New national vaping laws kicked in this week in Australia, meaning nicotine vapes will be available to adults without a prescription at pharmacies. However, at least two states, Tasmania and Western Australia, have vowed to keep them as prescription-only products. But should vapes be available beyond pharmacies? That’s the topic our opponents are tossing around in today’s Friday Fight.
Debating for the affirmative team we have criminologist James Martin and arguing the negative case we have professor of pharmacy Kathryn Steadman.
From July 1 this year, the only way to legally obtain a vape in Australia was from a pharmacy. This includes everything to do with vapes, from the devices to the liquids, regardless of whether they contain nicotine or not.
When we talk about “vapes” in pharmacies, we need to be clear. Gone are the days of flavours like Hubba Bubba, Sugar Cookie or Mango Tango. Vapes are now exclusively for therapeutic use, subject to higher quality requirements, packaging constraints, and nicotine limits. Flavours can only be mint, menthol or tobacco.
Restricting vapes to pharmacies is necessary for Australia at this time. We need to curb the surge in the use of questionable quality vapes seen over the last decade. The law required a prescription for vaping products containing nicotine but allowed nicotine-free vapes and devices to be widely available through convenience stores and vape shops.
Unfortunately, very few people obtained prescriptions for their nicotine-containing vapes. It has been easy to purchase vapes without a prescription because retailers often — and continue to — ignore the laws. It is well established that vapes purchased on the high street often contain nicotine even when sold as “nicotine-free”. This means those experimenting with supposedly nicotine-free vapes were actually using a product that laid the foundation for addiction and dependence issues.
The rapid rise in vape use among young people is particularly concerning, with around 10% of 14 to 17-year-olds in Australia reporting that they have vaped. Vape suppliers design their marketing specifically to attract young people, and the child-friendly flavours mask the presence of nicotine, leading to unintentional nicotine addiction.
While nicotine may not itself be overly hazardous to health in most adults, it is harmful to the developing brain where it can alter structure and function. Therefore, the use of nicotine products should be avoided during pregnancy, and in childhood and teenage years.
However, nicotine’s addictive properties are significant and impact everyone; users become dependent on nicotine just to maintain their normal daily functions. Stopping nicotine use is incredibly difficult, as any smoker can attest, with withdrawal symptoms taking a severe physical, mental and emotional toll on the person attempting to quit.
The health effects of long-term inhalation of non-nicotine components of vape fluids are also a concern. Our lungs are not designed to withstand the constant daily onslaught of chemicals. While there are certainly fewer nasties inhaled from vapes than tobacco, substances that are safe to eat are not necessarily safe to inhale repeatedly for many years.
Switching completely from tobacco to vapes substantially lowers overall health risk compared to continuing to smoke. Therefore it is important to ensure that people looking to quit smoking can easily access vapes as part of a broad range of available quit-smoking options. But for anyone who didn’t previously smoke, inhaling vape fluids should definitely be avoided.
For those looking to use vapes to quit smoking, improving the quality of devices is important. The removal of flavours like Hubba Bubba was the first step. Soon therapeutic vapes will be considered another type of nicotine replacement therapy for smoking cessation. This will occur once their quality, safety and efficacy meet the standards applied to other medical products.
Australia already has one therapeutic vape available through most pharmacies that is on its way to meeting these standards. It is costly and takes time to gather the evidence, so it won’t happen overnight. In the meantime, supplying only the best quality products through pharmacies ensures that therapeutic vapes are available to smokers who are trying to quit smoking, while also removing vapes broadly from the community and limiting access by young people.
Pharmacies are already experienced providers of smoking cessation services. They offer advice and counselling about the full range of assistance and medications available for quitting smoking. This is the ideal place for introducing therapeutic vapes as an option for those who have struggled to quit smoking using existing methods.
Therapeutic vapes may be sold in stores other than pharmacies in the future. The scheduling system for medicines currently allows for this for other nicotine-containing products. Nicotine patches, gums and mouth spray were once only available by prescription or in pharmacies. Gradually they were “down-scheduled” once their quality, safety and efficacy were established, making them more accessible as smoking cessation aids. The same can happen for therapeutic vapes.
Read the opposing argument by James Martin.
