One million additional GP appointments will be needed in Australia annually, according to the Health Department, as the government tightens its highly restrictive prescription-only policy on nicotine vapes.
The country’s prescription-only model has existed since 2021, but the vast majority of people who vape there have been getting their products through the illicit market. Figures like Health Minister Mark Butler have fueled alarmism around youth vaping, and the government is now ramping up efforts make everyone go through medical providers.
As of January 1, importing disposable vapes, regardless of whether they contain nicotine or if you have a prescription, has been prohibited. From March 1, importing any other vapes will also be banned, unless you have a license to provide them to pharmacies. A Personal Importation Scheme that allowed people with prescriptions to bring in vapes for their own use will be scrapped.
The closure of these loopholes means that attending a pharmacy with a prescription from a doctor or nurse practitioner—to which not everyone has easy access—will be the only way to legally obtain nicotine e-liquid.
And if you do that, you’ll have very limited choice: The new import rules restrict flavor options to mint, menthol or tobacco only—excluding the wide array of fruit and other flavors that many people find important in switching from cigarettes.
An estimated 1.6 million adults vape in Australia. Colin Mendelsohn, a doctor and long-time tobacco harm reduction advocate from Sydney, believes the country may have one of the world’s biggest illicit vape markets. Only 8 percent of adults who vape, he has noted, have nicotine prescriptions.
“Medical consultation adds further cost for the patient and the available pharmacy options are more expensive.”
With the latest clampdown, Dr. Mendelsohn fears, the Australian health care system will be overwhelmed. “General practice is under stress in Australia, the last thing we need is a million unnecessary visits per year,” he told Filter.
Doctors are limited to prescribing only three months at a time, meaning they can expect several visits per vaper per year. But this isn’t the only problem Mendelsohn pointed out.
“Medical consultation also adds further cost for the patient and the available pharmacy options are more expensive,” he said. People with prescriptions will reportedly have to pay up to AU$150 for a single vape.
When Australians who smoke disproportionately come from disadvantaged backgrounds, this creates a strong incentive not to switch—or for those who have switched to switch back. Cigarettes remain widely available at retail outlets.
Being obliged to obtain a nicotine prescription if you want to vape also doesn’t mean you’re guaranteed to get one.
“The great majority of doctors know very little about vaping.”
When I asked on social media about Australians’ experiences of seeing a doctor to get vapes, numerous respondents described facing medical ignorance. Gillian, for example, related that she’d “had a GP look me in the eyes and tell me they have no interest in prescribing nicotine vapes ‘because their father died of smoking related lung cancer,’ so no good experiences to report here other than accessing online services.”
“Doctors are constantly subjected to negative messaging from health and medical organizations who are opposed to vaping in Australia—they have been spreading fear, doubts and misinformation,” Mendelsohn explained.
“The great majority of doctors know very little about vaping,” he continued. “Typically patients get a lecture about the risks—unknown long-term risks, lung disease, uncertain effectiveness—and encouraged to try NRT or traditional treatment.”
There’s strong evidence that vapes are more effective smoking-cessation aids than nicotine replacement therapies like patches or gum.
“I was craving cigarettes again very quickly.”
Jake Warner, 19, lives in the Hawkesbury area of New South Wales. He began smoking at the age of 16, but managed to quit thanks to vapes, which he described as an “instant savior.”
However, when he went to his GP to ask for a prescription for vapes, the doctor was “consistently resistant,” he told Filter.
The doctor encouraged him to use nicotine sprays and patches instead. “I tried both and they were horrible,” Warner said. “I was craving cigarettes again very quickly.”
Similarly, when Adam Metelmann requested a vape prescription, his regular doctor in Adelaide, he told Filter, responded “absolutely not”—adding that vaping was “no different from smoking.”
Metelmann eventually managed to obtain a prescription after two telehealth consultations with other physicians. He described his first telehealth appointment as a “sharing of info session,” during which, “I seemed more aware of the available devices and brands than the doctor.”
“The situation is a repeat of the experience with medicinal cannabis—exactly what many of us predicted would happen.”
Alex Wodak, an Australian physician who advocates for both tobacco harm reduction and wider drug policy reform, compares the situation with prescription vapes to that seen with cannabis. Australia’s parliament legalized medical cannabis in 2016, with a prescription required to access the drug.
“After decades of cannabis demonization, hardly any Australian doctors were prepared to prescribe medicinal cannabis!” Dr. Wodak told Filter. “The current situation with prescriptions for vaping is a repeat of the experience with medicinal cannabis—exactly what many of us, including me, predicted would happen.”
Many Australians who vape have been left despondent by the growing restrictions, and some intend to continue relying on the illicit market rather than navigate the hurdles of seeking a prescription.
In one survey, 15 percent of 1,048 vape customers said the government’s restrictions on flavors meant they’d buy illegally. Another 29 percent said they would return to smoking cigarettes.
Many are paying a heavy price for their government’s anti-vape policies and messaging.
Samuel Parsons, a YouTube influencer with 185,000 followers known as “Vaping Bogan,” is taking another kind of drastic action. Earlier in January, he announced he would be leaving the country due to its harsh vaping laws, and moving to the United Kingdom where there’s widespread access.
Many who remain in Australia are paying a heavy price for their government’s anti-vape policies and messaging. Adult smoking rates have declined at a much slower rate than in countries where vapes are commercially available, as Mendelsohn has detailed in an article for Filter. And among Australians aged 14-17, the smoking rate more than tripled between 2018 and 2022.
Cigarettes kill over 22,000 Australians a year. Yet it’s youth vaping that somehow strikes Australian politicians as the more pressing public health concern.
Photograph by Vaping360 via Flickr/Creative Commons 2.0