizer could help me at home?”
Dr. Bagheri shared that a lot of times it is the patient that brings up the topic about using a nebulizer for medicine delivery. He appreciates that because sometimes during medical visits there are so many topics to cover, and a provider might not think about asking. His patients are most likely to be first exposed to nebulizers from children. If they are unfamiliar with a nebulizer and he begins to describe it, he’ll hear comments such as, “Oh! Yes, my niece uses one.” Especially for children, it’s easier to use a nebulizer due to the difficulty with hand/mouth delivery, but people of all ages can choose to use one.
In Southern California, where Dr. Bagheri lives, there are a lot of wildfires. And as a pulmonologist, many of his patients experience worse symptoms from their lung disease when there is so much smoke in the air. If the power goes out, they need a generator to run their stationary nebulizer or the options a portable nebulizer provides to power the device by car or battery pack. He encourages his patients to plan for disasters and power failures to ensure they are able to take their medicine when they need it most.
At the end of the day, it is a shared decision between a patient and healthcare provider on whether medicine is best delivered through an inhaler or nebulizer. There are pros and cons for each. Regardless of which route you take, be sure to know how to properly take your medicine so that you get the best possible relief from your symptoms.
Learn more at Lung.org/nebulizer.
This educational campaign received support from Viatris, Theravance and Verona.
Blog last updated: July 25, 2025
