Australian vapers will soon have an even harder time getting nicotine. On October 1, the government will ramp up a strict prescription-only vaping model. The law, which has already been in effect but seemingly brushed aside, will now have harsh penalties attached. The Australian Border Force plans to crack down on anyone importing nicotine illegally into the country; those who defy the rule can expect up to a $222,000 fine in Australian dollars.
Australia treats nicotine for vaping as a medicine, which is regulated by the Therapeutic Goods Administration (TGA). The agency classifies nicotine liquid in its Poisons Standard, though explicitly excludes combustible cigarettes. In practice, this means that it’s much easier for citizens to buy cigarettes than vaping products. An Australian smoker looking to switch to vaping, a far safer nicotine alternative, must visit a doctor and get a prescription. The pharmacy then has to stock the desired vaping product or be able to deliver it.
“Probably one to two percent of vapers have a prescription,” Dr. Colin Mendelsohn, the founding chair of the Australian Tobacco Harm Reduction Association, told Filter. “There are probably 15 doctors in the country willing to write scripts. Many don’t even know how to write them. And, with all the negative messaging, they have been discouraged to do so for years.”
The government has failed to fully enact this policy a few times, but the eventual consequences, of course, will be predictable. Tobacco harm reduction (THR) proponents, activists and drug-war critics have noted that, given the immense barriers to obtaining nicotine liquid and easy accessibility to combustible cigarettes, smokers will either keep smoking, return to smoking, or resort to an illicit market riddled with dangers, including criminal and financial ones. About 2.5 million Australians still smoke, with around 21,000 smoking-related deaths every year.
“We are the only Western democracy that doesn’t allow the commercial sale of nicotine. We are remarkably out of step, and there are huge repercussions.”
Yet despite these increasing hurdles, Australia’s National Drug Strategy Household Survey estimated that the number of Australian vapers increased from 240,000 in 2016 to 2019. At the moment, there could be as many as 600,000, Mendelsohn believes.
“We are the only Western democracy that doesn’t allow the commercial sale of nicotine,” Mendelsohn told Filter. “We are remarkably out of step, and there are huge repercussions.”
As Mendelsohn and Alex Wodak, a veteran drug law reform advocate and doctor in Australia, pointed out in a recent op-ed in The Sydney Morning Herald: “The decline in smoking rates in the UK and US has been two to three times faster than in Australia since 2013 when vaping became popular in those countries, despite Australia’s harsh tobacco control regulations, high cigarette prices and plain packaging.”
“If the new rules for nicotine in Australia fail, as seems likely,” they write, “then a different approach should be adopted.”
Mendelsohn is not confident that can occur without a substantial shift in the country’s culture and politics. And without a grassroots movement, that will be difficult.
Reformers have much to push back against. To a US audience, the foes of THR in Australia will be familiar. They are prominent, influential and well-financed public health organizations like the Australian Medical Association (AMA), Lung Foundation Australia (LFA), and the Thoracic Society of Australia and New Zealand (TSANZ). They are reactionary journalists looking to jump onto a moral panic about teen nicotine use. They are politicians, exporting an American fear about teen vaping rates and a string of vaping-related injuries not determined by US health authorities to be caused by vaping nicotine, who see nothing but potential harms.
But because vapes and e-cigarettes have never really been commercial products in Australia, the sort of vocal, consumer-driven THR advocacy seen in the States does not yet exist.
“None of this is about evidence,” Mendelsohn said. “It’s ideology. It’s abstinence versus harm reduction. It’s politics. It’s tobacco taxes. It’s a fear of new technology. It’s a whole range of things. But it’s not about evidence.”