Expert calls for total elimination of direct sales of vaping products

All sales of vaping products other than those prescribed by a doctor to aid in quitting smoking should be stopped to curb skyrocketing uptake of e-cigarettes in young people, says one of Australia’s leading tobacco control experts in a paper published today.

Writing in Public Health Research & Practice, a peer-reviewed journal of the Sax Institute, Associate Professor Becky Freeman of the University of Sydney says predatory retailers, manufacturers and importers of vaping products have exploited loopholes in regulations to flood the market with illicit products that appeal to young people.

In theory, Australia’s regulatory model should be effective in protecting young people from taking up vaping since a prescription from a medical practitioner is now required to access nicotine-containing products, which must only be used as an aid to quit smoking.

But in practice, Dr Freeman says manufacturers continue to import and sell vaping products that contain nicotine by simply failing to label them as containing nicotine or falsely claiming they are nicotine-free.

“Distinguishing between a legal non-nicotine vaping product and an illegal nicotine-containing device requires laboratory testing, which hamstrings effective enforcement of the regulations,” she writes.

“Stopping the importation of all vaping products into Australia, regardless of nicotine content, unless bound for a pharmacy, would simplify and increase the effectiveness of enforcement and stop the flood of illicit products. This would also end young people’s easy access to vaping products.”

A recent survey showed that about one-third of Australian teens aged 14-17 have vaped at some time, while previous research has found that vaping can cause harms such as poisoning, burns, addiction and lung injury.

Dr Freeman writes that Australia has fallen behind in tobacco control since the landmark plain packaging reforms of over a decade ago. Public health action has been understandably focused on the COVID-19 pandemic in recent years, which has led to stalled momentum in chronic disease prevention. Tobacco, alcohol, gambling and fast food industry players have been quick to seize the opportunity to exploit this lack of focus, she says.

“The Australian Government has been caught off guard by an aggressive industry that seeks to undo decades of effective tobacco control,” she writes.

But she writes that the good news is that “after 10 years of minimal action”, new measures and initiatives are in the pipeline to reduce smoking, which remains the single most important preventable cause of ill health and death in Australia.

In November 2022, the Federal Government announced it would reignite the fight against tobacco addiction with a package of new measures. Although these have yet to be put to the Australian Parliament, they are expected to include updated graphic warnings on tobacco products; prevention of the use of additives such as flavours and menthol; and a requirement for tobacco companies to be transparent about their sales volumes, pricing, product ingredients and emissions, as well as their advertising, promotion and sponsorship activities.

A new National Tobacco Strategy with ambitious targets for reducing smoking rates was recently endorsed by health ministers, while the Therapeutic Goods Administration recently launched a consultation on potential reforms to prevent children and adolescents from accessing vaping products.

Becky Freeman is an Associate Professor in the School of Public Health at the University of Sydney. She has over 20 years’ experience of working in the field of tobacco control and has authored dozens of research papers on the subject.

Other papers in the issue include:

• An Editorial by Professor Don Nutbeam, Editor-in-Chief of the journal, arguing for a greater focus on health literacy, as government inaction, poor quality health communication and the complexity of health services make it difficult for people to find, understand and use the health information they need to protect their health.
• A research paper and perspective that suggest inappropriate use of colonoscopy as a primary screening tool for bowel cancer is contributing to long colonoscopy wait times.
• A paper suggesting a targeted lung cancer screening program, combined with smoking cessation, could be  a cost-effective means to cut deaths in high risk groups in Australia.