GPs reminded of vaping changes

Matt Woodley

30/09/2021 4:17:51 PM

Vaping products are now only accessible in Australia as a smoking-cessation tool via prescription.

An older woman using an electronic cigarette.
The long-term health effects of vaping are unknown and their efficacy as a smoking cessation tool remains uncertain.

Under the changes, people will no longer be able to buy nicotine vaping products (NVPs) or import them from overseas websites without a valid prescription.
GPs can prescribe nicotine vaping products by becoming an Authorised Prescriber – which only takes a few minutes and is free – through the Special Access Scheme or by providing a prescription for three months’ supply via the Personal Importation Scheme.
RACGP President Dr Karen Price has encouraged all GPs to familiarise themselves with the changes.
‘GPs have a lot on their plate right now but it’s important that they are aware of what these changes to vaping laws mean for them and their patients,’ she said.
‘Prescriptions for nicotine vaping products are not a first-line treatment for smoking cessation and should only be tried when other measures, such as nicotine replacement therapy with behavioural support, have failed.
‘It will be the job of GPs in communities across Australia to apply discretion and judgment when considering the patient’s individual circumstances.
‘Those who do have a prescription will be able to obtain nicotine vaping products by filling the prescription via a pharmacy.’
RACGP-produced guidance is available for GPs, which covers the evidence on effectiveness of NVPs for supporting smoking cessation, their place in therapy and the practicalities of prescribing the products.
Dr Price also pointed out that there are other resources available to GPs stay up to date with the changes.
‘Any GP keen to learn more about these changes can take part in a webinar organised by Quitline and accredited by the RACGP on 5 October, which includes clinical guidance for nicotine vaping products,’ she said.
‘The webinar will describe the process for prescribing nicotine vaping products and outline all the clinical considerations involved. I encourage all GPs to sign up and learn about these changes that are coming into effect.
‘It’s important that GPs are wary of being pressured into prescribing these nicotine vaping products. The laws governing these products are in place for a reason – the long-term health effects of using e-cigarettes or vaping are unknown and the evidence base for their efficacy as a smoking cessation tool remains uncertain.
‘A prescription for these products should only be used as a last resort, vaping is not a risk-free, harmless version of smoking cigarettes. These are addictive and harmful products that can prove fatal if ingested in certain amounts.’
In the absence of an evidence base for how to prescribe these products for therapeutic use, practice points have been developed to minimise risk to prescribers and patients, including:

  • Nicotine vaping products are currently not approved therapeutic products, and it is valid and reasonable for medical practitioners to opt not to prescribe them
  • If prescribing, use the Authorised Prescriber or Special Access Scheme prescribing pathways instead of the Personal Importation Scheme to minimise the risk of the patient receiving imported products that do not meet the TGO 110 requirements
    •  These include requirements on labelling, child-resistant packaging, and the prohibition of other active ingredients beside nicotine
  • Avoid prescribing free-base nicotine at concentrations over 20mg/mL and limit the quantity of nicotine vaping products per prescription to a maximum of three months’ supply (and align the duration of supply with the timing of follow-up)
  • Avoid the use of flavours or limit these to just tobacco flavour since flavouring chemicals are not standardised and their safety for inhalation into the lung is not known
  • Provide follow up, as well as behavioural support
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Dr Surendar Kumar Advani   1/10/2021 6:28:49 AM

Thank you very much. It’s informative and helps. Chronic Nicotine can cause vascular problems and can increase blood pressure.

Dr Moti Ram Ukrani   22/10/2021 2:56:07 PM

Thanks for such great information , smoking is major culprit for CVD disease , Respiratory issues .

Dr Gillian Dorothy Deakin   27/10/2021 6:47:01 AM

Deeply dismayed with the College engaging in mission creep with this unacceptable burden on GPs.
Soon we will have to prescribe low alcohol beer from the pharmacy.
I have felt obliged to prescribe vaping for the last year as I strongly object to the government making the sensible shift from smoking to vaping illegal otherwise.
Universally, these ex-smokers are healthier. FACT.
In the US, the FDA has just approved vapes in recognition of this.
And we GPs must be advising smokers of such, when all else fails.
But, every consultation for a vaping script means one less doing our real job.
Vape products belong in the vape shops. The products sold in Australia should be regulated and not available to minors.
It's ridiculous to write a script for a product we then say is hazardous and we do not have the protection of knowing the product has been vetted.
I call on the College to boycott this . I am:
I have written my last script.