This study compared the handling and acceptability of the Easi-Breathe, a breath-actuated metered dose inhaler (MDI), with that of a conventional MDI. A total of 104 patients and 14 practice nurses took part in interviews at a central location. An additional 100 practice nurses were interviewed in a telephone study. Significantly more patients (86%) found Easi-Breathe easier than a conventional MDI to use correctly (p < or = 0.001). Overall, more patients preferred Easi-Breathe (82% vs 18%; p < or = 0.001), ease of use and confidence in successful dose delivery being the main reasons for their preference. Nurses thought that Easi-Breathe was easier for the vast majority of patients (97%) to use correctly, as well as being easier to teach and to use correctly in a crisis (p < or = 0.001). Overall, 79% of nurses preferred the Easi-Breathe to the conventional MDI (p < or = 0.001), ease of use and ease of teaching being the main reasons for their preference.