Originally posted on ABC website
According to the latest national drugs survey, more than half a million Australians are vapers and 2.4 million people have tried it at some point.
Later this month, the Therapeutic Goods Administration (TGA) will decide whether to make it illegal to import nicotine liquid for vaping without a doctor’s prescription.
It’s a move that vapers say would completely change the way e-cigarette users access liquid nicotine and could push people back to smoking cigarettes instead.
Here’s what you need to know about what might change and when.
What’s the situation at the moment?
Basically, most e-cigarettes are battery operated vessels. You add a liquid that is heated and inhaled into the lungs and simulates smoking a cigarette.
It’s illegal to sell liquid nicotine in Australia, so people have been importing it instead. You might’ve seen shops that sell vape liquids in Australia, the difference is they’re not supposed to contain nicotine.
There’s also the added complication that apart from South Australia, it’s already illegal to possess nicotine liquid without a doctors certificate, but it’s not something widely enforced.
Federal Health Minister Greg Hunt tried to ban nicotine liquid imports without a prescription in the middle of the year, but after backbench pressure and a campaign by users and lobby groups the deadline was pushed back.
Inside the Government, the battle continues. A leaked letter from earlier in December, signed by 28 Coalition MPs, called on Mr Hunt to delay the decision again until the whole party room has a chance to discuss it. That would mean holding off until February when parliament returns.
The ABC has heard from lots of people who vape, like emergency ward nurse Belinda Costigan, who used to smoke upwards of 40 cigarettes a day but now used an e-cigarette instead and said it had improved her health.
“Personally, my father died of lung cancer. We got 30 days’ notice from the time he was diagnosed to when he died,” she said.
Ms Costigan was a smoker at the time and recalls having a cigarette while visiting her father in palliative care and smoking at his funeral.
She strongly believes smokers should have an alternative, and in her own case credits vaping with helping her quit cigarettes.
“Everyone wants to be around for their children,” she said.
What’s about to happen?
When the TGA makes its decision by the end of this month, it won’t need to go to a vote in parliament because the regulator has the power to make the changes without legislation.
If it decides to proceed with the ban, it won’t be immediate. A date is likely to be set in the first half of next year for when it’ll come into force.
Border Force will then be able to seize imports as they arrive in Australia, and can impound them.
The main pain comes in the form of the fine, which would be up to $220,000 for breaching the ban.
While government sources say most people would not face anywhere near that penalty if they do get caught, that six figure fine has worried a lot of vapers.
Nicotine e-cigarettes and vaping liquids could also be sold by Australian chemists under the proposed changes.
Will this mean all vaping is banned?
No, but you’ll have to get a prescription from a doctor to be allowed to get the nicotine liquid.
At the moment people using vaping devices who directly import the drug can control how much nicotine they consume and can avoid having any medical conversations about cutting down or quitting.
While some vapers say it’s been a successful way to slowly wean off nicotine altogether, medical groups are worried that people are actually just swapping cigarettes for vaping, thinking it’s safer despite health advice it’s still risky and may cause severe lung damage.
Others are sceptical about the plan given there are only 14 doctors across Australia who have been registered to prescribe nicotine.
“It’s going to have a huge impact on the vaping community in Australia,” Ms Costigan said.
She says smokers can get a pack of cigarettes from any supermarket or service station without having to seek a medical opinion and is worried people who struggle to get a prescription will end up going back to cigarettes.
One of those few prescribing doctors is Gillian Deakin, a GP based in Sydney.
“People are dying [from cigarettes] and that’s a fact and right now, doctors know that vaping is safer than smoking,” she said.
“The system being proposed is designed to fail.”
Dr Deakin sees vaping as less harmful than smoking and that it should be treated like alcohol or cigarettes.
“People drink, and they drink to hazardous levels, they don’t require a prescription,” she said.
Why ban vaping and not smoking?
As well as concerns from groups like the Australian Medical Association about the long-term damage from vaping, the TGA is also worried more teenagers and young adults are taking to vaping.
The latest national drug survey found two thirds of current smokers and one in five non-smokers in the 18-to-24-year age group had tried e-cigarettes.
In Australia, smoking is already highly regulated in a different way, including plain packaging and graphic health warnings, a ban on public displays and the high taxes on the product.
The Health Minister is looking at vaping as a potential smoking cessation product, which is why it’s being considered for regulation by the Therapeutic Goods Administration.
Cigarettes, on the other hand, would never be thought about like this because they’re the substance the Government is trying to get people to stop using.
A parliamentary inquiry has been looking into vaping this year and is handing down its recommendations on how it should be treated today, but could also make suggestions for putting in place more rules and regulations around cigarettes.
What’s the latest health advice?
The Australian Medical Association (AMA) says no level of nicotine use is “safe” and the Royal Australian College of GPs argues the long-term health impacts of vaping are still unclear, and there’s disagreement about whether they actually help people quit smoking.
The Chief Medical Officer and state and territory health officers have also issued advice noting emerging evidence about a possible link with lung disease and unknown impacts of second-hand smoke.
There’s also fears that the involvement of some of the legacy cigarette makers in the vaping industry could mean Big Tobacco is driving the push for the take-up of e-cigarettes.
Another issue public health authorities have to factor in is mental health. Despite the physical health risks, there’s also acknowledgement that demonising those who smoke or vape has its own costs to users.
What happens next?
Once the battle over import rules is settled, the focus is likely to move on to what’s actually in a vaping liquid, or “juice”.
While some countries like New Zealand and the United Kingdom are seen as having more strict oversight over the production of vaping liquids, overall it’s largely unregulated in Australia.
That means there’s no requirement for liquid makers to be upfront about exactly what’s in their product, or to provide an accurate list of ingredients — something that makes doctors prescribing liquids nervous.
Recent research into the liquids sold on Australian shelves found many contained unlisted and potentially toxic chemicals.
One of those researchers is Associate Professor Ben Mullins from Curtin University, who said some of the chemicals were found at levels that could be deadly if chronically ingested.
“[The researchers] found that propylene glycol was fairly benign, and that’s one of the main components of e-cigarettes,” Professor Mullins said.
In the end, how future regulation happens will depend on how e-cigarettes are defined and categorised.
Should they be treated like a nicotine patch, classified by the TGA and sold in pharmacies with a prescription? Should they be in the same category as cigarettes with a health warning, subject to tax but also freely available? Or should they be likened to an alcoholic beverage, as some vapers have suggested?
How vapes are classified as either a consumer product or a therapeutic device will have significant bearing on the way they can be purchased and used in the future.
Originally Posted by Political Reporter Anna Henderson on the 18th December 2020 on www.abc.net.au