How will the vaping crackdown impact GPs?

Matt Woodley

2/05/2023 5:35:33 PM

A host of new restrictions should make e-cigarettes less available, potentially leading to more patients seeking prescriptions – and help quitting vapes.

Colourful vapes.
Nicotine vaping products featuring bright colours and different flavours will become illegal once the new restrictions come into force.

Federal Health and Aged Care Minister Mark Butler has vowed to ‘stamp out’ Australia’s vaping black market, having grown increasingly concerned about the high rate of e-cigarette use among teenagers and young people.
The new policies, unveiled ahead of his National Press Club (NPC) address, will see the Federal Government work with states and territories to: 

  • stop the import of non-prescription vapes
  • increase the minimum quality standards for vapes including by restricting flavours, colours, and other ingredients
  • require pharmaceutical-like packaging
  • reduce the allowed nicotine concentrations and volumes
  • ban all single use, disposable vapes.
They will also be supported by a $63 million advertising campaign designed to discourage vaping and smoking, with the moves backed by many public health and medical bodies, including the RACGP, National Asthma Council, Heart Foundation, and Public Health Association of Australia.
Professor Nick Zwar, Chair of the RACGP’s smoking cessation guidelines’ Expert Advisory Group, also praised the new approach and told newsGP that stopping the importation of non-prescription vaping products should help reduce usage rates among non-smoking young people.
‘Extending the ban to cover vaping products that are labeled as not having nicotine is a step forward that makes the regulation more workable and more likely to be able to be enforced,’ he said.
‘One hopes that will reduce the access of younger people who are non-smokers to vaping products, because that’s the main group that’s been taking up vaping.’
RACGP President Dr Nicole Higgins has also backed the announcement.
‘It’s great news the Government has heeded the RACGP’s calls and announced these measures,’ she said.
‘We must do much more to limit the number of young people, including children and teenagers, taking up nicotine vaping.
‘The last thing we want is a new generation of nicotine users, and since the brains of younger people are still developing, I’m worried that it will be even harder for them to quit nicotine compared to adults.’
Dr Higgins said steps to limit the aesthetic appeal of vaping products, including pharmaceutical packaging with warning labels, are especially welcome.
‘Nicotine vaping products are being sold featuring colourful flavours and we have even seen products featuring the same type of imagery as children’s breakfast cereal including cartoon characters,’ she said.
‘Clearly companies are targeting children and these cynical tactics must be stopped immediately.’
Another change, confirmed by the Minister’s office following his NPC speech, is the mooted scrapping of the authorised prescriber scheme, which would allow all GPs to prescribe nicotine vaping products.
However, while Professor Zwar said it will remove barriers to GP-supervised vaping, it could also reduce the ability to monitor the prescription activity that’s happening.
‘I’m not sure that the authorised prescriber requirement was much of a disincentive, so I don’t know whether that will encourage many more GPs to get involved,’ he said.
‘But, whether an authorised prescriber or not, it’s important that they look up information about these products and update themselves or expand their knowledge about their use.’
He also said more patients may seek out GPs as a result of the changes, but it will be difficult to gauge the impact until the measures have been put in place.
It wasn’t very large when the regulations were brought in last year … [but] that might have been because the regulations were not effective because they were easy to get around,’ he said.
‘If the regulation is effective, then yes [we will see an increase.
‘How big that influx will be remains to be seen.’
Another new group of patients who GPs may encounter, according to Chair of RACGP Specific Interests Addiction Medicine Dr Hester Wilson, is young people looking to quit vaping in light of the restrictions.
‘We’ve gotten the balance wrong [and] it’s going to be hard to put the genie back in the bottle,’ she said.
‘There is a group of smokers where the move from tobacco smoking to e-cigarettes is a worthwhile harm reduction measure … [but] GPs need further guidance on how to assist young people to cease vaping.
‘We need a comprehensive plan to support people to change behaviour and more guidance on treatment options.’
Professor Zwar also believes GPs will play a role in treating this cohort once the changes come in.
‘I don’t think GPs will be overwhelmed by the demand for smokers seeking help via vaping to quit,’ he said.
‘A bigger challenge might be young people who have become addicted to nicotine through vaping who are looking for assistance about what they do if vaping product access is effectively cut off.
‘There will be a significant number who are regular users and are nicotine dependent and will struggle with nicotine withdrawal and the behavioural aspects as well.
‘It is important for general practice to provide as much assistance for those young people as we can.’
Other measures aimed at tobacco and vaping harm reduction that are set to appear in the upcoming Federal Budget include:
  • increasing the tax on tobacco will be by 5% per year for three years, in addition to normal indexation
  • aligning the tax treatment of loose-leaf tobacco products (such as roll-your-own tobacco) with the manufactured stick excise rate
  • investing $30 million in support programs to help Australians quit, including through enhanced nicotine cessation education and training among health practitioners
  • around $264 million in funding for a new national lung cancer screening program.
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Dr Peter James Strickland   3/05/2023 8:40:30 AM

Prof Nick Zwar has missed some points here. One, is that those people vaping are NOT non-smokers at all. The Federal Govt gets about $12 billion/annum off tobacco smokers each year now--- the Government is dependent on that enormous amount of money, and are thus 'addicted' to it. Now they are increasing that tax again in 2023, and MORE young people are going to go to cigarettes. So, it is a con, AND will affect the poor, as it is them who are smokers more likely, and the government will have more money in the coffers. Why don't they ban the sale of cigarettes --the answer is obvious?

Dr Philip Ian Dawson   3/05/2023 6:34:24 PM

As if we aren't busy enough without fielding requests for appointments to prescribe vows. Either they are safe like other over the counter nicotine replacements or they really not, in which case ban them altogether, and put the nicorette inhaler on the pbs just like the other products. I won't be prescribing vapes. You can't die from one cigarette, but you can die from one vape!