The Therapeutic Goods Administration (TGA) vows to take action on illegal use and sale of vaping products as significant health harms for young people were announced.
‘Generation Vape’ has arrived with the Cancer Council’s 2022 research project of the same name revealing that almost a third (32%) of respondents aged 14–17 have used vaping products, 53% knowingly so.
Ease of access to vapes and ‘shameless’ marketing towards children, including bubble-gum flavoured options or pink unicorn packaging, are placing very young children at risk, according to federal Minister for Health and Aged Care Mark Butler.
Data from the Victorian Poisons Information Centre found more than 50 children under the age of five were poisoned by vaping in the last 12 months, he revealed last week.
According to new research in the Medical Journal of Australia, health risks include addiction, poisoning, seizures and loss of consciousness caused by nicotine overdose, headache, cough, and throat irritation. Young non-smoking users are also three times as likely to smoke regular cigarettes in the future.
The TGA sought feedback on four key areas for potential vaping reform including further control measures for nicotine vaping products and non-nicotine vaping products. Over 4,000 submissions were received from various stakeholders including State and Territory Health and Education Departments, health professional bodies and pharmaceutical industry and peak bodies.
Even Australia’s youth have requested tighter e-cigarette regulations to help them overcome their dependence, with 950 teenagers aged 13–19 contributing to South Australia commissioner for children and young people, Helen Connolly’s submission.
‘All we have to do is go to a cheap servo … and there we can buy a vape without being asked for identification of age,’ wrote one 16-year-old girl.
‘We’ve conducted tests where we go into stores and ask for vapes and then take them back into a laboratory and overwhelmingly and illegally, they contain nicotine.’
‘Stop treating kids with vaping addiction like they’re awful people because you would help an adult with one but not a child,’ added a 15-year-old girl.
This is what the TGA has proposed, and where public support lies.
Requiring import permits for all vapes
Regulations introduced in 2021 to restrict the sale of vapes as prescription-only products have failed to prevent young people obtaining vaping products ‘in higher numbers’, revealed the TGA. Adults are also accessing these devices without a prescription, with ‘large volumes of [devices] being imported, and supplied, unlawfully’.
To cut illegal supply off at the source, the TGA recommended that importers of vaping products require a permit, and that the personal importation scheme should be closed.
This proposal received support from most stakeholders, including all state and territory governments, with many also proposing harsher restrictions by tightening controls on non-nicotine vaping products.
‘Stopping the importation of all vaping products into Australia, regardless of nicotine content, unless bound for a pharmacy, would simplify and increase the effectiveness of enforcement and stop the flood of illicit products,’ said The University of Sydney Professor Beck Freeman in Public Health Research and Practice.
Anita Dessaix, Chair of Cancer Council’s Public Health Committee, agreed that ‘strengthening and enforcing the TGA’s existing legal prescription pathway’ is necessary to prevent addiction and health harms.
‘The Australian Government must stop illegal imports of vaping products destined for illegal sale, whilst every state and territory government must crack down on the hundreds of retailers illegally selling e-cigarette products outside of pharmacies, under the noses of authorities,’ she said.
Pre-market TGA assessment
While some vapes are marketed as ‘nicotine free’, manufacturers have been found by the TGA to conceal nicotine content in order to circumvent regulations.
‘We’ve conducted tests where we go into stores and ask for vapes and then take them back into a laboratory and overwhelmingly and illegally, they contain nicotine,’ said Minister Butler.
In its reform proposal, the TGA recommended an assessment of vaping products against a product standard to ensure quality and safety requirements are met.
Creating a regulated source of quality products would allow doctors to prescribe, pharmacies to supply and consumers to obtain safer vaping products, said the TGA.
However, this recommendation was only supported by half of state and territory governments, health professional bodies and individual health professionals.
Public health associations were similarly on the fence, with concerns raised that pre-assessment could be confused with TGA approval. Instead, they proposed vaping products be registered in the Australian Register of Therapeutic Goods.
Minimum quality and safety standards
Strengthening the Therapeutic Goods Standard for vaping products received widespread support from stakeholders, with proposed reforms designed to make vaping products less attractive to children and adolescents.
These include introducing warning statements, pharmaceutical-like packaging, lowering the nicotine content, and imposing restrictions on flavours.
Many submissions also suggested extending these reforms to non-nicotine vaping products.
While vapers, retailers, manufacturers and importers suggested the prescription model be abandoned, many supported some regulations in order to ensure quality and safety of vaping products.
Classification as ‘therapeutic goods’
The proposal to classify vaping products as therapeutics goods, which would ensure all nicotine-containing products would be captured by the regulatory framework, received strong support across the board.
Prof Freeman noted that e-cigarettes should only be used as the very last resort for adults struggling to quit smoking.
‘This would also end young people’s easy access to vaping products and enhance the prescription model to ensure all smokers who use e-cigarettes to quit also receive smoking cessation support from health professionals.’
Retail vaping will not be legalised
Not all options are on the table. Minister Butler was quick to shut down the proposal from some MPs to legalise vaping products as a harm reduction measure.
‘We are not as a government going to normalise this public health menace,’ he said. ‘It’s no coincidence … that the people driving that agenda are tobacco industry lobbyists because they know this is a pathway back to cigarettes and they know this is a pathway around the strong action we’ve taken in recent decades to drive down smoking rates.’
Changes expected sooner rather than later
While Minister Butler has not indicated when vaping reforms would take place, he acknowledged the increasingly significant extent of the problem and that the ‘urgency to act is this year’.
A second tobacco control round table, held by Minister Butler, will take place next month, with the TGA’s recommendations likely to be discussed then.
For more information on smoking and vaping, attend PSA’s Victoria/Tasmania Annual Therapeutic Update form 26–28 May 2023. Early bird registrations close on 16 April.