Alison Barrett writes:
Senior public health experts have criticised the Greens for forcing amendments to the Vaping Reforms Bill, which passed Parliament today.
Simon Chapman AO, an Emeritus Professor of Public Health at the University of Sydney, said it was “hugely disappointing bad news” that “the Greens have flushed the prescription-only access component of the reforms down the public health toilet”.
“If your child is vaping after these reforms, thank the Greens who feel they knew better than every significant health and medical body in the country,” he said in a compilation of statements distributed by the Science Media Centre.
“My heart goes out to visionary Health Minister Mark Butler, who must be bitterly disappointed.”
The Greens insisted on amendments to the Bill despite an open letter signed by dozens of health organisations and leaders urging federal MPs to support the Government’s Bill.
The amendments to the Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024 now mean that from 1 October, people over 18 years who wish to use an e-cigarette for therapeutic purposes will be able to purchase only from a pharmacy, without a prescription as the original Reform Bill intended.
An interim phase of three months from 1 July to prepare pharmacists for the new legislation will require people to obtain a prescription from a medical practitioner to purchase e-cigarettes from a pharmacy, Minister for Health and Aged Care Mark Butler said.
People younger than 18 years – who have been greatly influenced by the ease of access to e-cigarettes – will require a prescription from next week.
Missed opportunity
Professor Simone Pettigrew, a Research Professor at the George Institute for Global Health, said the amendments were “a missed opportunity to maximise the impact of e-cigarette bans to reduce youth vaping”, and that “our young people will be the ones to suffer the consequences”.
“The watered-down policy will still be important to reduce underage access to e-cigarettes, and the Albanese Government is to be congratulated on taking long overdue action on this issue,” she said.
“However, the change forced by the Greens will weaken the laws, pushing the problem down the line when further action will be needed to address high rates of nicotine addiction among young adults.
“Nicotine is a highly addictive substance and vapes enable the delivery of large amounts of nicotine. Making such products available without prescription is likely to result in ongoing vaping problems in Australia for the foreseeable future.”
Associate Professor Michelle Jongenelis, Deputy Director and Principal Research Fellow at the Melbourne Centre for Behaviour Change, the University of Melbourne, also said it was disappointing the Government’s Bill was not supported as tabled, especially as it “was backed by public health and supported by almost 80 health organisations and experts”.
Nicola Rahmanm, a PhD Researcher at Griffith University, said: “Placing nicotine vape products on the shelves alongside cold and flu remedies is like placing cigarettes next to paracetamol, making access to highly addictive nicotine products easy.
“What is required for the purposes of smoking or vaping cessation, is safe access to regulated products under the guidance of a trained health practitioner with comprehensive ongoing support.”
Disappointing
Professor Jonine Jancey, from Curtin University and an Australian Health Promotion Association Fellow, said it was “so disappointing” to see the proposed legislation watered down.
“Our elected members had a critical opportunity to make these a prescription-only vaping drug,” she said in the compilation statement.
“This approach would have made these vaping drugs accessible to people who want to quit smoking while keeping them out of the hands of younger people. It seems that an opportunity to prioritise community health has been lost.”
However, Jancey told Croakey that “this legislation is still progressive”.
“Australia is once again at the forefront of tobacco control, becoming the first country to ban the sale of vapes outside of pharmacies,” she said.
Dr Nicole Higgins, President of the Royal Australian College of General Practitioners, told Croakey the amended Bill isn’t what we originally asked for, but “I’m pragmatic, and we need to make sure that we don’t start a new generation of nicotine-dependent people”.
She added that the environmental impacts of e-cigarettes – non-recyclable plastics, heavy metals, lithium batteries – is something she expected the Greens party would have discussed.
Indeed, on the environmental impact of e-cigarettes, Dr Miles Park, from University of New South Wales, wrote in The Conversation today that e-cigarettes “represent a significant proportion of an alarming new category of e-waste”.
