Public health

Medicalising vaping a waste of time, inquiry told


Adults should be able to purchase nicotine e-cigarettes in shops without a prescription, a parliamentary inquiry has been told.

Representatives giving evidence at the inquiry’s first hearing yesterday argued for “light touch” consumer-based regulation, with a possible “therapeutic pathway” for companies that want to make smoking cessation claims for their products.

The inquiry into the use, marketing and appropriate regulatory framework for e-cigarettes and vaporisers heard yesterday from the New Nicotine Alliance Australia, Australian Drug Law Reform Foundation, tobacco treatment clinician Associate Professor Colin Mendelsohn and British American Tobacco, which the inquiry heard had invested $1 billion into vaping products.

Related story: Big tobacco’s role in vaping inquiry leaves TSANZ fuming

The inquiry was told e-cigarettes have been a success story for reducing smoking rates overseas but in Australia “harsh” rules informed by an “acrimonious” debate – in which opinion holds as much weight as scientific evidence – puts it out of step with countries like the UK, New Zealand and Canada.

Currently, e-cigarette delivery systems can be bought legally in every jurisdiction, but nicotine e-liquid is only lawfully obtained through the TGA under prescription.

But according to Victorian GP Dr Attila Danko of the New Nicotine Alliance most vapers buy the liquid illegally on the black market.

Dr Danko claimed that if the government went down a therapeutic regulation path, approved products would sit on pharmacy shelves while vapers continued to purchase their favourite brands on the black market.

“If you want to medicalise smoking and make it an illness then you’ll never get rid of smoking, you’ll never make it obsolete because there’s always going to be people who want to smoke,” he said.

A therapeutic regulation model would also be costly for industry, consumers and government, Professor Colin Mendelsohn told the inquiry.

He said the UK’s 10-year-old system – where it’s legal to sell nicotine-based products to adults and companies can apply through a therapeutic pathway to make smoking cessation claims – had led to “extremely low” rates of non-smokers or never-smoking children becoming regular users and a rapidly falling smoking rate.

“This balanced light touch approach seems to be working in the UK,” he said.

Dr Sandra Costigan, a toxicologist with British American Tobacco, recommended that the regulation of nicotine e-cigarettes should come under the remit of the Australian Competition and Consumer Commission.

This would enable prohibition of sale to minors, mandated standards for labelling and product warnings, ingredients and packaging, along with annual disclosure of e-liquid ingredients and batch testing with unique numbers for traceability, she said.

Australia’s model should allow for an “appropriate advertising regime that does enable information that would encourage switching [from cigarettes to e-cigarettes]”, she added.

During discussions on the safety of e-cigarettes, proponents referred to a review published by Public Health England in 2015 that identified e-cigarettes as 95 % safer than smoked tobacco.

Addressing the safety question, Dr Mendelsohn said: “no-one’s saying they’re completely safe but all the evidence suggests that they’re substantially safer (than smoking)”.

“I think we need to weigh that huge benefit of improving health in millions of smokers against the potential risks of kids taking up smoking, renormalising smoking, undermining tobacco control which are potential risks and which the (UK) College of Physicians after 10 years says there is no evidence for.”

He claimed a recent study published in JAMA Paediatrics, which found e-cigarette use was associated with greater risk for subsequent smoking in young people, had been “misinterpreted and misrepresented”.

 

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