Former GP calls for schools to adopt ‘vaping areas’

As Australia continues to crackdown on vaping and its boom among young people, one expert says a ‘prohibition’ approach is not the answer and has already led to a thriving black market.
 
Instead, former GP and Australian Tobacco Harm Reduction Association Chair Dr Colin Mendelsohn told a Parliamentary Inquiry on Friday that schools should create dedicated ‘vaping areas’ for students addicted to nicotine.
 
He said this must be done out of view from other students and with permission from parents, but that it represents a ‘compassionate and pragmatic’ solution to help young vapers.
 
The New South Wales inquiry was launched in September last year, with the goal of improving the state’s vaping regulation and compliance.
 
It is particularly concerned with vaping’s prevalence among children and young people, prevention services, potential health risks, and the effectiveness of current regulations in preventing illegal supply.
 
It comes as around 1.7 million Australian adults now vape, with almost 400,000 people picking up the habit last year alone.
 
About 20% of all 18–24-year-olds are vapers, as are one in six people aged 25–34, and one in seven children aged 14–17.
 
Dr Mendelsohn told newsGP he wants authorities to take a public health approach to regulating vaping, saying children should not be encouraged to vape, but ‘we can’t throw all the adult smokers under the bus either’.
 
‘The important thing is that regulation has to be balanced. So yes, of course there’s a valid concern and vaping isn’t for young people, but neither is smoking and neither is alcohol – there are lots of things, adult behaviours, that they shouldn’t do,’ he said.
 
‘We have a problem with youth vaping which is disruptive to the young people and the schools, and we haven’t found a solution to that.
 
‘An alternative is to allow them to use nicotine gums and lozenges at school because the fact is that these kids, some of them, are addicted and they go through withdrawal during the day, so a compassionate society will say, “we’ve got this problem, we’re not fixing it, let’s address this with the nicotine that these kids need”.’
 
But Associate Professor Rowena Ivers, a member of RACGP Expert Committee – Quality Care who also fronted the inquiry, told newsGP while vaping can play a positive role for some patients, its long-term effects are not yet known.
 
‘It’s about finding a middle ground – vaping can possibly be an option for people who are giving up smoking, but the unregulated vape access is really having a very detrimental impact on our young people,’ she said.
 
‘I’m personally opposed to [school vaping areas], but young people do need support … it’s about having the support of a GP, having advice on smoking or vaping cessation, having access to other therapies is important, and having a conversation about reducing nicotine exposure.
 
‘It’s about opening the conversation, discussing ways for people to wean down, thinking about other pharmacotherapies, and basically monitoring people and giving them support.’
 
Last month, the Federal Government again ramped up its vaping crackdown, introducing new plans to make it illegal to import, manufacture, supply, commercially possess, and advertise disposable single-use and non-therapeutic vapes.
 
The only legal vape products left would require a prescription, with patients still able to utilise nicotine vapes for therapeutic purposes as a second-line smoking cessation measure via their GP.
 
The RACGP had long called for this plan and supported the legislation upon its release, with President Dr Nicole Higgins urging GPs to ‘do everything we can to stop a new generation of nicotine users emerging’.
 
But Dr Mendelsohn described vapes as ‘the most effective quitting aid we have’, saying it works as a long-term substitute to smoking cigarettes.
 
‘Smoking is still the leading preventable cause of death and illness. Many people just can’t quit, and two out of three of them will die prematurely from smoking, so quitting aids have limited effectiveness,’ he said.
 
‘The problem is that this prescription model amounts to prohibition, and when you make a product so harshly restricted that over 90% of people refuse to follow a legal pathway, it’s clearly a form of prohibition.
 
‘We know from experience with illicit drugs that prohibition just doesn’t work, and we’ve seen that already evolving with vaping, we’ve got the rampant black market, widespread supply of unregulated products, easy access for young people, and difficulties with legal access for smokers.’
 
Dr Mendelsohn’s position is in-part formed by the belief that smoking cigarettes poses a larger health challenge than vaping, telling the inquiry that long-term vape use is highly likely to be ‘considerably less harmful’ than smoking, and that ‘no one has ever died from vaping nicotine’.
 
However, NSW’s Chief Cancer Officer Professor Tracey O’Brien told the same enquiry later in the day that there is still not enough evidence to determine how deadly vapes are.
 
‘There is no definitive evidence that vaping causes cancer, but I’d take caution at putting a full stop after that sentence, simply because we don’t have the duration of time to be able to prove that,’ she said.
 
‘Tobacco smoking took decades to prove that it caused cancer. It wasn’t until the 1960s that we knew that tobacco smoking caused lung cancer, and then several decades after that we now know that 15 other cancers apart from lung cancer are caused by tobacco smoking as well.
 
‘We do know that there are 200 odd chemicals contained with vapes, and many of those chemicals are known to cause cancer.
 
‘I have concerns about the health impacts in terms of cancer of the products that are currently being exposed to young people.’
 
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