But it should be a ‘last resort’ says the AMA and it doesn’t stem concerns over Big Tobacco donations adds the RACGP President.
The RACGP and AMA have backed the prescription-only model for vapes and the government’s recent announcements to restrict tobacco and vaping. But it’s not enough, say both groups.
Following a public consultation last year on proposed regulatory reforms for nicotine vapes and an ensuing suite of reforms – including allowing all GPs to prescribe nicotine vapes, plain packaging and flavouring and increased tax on tobacco products – the TGA launched an expanded consultation into the regulation of all vapes last month.
The new consultation proposed a prescription-only model, a ban on single-use vapes, an end to the Personal Importation Scheme, limits to advertising and pharmaceutical-like packaging for all vapes.
Importantly, the reforms would ban the import, manufacture and sale of all vapes unless prescribed by a doctor and dispensed by a pharmacist.
Speaking to The Medical Republic, Dr Higgins said a lot of the work around retail availability of non-prescription vapes was outside the RACGP’s remit as it centred on “border control and legal frameworks”, but welcomed the proposed prescription-only model and ban on disposable vapes.
In its response to the TGA’s proposal, the RACGP supported the access to vapes under the SAS C notification system, which allows unapproved therapeutic goods to be prescribed without prior TGA approval.
“This would likely streamline the prescribing process, by removing the administrative step of requiring approvals to be provided to pharmacies in order for prescriptions to be dispensed,” the response read.
“This simplified, streamlined process may increase the willingness of general practitioners to prescribe vapes to patients trying to quit smoking and thereby increase the likelihood of maintaining the ongoing therapeutic support critical to quitting.”
While the AMA also supported the proposal, it added that “while the AMA recognises that vaping may assist some people to quit smoking, this should be a last resort, prescribed by a patient’s doctor who has a strong understanding of their patient’s health and history”.
“Indeed, there is no strong evidence that vaping is an effective smoking cessation tool,” the submission read.
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Dr Higgins also expressed concerns about access to other options central to a GP’s toolkit to target smoking cessation, including nicotine patches and gums.
Some nicotine replacement therapies, including gums, lozenges and potentially patches, are being removed from the PBS as price cuts mean they will no longer attract subsidies, said Dr Higgins.
“They’re an important part of our toolbox for addressing smoking cessation, and we need to make sure that there’s going to be accessible to the most vulnerable groups.”
While both the RACGP and the AMA supported the TGA’s proposed reforms on plain, pharmaceutical-like packaging with warnings for vapes, Dr Higgins added that “we also need to ensure the heated tobacco products are also covered by the plain packaging requirements”.
She said it’s important “we don’t end up with a these being marketed as a light cigarette, it is safe, which we know is not the case”.
According to Dr Higgins, the RACGP also felt that there was a “lost opportunity” to “reduce the influence of the tobacco and vaping industry”.
“We do have some concerns about things that weren’t addressed,” she said.
“Particularly around political donations from tobacco and vaping companies.
“[Tobacco and vaping companies] are explicitly allowed to make political donations under exception and that is of concern.”
But Professor Robson hailed the federal government’s aggressive action.
“We are in a situation where kids are becoming so addicted, they are hitting the vape in school yards and classrooms,” he said in a media release.
“This is an entirely unacceptable situation — but it’s not the kids’ fault. This crisis is on the hands of Big Tobacco and the industry’s insidious tactics to lure kids with bright colours, fruity flavours and false assertions the products are free of nicotine.”
The government has promised a $737 million fund to protect against tobacco and vaping harm in the 2023-24 budget.
