Where I live, they mostly prescribe spacers to children, though I know some adults who use spacers (including myself once I got proper treatment). It's hard when most people including doctors associate asthma with children and senior citizens, but not everyone else in between. Spacers have made a bit of a difference for me, though I still need my nebulizer on more intense days. I wish they were less expensive too, but I read somewhere that you could DIY one out of a plastic bottle. I could send the link if I find it.