17 July 2017

AMA e-cig submission ‘an evidence-free zone’

Addiction AMA TheHill

As an AMA member, I am embarrassed by the Australian Medical Association’s submission to the federal government’s e-cigarette inquiry. It contains factual errors, misleading information, important omissions, unscientific arguments and cherry-picks evidence.

I am not the only one. A well-known US Public Health academic, Professor Michael Siegel has written a scathing critique.

International experience

The submission raises concerns about e-cigarettes, but ignores the valuable lessons and information learned from the growing international experience and research. The comprehensive reports by Public Health England, the UK Royal College of Physicians, the University of Victoria in Canada and the UK Centre for Tobacco and Alcohol Studies are not even mentioned.

The report ignores the fact that Australia is out-of-step with our peer countries. Nicotine is legal or being legalised in the UK, US, EU, Canada and New Zealand and outcomes have been very positive. Are we right on this issue and they are all wrong?

New Zealand has begun the process of legalising nicotine-containing e-cigarettes and e-liquid as a consumer product. In the UK, e-cigarettes are legally available to adults and are widely used with the strong support of government and most public health agencies.

Riddled with errors

The submission proudly asserts Australia’s world-leading tobacco control status by quoting smoking rates from 2013, but curiously ignores the 2016 smoking rates, which show that there was NO significant drop in smoking prevalence between 2013-2016. This unprecedented flatlining of Australia’s smoking rate is an argument in favour of introducing new and innovative strategies, such as e-cigarettes.

It states that ‘young people using e-cigarettes often progress to tobacco smoking’, implying that e-cigarettes lead young people who would never have smoked, to become smokers. In fact, many studies have found that regular vaping is rare in young people who have never smoked (<0.5%). In countries where e-cigarettes are readily available, smoking rates are declining rapidly in young people and are at record low levels.

The submission states ‘Canada is currently in a very similar situation to Australia’. Not true. Canada has committed to legalising nicotine and regulating e-cigarettes as a separate class of (non-tobacco) products. The legislation (Bill S5) has passed through the Senate and the first reading in the House of Commons.

It asserts that ‘The use of e-cigarettes has not increased at the same rate that has been observed overseas’. This is incorrect. Data from the ITC study showed that the rate of growth of use of e-cigarettes was equivalent in Australia and the UK between 2010-2013 and rapid growth has continued since.

‘Norway has banned e-cigarettes’. This is misleading. Norway announced it is lifting its ban in 2016. And on it goes…

By sloppy research and uncritically following the status quo and NHMRC guidelines, the AMA has let down smokers, its members and public health.

Other documents

AMA Position Paper on Tobacco and E-cigarettes, 2015
Colin Mendelsohn. Is the AMA statement on e-cigarettes consistent with the evidence? Australian Medicine, April 2016

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2 Comments on "AMA e-cig submission ‘an evidence-free zone’"

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Joe Kosterich
1 year 3 months ago

It is unfortunate that the AMA has allowed itself to be a mouthpiece for the anti vaping lobby. The evidence for e-ciagettes as a safer option for smokers is strong. Opposition to them is driven by ideology rather than science. One wonders if some opponents have a fear that their government funding might be at risk if people smokers used e-cigs rather than quit programs?

David Chan
David Chan
1 year 3 months ago
Sir – thank you Assoc Prof Colin Mendelsohn for your article. For many years, I have criticised the AMA, RACGP and medical colleagues about the veracity and scientific accuracy of the many medical advice that the medical organisations have given to various groups especially the Government , where laws have been enacted that impact greatly on the Australian public and businesses. Prime examples have been laws passed concerning smoking especially second hand cigarette smoke (passive smoking) and safety of cannabis. Medical advice has quite blatantly been lacking robust scientific or clinical evidence for many of the claims and very often… Read more »