GPs warn big tobacco is ‘trading one public health disaster for another’ with vapes

18 January 2023

By Natassia Chrysanthos, The Sydney Morning Herald

The Australian College of GPs has warned Australia risks trading one public health disaster for another as “big tobacco” morphs its strategies to hook a new generation on vaping, adding to a chorus of health organisations urging the federal government to tighten rules around e-cigarettes.

As retailers backed by tobacco companies called for the government to allow them to sell vapes behind the counter, Nicole Higgins, president of the Royal Australian College of General Practitioners, cautioned the tobacco lobby was using old tactics in the debate over vaping laws.

“Big tobacco fought Australia’s efforts to reduce harm from smoking at every step,” she said. “Their strategies are the same, and just as cynical as ever. More and more young people who have never smoked cigarettes are now vaping and this is deeply concerning.”

The RACGP’s submission to a review conducted by the Therapeutic Goods Administration joined other groups including the Australian Medical Association in urging the federal government to continue the country’s precautionary approach to e-cigarette regulation.

The six-week TGA consultation closed on Monday following Health Minister Mark Butler’s promise late last year to tackle Australia’s runaway vaping market, which some figures estimate includes more than one million vape users.

“We are at risk of trading one public health disaster for another,” Higgins said.

The RACGP’s submission called for pharmaceutical-like packaging on legal vape products, which would clearly outline risks including poisoning and burns, while Higgins warned there was still limited evidence about the long-term safety of inhaled flavourings.

“Getting people addicted is a core part of Big Nicotine’s marketing strategy. It is also a strategy that attempts to side-step efforts to improve health through questionable and furtive marketing, such as use of influencers to create a new generation of nicotine users.”

The Heart Foundation’s chief executive David Lloyd said the country was at a “sliding doors moment” as he called for the government to hold the line, including by toughening import controls and requiring a regulated source of vaping products.

“Australia is already awash with black market vapes and e-cigarettes because there is a lack of regulation and enforcement. We need to act now and stop sleepwalking into what could potentially be one of the greatest public health disasters of the 21st century,” he said.

‘This is simply ‘smoking 2.0’.′

Heart Foundation CEO David Lloyd

The Heart Foundation’s submission said the routine supply of vapes to young people was “directly contributing to a new generation becoming addicted to nicotine, a chemical which is known to cause increased blood pressure, heart rate, flow of blood to the heart and a narrowing of the arteries”.

The foundation supported banning all vape flavours except tobacco, requiring plain packaging, reducing the nicotine concentration in products and prohibiting disposable devices.

“A small window remains to toughen regulations and protect our children and young people … this is simply ‘smoking 2.0’.”

Pro-vaping groups and some doctors promote vaping as a smoking cessation tool and new laws the Coalition introduced in 2021 required people to obtain a doctor’s prescription to buy legal vape products.

However, the restrictions did not stem consumer use or illicit supply: NSW Health data published last year showed 11 per cent of people aged 16 to 24 years old reported being current vape users – more than double the number from 2020 – while a black market developed at convenience stores and online.

Lobby groups representing Australian retailers, including the Australian Association of Convenience Stores and Master Grocers Australia, are pushing for a consumer model in which adults would be able to purchase regulated products behind the counter in the same way they do cigarettes.

They argue the government would never be able to stop young people from using the products under current conditions because a licensing framework is the only way to stop the booming black market.

Both are supporters of the Responsible Vaping Australia movement led by British American Tobacco. A spokesman for BAT said it did not make a submission to the TGA.

The Pharmacy Guild, which represents community pharmacies, rejected the consumer model and called for limited vape flavours to reduce appeal, as well as plain packaging and banning disposable products.

“The guild recognises that [e-cigrarettes] are not the first line agents to aid smoking cessation and that there is little to no evidence to support their effectiveness,” its submission said.

“However, in the interest of public safety, the guild supports the proposed reforms to tighten the regulations surrounding [e-cigarettes] in an aid to reduce the black-market sale, unauthorised supply, and adolescent use of such products.”

It said the best way forward was to ensure vapes remained regulated as therapeutic goods while the government worked with health professionals to regulate broader black market supply in Australia, including illicit retail sales.

Butler will meet on the issue with state and territory health ministers once the TGA review is finalised.