Time to put health above profit, say doctors in support of new vaping reforms.
The importation of disposable, single-use vapes, with or without nicotine, will be banned from 1 January 2024, the federal government has announced.
Following the first step of the reforms – banning the import of single-use, disposable vapes – the import of all vapes apart from those meeting TGA standards for prescription vapes will be banned from 1 March.
Patients will be able to receive prescriptions for vapes for smoking cessation from all medical and nurse practitioners through the Special Access Scheme (SAS C), and fill scripts at pharmacies.
Speaking from Parliament House today Mr Butler said “vaping was sold to governments as a therapeutic product to help long-term smokers quit.”
“It was not sold as a recreational product, especially not one targeted to our kids, but that is what it has become.”
According to RACGP president Dr Nicole Higgins, the college has been working closely with the TGA to find a way to beat nicotine addiction that works for GPs and patients alike.
“We’ll hear a lot of rhetoric about freedom and choice, but let’s put people and health ahead of profit and addiction,” said Dr Higgins.
“The expansion of prescribing to more practitioners and lessening the administrative burden of nicotine vapes for smoking cessation will help us to support our patients.”
Speaking to Rheumatology Republic, the RACGP’s smoking cessation guidelines’ expert advisory group chair Professor Nick Zwar concurred, saying he hoped the SAS C scheme would encourage more GPs to prescribe vaping for smoking cessation, where clinically valuable.
Uptake for GP involvement in the current scheme, which requires application to the TGA to become an authorised prescriber, has been limited, according to Professor Zwar.
There have been “legitimate reasons why doctors have cautions about [vaping for smoking cessation]”, said Professor Zwar, including limited data on long term effects of vaping for smoking cessation and no approved medically products.
But his hope is that the TGA standards that will be enforced next year will provide “more assurance that the nicotine vaping products that are available through the medical access framework, do meet quality standards”.
Professor Zwar said he expected there may be an uptick in requests for prescription vapes, which, given the responsiveness of general practice to patient needs, will result in more GPs involved in vaping prescriptions.
“There is a need to help people to stop smoking and nicotine vaping products have a role in that in selected people, not as a first line, but that is an option for people who have not succeeded with the currently available and approved pharmacotherapies.”
Dr Higgins added that “it’ll also be important for pharmacies to have the appropriate prescription nicotine vaping products available when the changes come into effect”.
The RACGP is working on updating its vaping for smoking cessation module “providing practical advice on how to write a prescription for a nicotine vaping product” and a module on vaping cessation that it plans to have published by the end of the year before these reforms come into effect.
The AMA also welcomed the new process for accessing vapes for smoking cessation.
“While the evidence for vaping as a quit smoking tool is limited, the AMA also welcomes the introduction of the new Special Access Scheme pathway to prescribe vapes, which will facilitate improved access for Australians when there is a clinically appropriate need,” he said.
Australia’s peak body for public health, Public Health Association of Australia, applauded the announcement.
“If some smokers find e-cigarettes helpful to quit smoking, that pathway will still be open,” said Public Health Association of Australia CEO Adjunct Professor Terry Slevin.
“But instead of being self-regulated, it will be under medical supervision where there’s a much higher chance of success.”
As part of the March tranche of the reforms, Australians will be blocked from personal importation of therapeutic vapes from overseas and therapeutic importers and manufacturers will be faced with strict TGA standards that they must demonstrate they comply with for import.
Importers will also need to obtain an importer’s permit and licence from the Australian Government’s Office of Drug Control.
Mr Butler added that the government will also introduce new legislation to ban the supply of all vapes that do not meet TGA standards – including plain packaging, no flavouring, and prescribed levels of nicotine – from sale, advertisement and local manufacturing in early 2024.
Enforcement will receive a funding injection of $25 million to the Boarder Force and almost $60 million to the TGA over two years to enact the new reforms.
Mr Butler said the reforms were aimed at retailers, not individuals.
“The laws focus on vendors, not on people, not on customers, certainly not on kids, and that’s what we want to see enforced,” he said.
The changes should be signed off by the executive council in December.
Any disallowance motion cannot be raised until February 2024 when the House of Representative reconvenes after the summer.
Professor Robson said he was encouraged to see decisive action from all levels of parliament and encouraged all MPs and senators to rally behind the reforms.
“To do otherwise would be shameful.”
PHAA’s Professor Slavin concurred, adding that “street-corner nicotine vendors selling brightly coloured pina colada, gummy bear, or blueberry flavoured products, which contain ingredients never designed to be inhaled into human lungs, will have to find their profits elsewhere”.
“The government’s proposed actions are good news for parents and carers of young people who vape, and bad news for the vaping and nicotine industry desperate to find younger customers they can hook for life.”
