Cigarette substitute on hold

Separate to vaping products such as nicotine-containing e-cigarettes, heat-not-burn tobacco products use aerosols containing nicotine and other chemicals, heating tobacco by battery-powered systems to create a flavoured vapour containing nicotine which is inhaled by the user.
 
In November last year, global tobacco giant Philip Morris International sought approval from the Australian Government to sell these products as cigarette substitutes, lodging an application to the Therapeutic Goods Administration (TGA) endorsing its smoke-free, nicotine-based product as a safer alternative to the toxic chemicals found in cigarettes.
 
The TGA’s interim decision to block the heat-not-burn products follows call from a number of healthcare organisations to protect public health, including the RACGP, the Lung Foundation, and the Australian Council on Smoking and Health.
 
As part of the RACGP’s high-profile stance against Philip Morris’ proposal, its February submission to the TGA openly opposed the approval of heat-not-burn tobacco products in Australia.
 
‘The RACGP strongly recommends that the TGA does not approve the proposed amendment and adopts a protective and precautionary approach to heat-not-burn-products’ the submission states.
 
The college likened heat-not-burn tobacco products to e-cigarettes, which it has cautiously suggested only be considered as a second-line intervention in limited circumstances, reiterating it does not endorse vaping.
 
The introduction of heat-not-burn products as a ‘safer alternative’ to smoking tobacco, or a potential cessation aid, is likely to follow a ‘similar trajectory’ to e-cigarettes and raise many of the same concerns, according to the RACGP submission.
 
As with nicotine-containing e-cigarettes, the college stresses that the long-term risks of heat-not-burn tobacco products have not been established, and more research is needed to certify their safety. The evidence that heat-not-burn products pose lower risk than other cigarette substitutes is also lacking.
 
RACGP President Dr Harry Nespolon has commended the TGA’s decision.
 
‘This is only an interim decision but most welcome news because there is simply no evidence these products are any safer than smoking cigarettes,’ he said.
 
‘That is why the RACGP wrote to the TGA opposing Phillip Morris’s application to amend the Poisons Standard to make heat-not-burn tobacco available in Australia.
 
‘The RACGP will continue its campaign of anti-smoking messages, including opposition to heat-not-burn tobacco products.’
 
Dr Nespolon also questioned the marketing strategies used by tobacco companies, alleging certain products pose lower risk, comparing them to since-banned past campaigns.
 
‘Companies such as Phillip Morris have claimed that heat-not-burn tobacco products pose a lower risk to health due to a milder exposure to toxicants, but this has recently been rebutted by academic research,’ he said.
 
‘This assertion is remarkably similar to earlier marketing campaigns by tobacco companies that promoted “light” and “mild” cigarettes, as well as filtered and low-tar cigarettes, as posing a “lower health risk”.
 
‘Those campaigns are now illegal and we must always remain vigilant about what “big tobacco” is trying to sell us … [they have] one objective only – make larger profits by selling more of their products.’
 
The RACGP’s Supporting smoking cessation: A guide for health professionals received global recognition with a World No Tobacco Day 2020 award for its contribution to support smoking cessation.
 
The TGA’s final decision on heat-not-burn products is due to be made in August.
 
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