The new laws close a loophole in federal legislation which has enabled the unregulated importation and illegal sale of nicotine containing vaping products, or “e-cigarettes”, in each State and Territory.
AMA President Dr Omar Khorshid said under the new rules, nicotine containing vaping products will only be able to be accessed via a prescription from a doctor. He said the changes have a stated aim of protecting the non-smoking public, especially younger people and children, from the clear harms of nicotine poisoning and addiction.
“Vaping is not the risk-free version of smoking that some would have us believe. It is addictive, is associated with proven harms and we know that if nicotine gets into the hands of young children and is ingested, it is highly toxic and can be fatal in very small amounts,” Dr Khorshid said.
The new regulations aim to make nicotine containing vaping products less accessible and aim to prevent the terrible exponential increase in use that is being seen overseas, such as in the US, where around one quarter of all high school students have admitted to current or recent use of mainly high concentration products.
“The vaping lobby will inevitably moan about a terrible new imposition and make exaggerated claims that a smoking cessation tool is being lost,” Dr Khorshid said.
“The reality is that there is very little evidence that nicotine vaping products are effective in smoking cessation, whilst there is clear evidence that they act as a gateway for young non-smokers to become smokers, in addition to causing nicotine addiction and poisoning.
“Tellingly, Big Tobacco is increasingly a player in producing these products , and their marketing is targeting young people with packaging and flavours designed to hook children and adolescents,” Dr Khorshid said.
The Royal Australian College of General Practitioners is releasing best practice guidelines to support GPs if they are approached by smokers and nicotine vapers to prescribe these products for cessation. However, because of the limited evidence supporting their use in cessation, nicotine vaping products should be considered a last resort. The AMA’s view is that GPs, in working with their patients, should not feel pressured to prescribe them.
“There are more evidence-based methods for smoking cessation that currently exist, such as behavioural counselling, nicotine replacement therapy, and some prescription medicines.
“According to the latest data, from the 2019 National Drug Strategy Household Survey, approximately 2.6% of Australian adults reported current vaping. This is a significant increase from 1.2% in 2016.”
Dr Khorshid said the AMA was particularly concerned about the uptake of vaping among young people. In 2019, nearly 2 in 3 (64%) current smokers and 1 in 5 (20%) non-smokers aged 18–24 reported having tried vapes.
“Although the loud advocates of vaping argue they’re mostly used by people wanting to quit smoking, the data we have doesn’t support this claim. Just 43% of people who said they used vapes were regular smokers at the time they took up vaping, and the most common reason reported for trying e-cigarettes was ‘out of curiosity’.”
Dr Khorshid said while the new laws are world-leading, the AMA believes they are only a start and more will need to be done in the future to fulfill their stated aims of the protection of the public, including limiting the maximum nicotine concentration in products to 20mg/ml, the banning of the option of personal importation, and the addition of these products to state-based Real Time Prescription Monitoring systems to prevent doctor-shopping.
Most importantly, the AMA believes an independent national safety-monitoring framework must be funded and implemented to monitor the effectiveness of the changes and for any ongoing residual harms faced by the community.
“Australia has led the world in measures to reduce smoking in the community. We must not turn this victory into a catastrophic defeat by creating a new generation of nicotine addicted vapers and permitting the tidal wave of harm to children that has been seen overseas.”