Having just read the question about sometimes not knowing if your Spiriva had worked properly has prompted me to ask this question - what do you do if you sneeze or cough just after using your inhaler? If it was, say, Ventolin, it wouldn't matter, you could just have another puff, but for the inhalers that are limited to once or twice a day, i.e. Spiriva, Symbicort, etc., what do you do? Risk another puff in case you you MAY have sneezed/ coughed most of it out? I personally dither a bit and then tend to take it again, only not breathing in so hard just in case!!