t know if this is pertinent, but Advair caused such extreme coughing (almost incapacitating bronchitis) that I stopped using it. As
for Spiriva, I find it extremely drying. I only use it every fourth day. On that regimen it helps. My lung health is actually much better and I am more comfortable since I gave up Advair, and my coughing is moderate. Advair also caused me to develop adrenal fatigue, which was quite dreadful, and I am still recovering from it.