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Majority Senate report makes right call on vaping

AMA/ACOSH joint statement on Senate Tobacco Harm Reduction Inquiry

The Australian Medical Association (AMA) and the Australian Council on Smoking and Health (ACOSH) united today to strongly endorse the majority report from Senators Henderson, Urquhart, Sheldon and Griff following the Senate Inquiry into Tobacco Harm Reduction.

“Australia is a world leader in reducing smoking and tobacco-related harm and, like the significant majority of Australia’s leading health organisations, the AMA and ACOSH strongly support a precautionary approach to e-cigarettes,” AMA President Dr Omar Khorshid said.

“Australians, and the Australian Government, have confidence in the ability of the independent Therapeutic Goods Administration (TGA) to make decisions on what medications are safe and effective for Australians.

“At this stage, there is insufficient evidence that nicotine-delivering e-cigarettes actually help people quit smoking, compared to other cessation aids, and there is strong evidence that they increase the risk of young people taking up smoking.

“We don’t know yet what the long-term effects of inhaling heated liquids directly into the lungs are, and we don’t know what is in some of these vaping liquids.

“The Australian Government should continue to restrict access to e-cigarettes unless robust evidence emerges supporting their use as a quit smoking aid.”

The majority report backs the TGA’s interim decision to make liquid nicotine available on prescription only, and recommends educating doctors about the ability to prescribe liquid nicotine as a quit aid.

It also calls for more research into the possible effects of flavourings and additives to vape fluid.

“This Senate Inquiry was the result of relentless lobbying by a small number of vaping and retailing organisations, with assistance from Big Tobacco companies,” ACOSH Chief Executive, Maurice Swanson, said.

“Many of the submissions received by the Inquiry that supported making e-cigarettes more freely available repeated the arguments presented for this proposition by tobacco companies.

“It is essential that Australian governments are not distracted by tobacco industry lobbying and continue to focus on evidence-based strategies that have been proven to reduce the prevalence of smoking in both adults and children and reduce the burden of tobacco-caused disease on the health system and the community.

“These strategies include well-funded and sustained public education programs, support for increases in tobacco tax, further prohibitions on the marketing of tobacco products, expansion of smoke-free public places, support for plain packaging, systemic provision of support for smoking cessation through all levels of our health system, and special programs for vulnerable communities.”

The majority report considered the following facts:

  • The essential and independent role of the Therapeutic Goods Administration (TGA) in reviewing evidence for whether new products are safe and effective in helping smokers quit;
  • High levels of e-cigarette use by children and young people in countries such the US, Canada and New Zealand, where they have been made freely available and promoted as a consumer product;
  • Strong evidence that the use of e-cigarettes by non-smoking children and young people increases the risk of taking up cigarette smoking by 3 – 4 times;
  • Insufficient evidence that nicotine-delivering e-cigarettes are efficacious for smoking cessation;
  • The significant majority of smokers who use e-cigarettes to give up smoking continue to smoke and use e-cigarettes, and by doing so do not reduce their risk of serious and deadly conditions such as lung cancer, chronic obstructive lung disease and heart disease;
  • Former smokers who use e-cigarettes are around twice as likely to relapse and resume current smoking as those who do not use e-cigarettes; and
  • The accumulating evidence on the harms caused by e-cigarettes to the lungs, heart and blood vessels.

Background

  • Doctors can already prescribe nicotine for vaping products when used therapeutically. However, they need to go through the TGA Access Pathways (Special Access Scheme, or the Authorised Prescriber Pathway) because there is currently no TGA approved nicotine vaping product.
  • This process will not change under the new Scheduling proposal, however, doctors may see an influx of patients who usually import their product personally.
  • Doctors prescribing nicotine vaping products is currently very rare – the TGA told Senate Estimates that about 10 medical practitioners currently do this.
  • If the interim decision is made official, the TGA has proposed an implementation date of 1 June 2021.