Government proposes major vaping clampdown

The Federal Government has set the scene for a significant overhaul in the way vaping products are regulated following a sharp rise in their use, particularly among young people.
 
On Wednesday, Federal Health and Aged Care Minister Mark Butler announced the launch of a public consultation into proposed Therapeutic Goods Administration (TGA) reforms.
 
It is seeking feedback on a series of suggested measures designed to ensure safer products, tighter marketing restrictions and a clampdown on the burgeoning black market.
 
Minister Butler also flagged new legislation aimed at cutting smoking further, an announcement timed to coincide with the 10th anniversary of the introduction of plain packaging for cigarettes.
 
Professor Nick Zwar – who chaired the Expert Advisory Group on Smoking Cessation guidelines – welcomed the proposed measures, and said that vaping has increased in ‘an alarming way’, particularly among young people.
 
‘I think part of that has been the lack of ability of Border Force to stop illegal importation,’ he told newsGP.
 
‘It’s also been that the public health workforce has been very focused on COVID and they haven’t had the usual capacity to address this emerging problem.
 
‘When you talk to people in schools or people who work in public health units, they will tell you that it’s a major problem.’
 
Currently, vaping products can only legally be used via authorised prescribers.
 
As of September this year, there were 1214 authorised prescribers recorded, including many GPs, who are allowed to prescribe unapproved nicotine vaping products.
 
However, vaping has increased exponentially despite the attempt to limit access. Cancer Council Victoria produced a report in October showing the rate of e-cigarette use has more than doubled from 3% in 2018–19 to 6.1% in 2022.
 
Usage is growing most rapidly among young women aged 18–24, it reported, citing an increase from 2.8% to 15.2%.
 
Less than 9% of those who reported using an e-cigarette in the past year said they had a prescription.
 
The issue of accessibility and lack of product regulation has increasingly been in the spotlight this year, including a Four Corners investigation into vaping’s increased popularity and the ease of black market access.
 
At a Senate Estimates hearing on 10 November, TGA National Manager Professor John Skerritt acknowledged ‘an unacceptable level’ of vaping products getting to children and adolescents.
 
‘There’s a view by Government that as a matter of urgency the dramatic increase in youth vaping needs to be addressed,’ he said.
 
‘Within the current regulatory framework, it is intended to stop access for children and young adults, but clearly it is insufficient.
 
‘It’s not working well enough at the moment.’
 
As part of the changes, Professor Zwar would like to see a vaping product that is an approved medicine in Australia.
 
‘From a GP’s point of view, that would make it like another form of NRT [Nicotine Replacement Therapy], which basically is what it is,’ he said.
 
‘We would then have confidence in the assessment of the product, and we’d know what’s in it and what’s not in it.’
 
However, he warns that any new measures should not hinder those using vaping for smoking cessation.
 
‘It’s good thing attention is on [the issue],’ Professor Zwar said.
 
‘There’s always a risk that in moving to deal with the emerging issue of vaping use in young non-smokers, we will inadvertently make it more difficult for people who are smokers and wanting to get nicotine vaping products to help them quit.’
 
Wayne Hall, the Emeritus Professor at the National Centre for Youth Substance Use Research at the University of Queensland, agrees that it is time for much tighter regulation of vaping products.
 
‘The products that are being used by young people, these cheap, disposable flavoured vapes, which seem to be illegally imported, we certainly need to be stopping that,’ he told newsGP.
 
‘Clearly there’s a great need for a much tighter regulation and licencing of people who sell these products, and better consumer protection so people who buy them know what it is they’re buying.’
 
He also called for more public health education.
 
‘The message really needs to be put out there loud and clear if you don’t smoke, don’t vape,’ Professor Hall said.
 
‘And that applies regardless of age, but obviously, particularly for young people.’
 
However, he is sceptical whether continuing to restrict access to vaping products to prescription-only will work.  
 
‘What you risk is the creation of a commercial for-profit sector in primary healthcare that will prescribe those products to anybody,’ he said.
 
‘It is important that the TGA will do a public consultation, but I just hope there is an opportunity to discuss options other than regulating those products solely as medical devices.’
 
The proposed TGA reforms follow a roundtable held in September with vaping experts – including an RACGP representative – seeking input on the effectiveness of current regulations.
 
On Wednesday, Minister Butler said the Government will take a close look at the way vaping products are presented.
 
‘We also want to learn from the lessons of plain packaging in tobacco,’ he told journalists in Canberra.
 
‘Parents know that vapes are being marketed out in our community with pink unicorns on them and bubble gum flavours.
 
‘It’s no mystery who those are being pitched to. We know that that has been pitched to not just adolescents, but in some cases, younger children.’
 
Tobacco control
The Minister also announced reforms streamlining tobacco controls nationally, along with 11 new measures including an update to graphic warnings, the standardisation of packet sizes, and cutting the use of flavours.
 
Professor Zwar again welcomed the initiative, saying that tobacco control needs constant attention, despite a marked decline in the number of smokers in recent years.
 
‘There’s probably been underinvestment in tobacco control,’ he said.
 
‘There’s been a tendency to think that tobacco is solved as a public health problem, and we can move on to focusing on other things.
 
‘There is a need to continue to work to discourage tobacco use, encourage quitting, and support people to be non-smokers.’
 
According the Australian Institute of Health and Welfare (AIHW), around 11% of people aged 14 and over smoked in 2019, down from 24% in 1991.
 
In response to the Government announcement, RACGP President Dr Nicole Higgins called for all political parties to reject donations from Big Tobacco companies.
 
‘I welcome these new measures because we must do more to deter people, particularly young people, from taking up the nicotine habit,’ she said.
 
‘The fight against Big Tobacco is far from over and today’s measures will make a real difference.’
 
The consultation on proposed vaping reforms is open until 16 January 2023, with details on how to contribute available on the TGA website.
 
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