It is difficult for individuals to directly control their exposure to air pollution. This is because there is often a disconnect between the producers of air pollution and the people who are most impacted in our communities, particularly those who are already physiologically vulnerable or are in marginalized populations. So, for the more than 6 million people who die as a result of exposure to air pollution every year,1 there is little that can be done unless someone intervenes on their behalf. Air pollution is bad for health—this is an indisputable fact. Air pollution is made up of a complex mixture of gases and liquid/solid particles. Nitrogen dioxide can cause direct impairments on respiratory health2 and readily permeates the respiratory membrane with effects on cardiovascular physiology and inflammation.3 Particulate air pollution (particulate matter [PM]), especially fine PM with an aerodynamic diameter <2.5 μm (PM2.5), is one of the key drivers of the detrimental health effects of air pollution.4 PM2.5 is small enough to traverse the upper airway defences and reach the gas exchange regions of the lung. Through interactions with the epithelial cells lining the airway and alveoli, resident macrophages and other immune cells, PM2.5 can generate oxidative stress, induce inflammation, modify immune function and promote/cause tissue injury.5 Some PM2.5 particles are internalized by lung cells, can be trafficked to other sites in the body or traverse the respiratory membrane leading to interstitial responses and, in some cases, enter the circulation. In line with this, exposure to air pollution has been shown to impact almost every organ system in the body. In some ways we already know what the problem is and the battle is more about implementing a solution—reducing air pollution to improve health. We already have a detailed understanding of the exposure–response relationship for air pollution. These relationships point to one thing—there is no safe level of air pollution.6 Health effects for many of the key components of air pollution, particularly NO2 and PM2.5, can be demonstrated at the lowest measurable point on the exposure–response curve.7 Interestingly, the exposure–response relationship is steepest at low exposure concentrations6 meaning that there is still much to gain from a community health point of view by reducing air pollution in areas that are considered to have relatively good air quality. There are many sources of air pollution. Unfortunately, the individuals who are impacted by poor air quality are often not directly responsible for the air pollution they are exposed to; and, in some cases, such as the use of biomass for the purposes of heating and cooking, individuals who are indeed contributing to the problem often lack the means or resources to reduce their individual contribution to poor air quality.8 It is incumbent on governments to act on behalf of their citizens to promote activities and behaviours that improve air quality. The starting point for this is a legislative framework that promotes continual reductions in air pollution.9 Many global jurisdictions lack an appropriate air quality framework or, where one does exist, it relies on reporting thresholds which imply that some levels of air pollution are safe—which we know is not the case. In order for an emission reduction framework to be effective, an appropriate system for air quality monitoring needs to be in place to track change. As modelling and satellite imaging improves, estimation of air pollution levels on a national, and indeed a global scale,10 at very high resolution are becoming increasingly viable. Of course, all of this needs to be underpinned by effective local policies and incentives that support transitions to cleaner air practices for those who are the most vulnerable or lack the necessary resources. So, what is left to do? There is a cogent argument that more research demonstrating that air pollution impacts on health is unnecessary. It would certainly be hard to argue that more is required to influence policy change given that a Pubmed search of “air pollution AND health” lists ~5000 publications for 2022 alone. Where we do lack evidence is in the area of the most effective interventions to minimize the health effects of exposure to air pollution for individuals.11 The includes identification of the most effective approaches to reduce exposure, strategies to manage existing conditions and the most effective means to signal to individuals when an intervention or behaviour modification should be enacted that suits their situation. For people with an existing respiratory condition who are at higher risk, there is almost no empirical evidence to support how their condition should be managed if it deteriorates. Most advice that is provided to people with existing respiratory conditions focusses on managing symptoms according to their current medical plan—but this assumes that the underlying pathophysiological response to air pollution that drives symptom deterioration is the same for other triggers. For example, are the underlying cellular and molecular mechanisms driving a deterioration in lung function in an asthmatic due to exposure to air pollution the same as those during a virus-induced exacerbation?—probably not. Does this then impact on how that person should manage their symptoms or be treated at the point of hospitalization?—we simply do not know. It is clear that exposure to air pollution impacts the lives of millions of people worldwide every year. It is imperative that we act to address this problem. In addition to advocating for policy change using our network, researchers should focus on identifying the most effective harm reduction strategies for public health messaging and interventions, and the treatment of individuals who are experiencing an air pollution related deterioration in health. By focussing our energy where the gaps are, rather than continuing to describe the problem, we will have the greatest impact on those who are most vulnerable to the effects of poor air quality. None declared. Open access publishing facilitated by University of Tasmania, as part of the Wiley - University of Tasmania agreement via the Council of Australian University Librarians.