Introduction by Croakey: New vaping reforms effective this week will mean people 18 years or older can now buy vapes without a prescription from a participating pharmacy for the purpose of managing nicotine dependence.
From 1 October, the only lawful way to purchase a vape without a prescription is through a pharmacy following a consultation with a pharmacist, according to the Department of Health and Aged Care.
This latest shift in laws covering vaping was a concession by Health and Aged Care Minister Mark Butler to the Greens, to ensure the passage of world-leading vape regulations rolled out this year.
“The tragedy is that vaping is now a gateway for those smoking rates amongst our youngest citizens, starting to climb again after all the work we’ve done over 50 years,” Butler told 3AW this week.
Below, Professor Coral Gartner, Director of the NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame at The University of Queensland, highlights in an article first published in The Conversation, that barriers and challenges may limit access to vapes as a tool to quit smoking.
The article, originally published with the headline ‘Pharmacists are now allowed to supply nicotine vapes over the counter. But they might not be so easy to access’, echoes some of the issues raised at a recent webinar hosted by the Consumers Health Forum of Australia webinar, which heard calls for the development of consumer friendly and targeted messaging on legal, safety and access issues regarding vaping.
Meanwhile, although appearing to be a victory for public health advocates, Philip Morris International’s sale of Vectura, an asthma inhaler company it purchased in 2021, raises “lingering concerns about PMI’s broader strategy”.
President Anne Holland and CEO Vincent So of the Thoracic Society of Australia and New Zealand recently wrote in The Medical Journal of Australia’s Insight publication that PMI’s “knowledge and resources acquired during the ownership [of Vectura] could pose a significant threat to the integrity of the pharmaceutical industry”.
PMI has publicly stated that although it is selling Vectura, it has accumulated enough knowledge from the inhaler business to continue developing its own pipeline of respiratory products and inhaled therapeutics, they wrote.
Coral Gartner writes:
From October 1, new changes to Australian laws around vaping products should make it easier for adults to get low-dose nicotine vapes as a tool to quit smoking.
Pharmacists will be able to supply vapes containing up to two percent nicotine without a prescription following a patient consultation.
People aged under 18 will still need a prescription to access vapes, while anyone seeking a vape containing a higher dose of nicotine will similarly still need a prescription.
So how did we get here? And are these changes going to make it easier for people to access nicotine vapes to help them quit smoking?
Series of changes
Evidence suggests vapes containing nicotine can help people quit smoking, and may be more effective than other nicotine replacement therapies. For people who haven’t been successful with other methods, using vapes to quit smoking may be a reasonable option to try.
Vaping is certainly not without risks. However, vapes emit far lower levels of harmful chemicals compared to cigarettes, so the health risks of vaping are likely much less than those of smoking.
Since 2012, Australians have needed a prescription to access vapes that contain nicotine, while nicotine-free vapes were allowed to be sold under the same conditions as tobacco products in most of Australia.
However, many vapes that were sold under the guise of being nicotine-free contained undeclared nicotine. Few Australians obtained a prescription, even when using vapes to quit smoking.
Spurred by reports of a rapid increase in vaping among young people, Health Minister Mark Butler commenced a series of changes to federal laws with the goal of stamping out recreational vaping.
These reforms commenced in 2024 with a complete ban on the importation of disposable vaping products from January 1.
From March 1, general retailers such as tobacconists were permitted to run down their existing stock of vapes, but could not legally restock. Individuals were also no longer allowed to import vapes for personal use, even if they had a prescription.
On July 1, further changes banned general retail sales of vapes regardless of their nicotine content. Only pharmacies could supply vapes on prescription for therapeutic purposes.
From July 1 there were also changes to the types of vapes pharmacies can supply – all flavoured vapes other than tobacco, mint or menthol flavour were banned. The idea is these vaping products will be less attractive to young people.
As of today, changes to federal laws allow pharmacists to supply low-dose nicotine vapes without a prescription.
Some barriers
The changes beginning today are intended to balance access to vapes for adults for therapeutic use with the need to protect young people from taking up vaping by maintaining health practitioner oversight of supply.
Removing the prescription requirement for some patients should also free up GP time and reduce costs.
People with a high nicotine dependence, such as those who smoke heavily, may need a higher dose of nicotine to effectively manage the withdrawal symptoms when quitting smoking.
The two percent limit for over-the-counter supply matches concentration limits imposed in some other countries, such as the United Kingdom.
Another benefit of the change is that it fits the government’s intention of not penalising individuals for using vapes. Unauthorised possession of a prescription-only medicine is a serious offence that can potentially attract large fines and jail terms in some jurisdictions.
There were concerns about whether this was the most appropriate classification for vapes when cigarettes remain widely available without similar restrictions and penalties.
However, patients seeking to buy vapes directly from a pharmacy may still encounter some barriers. Many pharmacists have not welcomed the removal of the prescription requirement for several reasons.
First, the amendment to remove the prescription requirement was announced without a formal public consultation process and with a very short time frame to implementation, of about three months.
While pharmacists have been supplying vapes on prescription for some time, the primary responsibility has been with the prescribing doctor.
Pharmacist concerns
Some pharmacists have expressed concern about whether their professional indemnity insurance will cover supply without a prescription, because vapes are not approved as medicines. Others may object to supplying vapes because they see it as like selling cigarettes.
There are also practical issues for some pharmacies, such as having enough staff and a private space to provide appropriate counselling.
Under the new laws, a pharmacist must consult with the patient to confirm a vape is clinically appropriate before supplying it, and get their consent to be supplied a product that’s not an approved medicine.
Given these concerns, some pharmacies may decide to continue only supplying vapes to adults with a prescription. Others may also choose not to stock vapes.
There may also be differences in access around the country because states and territories can impose further restrictions. For example, the Tasmanian parliament is considering a bill that, if passed, will retain the current restrictions for supply of vapes in Tasmania – a prescription needed for adults and no supply allowed for under 18s.
Meanwhile, Western Australia has announced it will also retain the current prescription requirement. Other states may follow too.
Several options
Vapes are one of a range of smoking cessation products available over-the-counter in pharmacies, including nicotine patches, mouth sprays, gums and lozenges.
From 1 October, a new option called cytisine, a non-nicotine smoking cessation medicine, may also be available without a prescription in some pharmacies.
So people seeking support to quit smoking should talk to their pharmacist or Quitline about the full range of options available to find the best one for them.
About the author and disclaimer
Professor Coral Gartner is Director of NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame at The University of Queensland.
Gartner receives funding from Australian Research Council and the National Health and Medical Research Council. She is a member of the Society for Research on Nicotine and Tobacco and the Public Health Association of Australia.
See Croakey’s archive of articles on vaping.