I was recently invited to present an update on vaping in Australia at the 3^rd US E-cigarette Summit in Washington DC. Australia is unique in that it is the only westernised democracy to ban the sale and use of nicotine for vaping. Here is an outline of the sorry state of vaping down under.

The law

Although relatively benign with normal use, liquid nicotine is categorised as a dangerous poison (like arsenic and strychnine) under federal law and it is a criminal offence to possess or use it, unless you hold a prescription from a doctor. However, very few doctors will write prescriptions.

Under state laws, nicotine liquid is regulated strictly under tobacco laws, as if it was a deadly tobacco product. Vaping is banned in smoke-free areas, and advertising, display and sales to minors are also banned. More here,

Opposition to vaping

Incredibly there is almost universal opposition to vaping in Australia from peak medical bodies (NHMRC), the medicines regulator (TGA), all health departments, most medical associations and all health charities. Vaping is opposed by the following groups:

The contrast with other countries is striking. Vaping is supported by the world’s two largest cancer charities, Cancer Research UK and the American Cancer Society. However it is opposed by Cancer Council Australia. Similarly, the British Medical Association and New Zealand Medical Association support vaping but it is vigorously opposed by the Australian Medical Association.

In Australia, only the Royal College of Psychiatrists and Drug and Alcohol Nurses Association publicly endorse vaping so far.

Vaping in Australia

In 2016, there were 227,000 vapers or 1.2% of the adult population , a much lower rate than most other comparable countries.

Sources: Mexico NPCDAT 2016-17; Australia NDSHS 2016; NZ HLS 2017; Germany Kotz 2018; Finland Ruokolainen 2017; EU Eurobarometer 458 2017; US MMWR 2018 (NHIS, CDC 2017); Canada CTADS 2017 (15+); France Pasquereau 2018; Greece Farsalinos 2018; GB ASH 2018

Seventy per cent of Aussie vapers used nicotine (11% didn’t know). A recent study found that 65% of purchases are online (mostly from overseas), a much higher rate than other western countries where sales are not banned.

Smoking rates

National survey show that smoking rates are falling much faster in countries where vaping is widely available such as the US and UK, than in Australia. The decline in smoking in Australia has slowed dramatically since 2013 despite Australia having the highest cigarette prices in the world, plain packaging and strict tobacco control.

Sources: Annual Population Survey, Office of National Statistics; US. National Health Interview Survey, CDC National Centre for Statistics; Australia. National Drug Strategy Household Survey, AIHW - ABS National Health Survey

Other consequences of Australian vaping policy

• Tobacco prices have tripled in the last 10 years. Many smokers who cannot quit are under huge financial stress but are denied the far cheaper and safer alternative
• An increase in illicit tobacco importation and illegal tobacco crops by organised crime groups, due to the high profit margin of high prices
• A complete lack of regulation of safety and quality standards and a black market supply of vaping products.
• Smokers who cannot quit are forced to commit a criminal offence in order to improve their health by vaping.
• Vaping products are hard to access by disadvantaged groups, increasing the health gap and financial inequalities

Download the slides here.
Video and slide presentation: here (#4, 15min)

Posted by Colin Mendelsohn, colin@athra.org.au

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