Provisional guidance out for vaping changes

The RACGP has published provisional guidance to help GPs navigate major changes designed to cut down on the use of vapes in Australia.
 
From 1 January, the import of single-use vapes into the country was banned, one of several Federal Government measures introduced in response to a rapid increase in the usage of vapes, particularly among young people.
 
Guidelines aimed at health professionals have been adapted by the RACGP Smoking Cessation Expert Advisory Group to tie in with the changes.
 
The rating of evidence for e-cigarettes as a smoking cessation aid after the failure of first-line therapies has now been upgraded from low certainty to moderate following a review of evidence.
 
An additional chapter on vaping cessation is also now included, with authors describing that work as ‘challenging in several ways’.
 
‘First, there is little evidence on supporting vaping cessation strategies, and we rely very much on what we know works for smoking cessation,’ the document states.
 
‘Second, legislative change is complex and some of this change needs to occur over a longer timeframe to allow industry to make the necessary changes to products available through the therapeutic access pathway.
 
‘As a result, we don’t currently know some of the detail that will affect prescribing pathways and product availability.’
 
As of 1 January, all GPs and nurse practitioners can now prescribe therapeutic vapes for smoking cessation or the management of nicotine dependence without applying to the Therapeutic Goods Administration (TGA).
 
‘This will reduce the administrative burden on prescribers while facilitating legitimate access to therapeutic vapes as part of a medically supervised smoking cessation strategy,’ the TGA stated.
 
The TGA also advises that the existing authorised prescriber and special access scheme B pathway can still be used.
 
The usage of that access scheme, and the take-up of authorised prescriber status has been relatively limited.
 
Last year, the Australian and New Zealand Journal of Public Health released research indicating that almost half of those aged15–30 have tried vaping.
 
Of the 1006 people surveyed, only 7% obtained e-cigarettes via prescription.
 
GPs have been warned they are likely to receive more presentations from patients for vaping prescriptions as well as for vaping cessation.
 
However, the impact on overall supply remains uncertain, with the efficacy of new border controls and the extent of vape stockpiling only likely to become clear over the next few months.
 
A further ban on the import and manufacture of all non-therapeutic vapes – not just disposable ones – will come into force in March, with restrictions on flavourings also due to be introduced later this year.
 
The legislative changes, which were first flagged in November 2022 and designed to reduce the appeal and availability of vaping products, are supported by the RACGP.
 
RACGP President Dr Nicole Higgins previously said the college is working closely with the TGA. 
 
‘The expansion of prescribing to more practitioners and lessening the administrative burden of nicotine vapes for smoking cessation will help us to support our patients,’ she said.
 
Professor Nick Zwar, Chair of the RACGP Smoking Cessation Expert Advisory Group, told newsGP that changes to GP education are currently being discussed, with webinars likely to be scheduled later this year.

The reforms follow a rapid expansion of the black market when vapes were made prescription-only in October 2021, but with little investment in reducing imports.
 
The provisional guideline published by the RACGP is out for stakeholder review until 19 January.
 
Further changes to the guidelines will be made once all the legislative changes are in place.
 
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