Asthma, a respiratory disease that inflames and obstructs airways, is prevalent in cross-country skiers at a much higher rate than the general population due to the high exertion of skiers in cold temperatures and poor air quality environments. The high rate of asthma is expectably responsible for high rates of inhaler use among cross-country skiers; this has created debate about inhaler use due to the doping abilities of some inhaler drugs.

This study interviewed elite cross-country skiers on the interconnected topics of respiratory health, inhaler use, and air quality to give a voice to the affected population and to add a qualitative outlook to existing quantitative literature on these topics. Responses were transcribed and then descriptively and inductively coded to identify common themes and highlight outliers. Responses allow for the perception of skiers on inhaler regulation, doping, and use, training adaptation methods for poor air quality, and both personal and general respiratory issues related to the sport to be understood. The majority of interviewed skiers connected air pollution and cold temperature exposure, especially at a young age, with the development and exacerbation of respiratory issues and the subsequent use of inhalers. Some responses and themes reveal new literature gaps on respiratory health in cross-country skiing and athletics in general; these gaps demand further research.