Monitoring matters
Many public health experts stressed the need to continue improving the reforms and monitoring their impact.
Jancey told Croakey we need to be vigilant about monitoring and enforcement to “ensure there is no illegal sale of vapes. There will need to be community education programs to support this approach”.
Adjunct Professor Terry Slevin, CEO of the Public Health Association of Australia (PHAA) said “further reviews and evaluations of these reforms will allow us to continually improve vaping legislation”.
Slevin said the next step will be to ensure the legislation is effectively enforced and ensure those who are addicted to nicotine, whether through cigarettes or e-cigarettes, get the support they need.
He also emphasised the need to remain focused on the “destructive impact” of the tobacco and cigarette industry.
“Australia has taken unique action on vaping, but we need continual and ongoing government investment in a range of strategies to further reduce smoking and vaping rates,” Slevin said.
“The fight against big tobacco, e-cigarettes and all other nicotine products, still has a long way to go.”
Dr Sandro Demaio, CEO of VicHealth, told Croakey that by restricting the sale of vaping products to pharmacies only, we are closing a significant loophole that has allowed supply of these products to young Australians.
“There will need to be further discussions between Government and pharmacies about how this will roll out on the ground,” Demaio said.
Associate Professor Raglan Maddox, from the National Centre for Epidemiology and Population Health, also highlighted the importance of the review period, to ensure we can accurately assess its impact and “evolve the legislation as needed”.
Maddox told Croakey that while it is disappointing the legislation did not pass in its original form, “the current situation cannot continue”.
E-cigarettes are not safe, he said, causing addiction, poisoning, acute nicotine toxicity and lung injury.
Parents, teachers and principals continue to express concerns that such a harmful, highly addictive product like vapes are far too easily available, especially to young people, Maddox told Croakey.
“In just the past year, more than 400,000 teenagers reported vaping at least monthly, if not more,” he said.
“The bill will go a long way to make sure e-cigarettes are not easily accessible by young people and non-smokers, and that vaping is not normalised and considered socially acceptable.”
The figure reported above (n=400,000) was from modelling by Cancer Council Australia this week, emphasising the significant uptake of e-cigarettes in young people in the past year. It is based on data from the Australian Bureau of Statistics, Australian Institute of Health and Welfare and Cancer Council Victoria.
In researching this story, Croakey reached out to Indigenous health and tobacco control academics, as well as several Aboriginal Community Controlled Health Organisations, and will update this article with any responses.
Pharmacies only
While the Pharmacy Guild of Australia opposes the bill, Higgins said that smoking-cessation is part of pharmacy’s scope of practice and they are “well suited to manage” this and already dispense vapes under prescription from a GP.
The important thing is that every contact with a health professional from someone who’s seeking a vape is an “opportunity to talk about quitting”.
The new legislation is also an opportunity to change the conversation away from colours and tastes, as marketed to our kids, and bring it back to a health space, she said.
Jancey told Croakey that pharmacists will need to be supported in the process “through education, along with the provision of educational resources for their clients”.
The Scimex compilation of statements also included comments from Dr Colin Mendelsohn, the founding chairman of the Australian Tobacco Harm Reduction Association, which received seed funding from 2017-2019 from e-cigarette companies, and Dr Alex Wodak AM, Board Director of the Australian Tobacco Harm Reduction Association.
Mendelsohn welcomed the Greens’ amendments as “good news for smokers, vapers and public health” but warned that the black market would continue to thrive.
Wodak said the bill represented “continuing slow-motion vaping policy collapse, not ‘world-leading policy’ as Minister Butler claims”.
Croakey asked Greens Senator Jordon Steele-John for comment about the concerns raised by public health experts. At time of publication, no response had been received. Greens leader Adam Bandt has rejected claims the amendments amount to a watering down of the bill.
Further reading
https://intouchpublichealth.net.au/vaping-regulation-what-just-happened/
See Croakey’s archive of articles on vaping