Streamlining could make GPs more willing to prescribe vapes: RACGP

Jolyon Attwooll

26/09/2023 3:42:19 PM

In feedback provided to the TGA, the college has reiterated its support for reforms designed to minimise vaping harms.

Illegal vaping products
A black market of vaping products, many targeted at young people, has ballooned in recent years. (Image: AAP)

Proposed vaping reforms could encourage more GPs to prescribe to patients who are trying to give up smoking, the RACGP has said.
In correspondence to the Department of Health and Aged Care (DoH) this month, the college again expressed its backing for proposals that have been in development since last year.
Responding to a further round of consultation, the RACGP outlined its support for the prescription of vapes under the Special Access Scheme (SAS) Category C or the Authorised Prescriber scheme used for dispensing products not listed on the Australian Register of Therapeutic Goods.
‘This simplified, streamlined process may increase the willingness of GPs to prescribe vapes to patients trying to quit smoking and thereby increase the likelihood of maintaining the ongoing therapeutic support critical to quitting,’ the RACGP’s letter states.
If the proposed change comes into effect, it will mean GPs who are not authorised prescribers will no longer need to provide individual approvals to pharmacies for dispensing under SAS Category B as has been required since October 2021.
The RACGP warns that if all GPs are permitted to prescribe vapes for smoking cessation, any extra administrative burden should be avoided.
‘GPs’ prescriber numbers should be automatically assigned approved prescriber status and information about dispensed vapes should be collected from the point of dispensing,’ the letter says.
The college also said prescribing changes should be added into clinical practice software, noting that an ‘initial investment of time and education would be required to support GPs in taking up this change’.
The consultation is the latest step in a proposed package of reforms for nicotine and tobacco use in Australia.
Other measures announced by the Federal Government in May target a black market for vaping products that has ballooned in recent years, causing consternation about a spike in their use, particularly among young people.
Legislation is currently being discussed to clamp down on the availability of non-prescription vapes, as well as to introduce minimum quality standards including restrictions on flavours, and regulate the presentation and packaging of vaping products.
All single use disposable vapes will also be banned.

Federal Health and Aged Care Minister Mark Butler stated earlier this month that he is confident the tighter restrictions can be put in place by a single piece of legislation, saying that the process ‘will take a bit of time’.
In this month’s correspondence with the DoH, the RACGP acknowledges the ‘critical’ challenges of border control, importation, regulation, manufacturing and supply issues, but notes the issues lie outside of the college’s scope.
Since vapes became prescription only in October 2021, only a relatively small proportion of GPs registered as authorised prescribers of unapproved nicotine vaping products, with the TGA confirming 1963 applications in total as of April this year.
Authorised prescribers have also reported low take-up among patients, with the Chair of RACGP Specific Interests Addiction Medicine Dr Hester Wilson previously telling newsGP she had issued almost no prescriptions since the framework came into place. She cited their wide availability on the black market as the principal reason for the lack of interest.
The existing RACGP Smoking Cessation guidelines state that vapes are recommended as a last-line treatment for patients who have attempted to stop smoking by all other means.
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Dr Justin Oughton   27/09/2023 7:49:14 AM

The medicalisation of nicotine, a drug as addictive as opioids and benzos, but with no clear medical use seems ridiculous and risks legitimising the existence of a product designed to exploit its users as tobacco has done before it. We have now had a few years of the presence of vapes as a smoking cessation tool and I can attest that they are ineffective for this due to the speed of action and the method of delivery. I now have a number of patients that are addicted to tobacco and vape with which to deal with. GPs have enough issues with the other dependency forming pharmaceuticals. I don’t recommend adding another to the list. Tobacco seems to be well regulated now with the impact of cost, access, and changes to the acceptability of smoking dramatically decreasing the prevalence and frequency of tobacco use. This same model just needs to be applied to vaping. Until studies show that vaping improves people’s health, the product should not receive medical endorsement.

Dr Jacqueline Anne Barry   27/09/2023 6:23:12 PM

I'm not sure which GPs they are representing on this. I will NEVER prescribe vapes. I see them as a path to increased nicotine addiction, so will stick with other methods that have worked previously. Sometimes it takes a few attempts, but that is what the counselling part of the process is for.
The problems we see in schools now are but a glimpse into the near future with increase nicotine addiction, especially in young people, for the first time in decades. Just ban them all now! There is NO SAFE LEVEL