Australia Tightens the Screws Further on Vaping Nicotine

    Australia is planning to strengthen its regulations to prevent smokers from switching to vaping nicotine. The draft National Tobacco Strategy 2022-2030 proposes “additional measures to further restrict the marketing, availability and use of all e-cigarette components.”

    Australia is already the only Western democracy to require a nicotine prescription to vape. Vaping is framed as a threat to public health, rather than an opportunity to improve it.

    Public consultation is currently being conducted on the draft Strategy, until March 24.

    The previous National Tobacco Strategy 2012-2018 was an embarrassing failure. A target of 10 percent adult daily smoking was set for 2018, but only 13.8 percent was achieved. The draft 2022-2030 Strategy has now set the same target of 10 percent for 2025. However, without ready access to vaping, this goal is certain to be missed once again.

    In Australia, it will remain much easier to buy deadly cigarettes than the far safer alternative.

    In sharp contrast, neighboring New Zealand recently set a 2025 daily adult smoking target of less than 5 percent, for all population groups, in its Smokefree Aotearoa 2025 Action Plan. Vaping is a key element of this plan: “Those who are not ready to quit, or are unable to, now have an alternative at much less cost and risk to health,” it states.

    Concerns over the criminalization of Māori people make New Zealand’s increasingly prohibitionist approach to smoking highly controversial. At the same time, its plan would make vaping products more accessible than cigarettes. In Australia, meanwhile, it will remain much easier to buy deadly cigarettes than the far safer alternative.

    Even without the planned anti-smoking measures, the benefit of vaping has been clearly demonstrated in New Zealand. Over the last 12 months, since new vaping legislation was introduced, there has been an unprecedented 20 percent decline in the adult (daily and non-daily) smoking rate (from 13.7 percent to 10.9 percent). This decline is likely to be almost entirely due to vaping, as there have been no other significant tobacco policy changes during this time. In contrast, the adult smoking rate in Australia fell by 10 percent in six years from 2013-2019 (16.4 percent to 14.7 percent).

     

    Smoking rates have also fallen much faster recently in other countries with high rates of vaping, such as England and the United States.

     

    Australia’s harsh restrictions on vaping, together with high cigarette prices, cause the greatest harm to the most vulnerable members of society, who have the highest smoking rates. These include people on low incomes, people struggling with mental health conditions or substance use disorders, and people experiencing homelessness. Forty per cent of Indigenous adults still smoked in 2019.

    There is growing evidence that internationally, the uptake of vaping may be higher in disadvantaged groups, making it a key tool to reduce health and financial inequalities. 

     

    Policy Guided by Fear and Misinformation

    According to the draft Strategy, Australia’s precautionary approach “is underpinned by the current state of evidence regarding: the direct harms e-cigarettes pose to human health, their impacts on smoking initiation and cessation, uptake among youth and dual use with conventional tobacco products.”

    However, these concerns are misguided. Vaping is not risk-free but there is overwhelming scientific agreement that it is far less harmful than smoking and a more effective quitting aid than nicotine replacement therapy. Uptake of regular vaping is rare in non-smokers.

    Rather than being a gateway into smoking, the overall evidence suggests that vaping is diverting more young people away from smoking than encouraging them to smoke. Dual use is a transitional stage leading to switching completely away from cigarettes and most dual users have significantly reduced cigarette consumption.

    Another justification for harsh restrictions by Australian authorities is a misinterpretation of the WHO Framework Convention on Tobacco Control (FCTC) guidelines. According to the draft Strategy, “Australia’s policy settings for novel and emerging tobacco products will continue to be guided by the WHO FCTC.”

    However, as a signatory to the FCTC, Australia is obligated to support tobacco harm reduction. The FCTC requires Australia to not only allow reduced-risk products but actively promote them. In the introduction, article 1(d) of the FCTC defines tobacco control as: 

    “a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke” [My emphasis.]

    The involvement of the evil tobacco industry is also invoked to justify restrictions on vaping. Although we can’t trust the tobacco industry, based on past behavior, to prioritize anything but profits, our overriding priority should be to reduce the death and disease caused by combustible tobacco as quickly as possible. Safer alternatives to smoking will save lives, regardless of who makes them. It is unscientific and immoral to oppose all safer products just because some are associated with tobacco companies. International tobacco companies are slowly switching away from combustibles to lower-risk products and this transition should be encouraged and accelerated.

    Smokers are being thrown under the bus.

    The “primary focus and goal” of Australia’s proposed vaping regulations is to protect children and young people without any consideration of the lifesaving benefits of vaping for adult smokers. Vaping is the most effective quitting aid available and has helped millions of smokers who have been unable to quit with other methods.

    Fifteen past presidents of the SRNT, the peak international organization for research into nicotine and tobacco, wrote recently “We believe the potential lifesaving benefits of e-cigarettes for adult smokers deserve attention equal to the risks to youths.” They continued “The public health objective should be to develop policies and interventions that both reduce youth vaping and increase adult smoking cessation.”

    Balanced regulations can support the needs of both groups, minimizing access for young people while facilitating access for adult smokers.

    Continuing the traditional “quit or die” approach will result in a continuing sluggish decline in Australian smoking rates and another failure to reach the smoking target. Smokers are being thrown under the bus. Lives are being lost unnecessarily. We need to do better.

     


     

    Top image by marselelia via Pixabay. Inset graphics by Colin Mendelsohn.

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