The Future of Vaping
April 25, 2023
What we know about vaping
As mounting pressures grow in mainstream media, Australian health professionals eagerly await the Therapeutic Goods Administration’s (TGA) recommendations on vaping laws. A recent study published in the Medical Journal of Australia provides a comprehensive review of the health impacts of e-cigarettes. The study conclusively confirms the dangers of vaping and leaves no room for doubt on the issue. The study found that vaping causes addiction, poisoning in small children, seizures, loss of consciousness, headache, cough and throat irritation, and burns caused by exploding batteries. Many other leaders in the space are now calling for stronger regulations and strict enforcement of existing laws to prevent another public health crisis. With the number using and being exposed to vaping continuing to rise, many leaders are feeling the pressure to protect the next generation of Australian children from the harms of vaping.
In its submission to a TGA consultation earlier this year, the Australian Medical Association (AMA) called for the scrapping of the personal importation scheme, stronger controls on all vaping products through customs, and proposed reducing the nicotine concentration limit in e-liquids – from 100mg/ml to 20mg/ml. Additionally, they proposed new limits on the flavours and volume of nicotine that can be prescribed or ordered. Professor Robson, chairman of the AMA urged the government to work with state and territory governments to add NVPs to real-time prescription monitoring programs and amend MBS telehealth smoking cessation items to ensure that only a patient’s usual doctor can prescribe NVPs to help people stop smoking.
The emergence of vape pens as an alternative to traditional smoking started in the mid-2000s. This has resulted in a change in nicotine consumption habits and while cigarette smoking had been on the decline for decades, the uptake of vaping among young never-smokers has led to a steady uptake of vaping. Vaping has become the preferred nicotine consumption method among young people, with an estimated one in five high school students experimenting with, or currently vaping in Australia. However, relatively little is known about the health consequences of chronic vaping, despite the initial belief that vaping is a safer alternative to smoking. The toxic substances found in vape aerosols have raised new questions about the long-term safety of vaping. Additionally, the 2019 E-cigarette or Vaping product Use-Associated Lung Injury (EVALI) outbreak, ultimately linked to vitamin E acetate in THC vapes, raised further concerns about the health effects of vaping.
The origin of vaping can be traced back to the 1930s, but it wasn’t until the mid-2000s that this dangerous trend gained popularity. The modern vape pen was developed in Beijing, and the Juul vape pen, which dominates the US market today, was created by Stanford students. The Juul model made it easy to insert disposable cartridges of flavoured nicotine solution, allowing manufacturers to expand their range of harmful products.
Despite the innovation in vaping technology, there is still little understanding of the health consequences of using these products. Vaping aerosols contain toxic substances that have raised serious questions about their long-term safety. The EVALI outbreak, or “popcorn lungs” (a term coined by youth media), linked to THC vapes, has highlighted the potential health effects of vaping, including lung injury and death.
The exact cause of lung injury from vaping is not yet fully understood, but theories suggest it’s caused by direct toxic effects of e-cigarette aerosols, which can lead to inflammation and oxidative stress. Other theories suggest the lung injury is caused by an immune response to inhaled toxins. Moreover, chronic vaping may cause long-term damage to the respiratory system, leading to chronic obstructive pulmonary disease. It’s clear that vaping is a dangerous trend that should be avoided at all costs.
6 facts you need to know on vaping in Australia
From 1 October 2021, all nicotine vaping products, including nicotine e-cigarettes, nicotine pods, and liquid nicotine, are classified as Schedule 4 (prescription only) medicines in Australia. Nicotine replacement therapies (NRTs) that do not require a prescription will still be available from pharmacies and some retail outlets.
There are currently no nicotine vaping products approved by the Therapeutic Goods Administration (TGA) and registered in the Australian Register of Therapeutic Goods (ARTG), making them ‘unapproved’ medicines.
The TGA has introduced a standard for unapproved and export only nicotine vaping products called the Therapeutic Goods (Standard for Nicotine Vaping Products (TGO 110) Order 2021, which includes minimum safety and quality requirements.
Nicotine vaping products are not recommended as first-line treatment for smoking cessation, but may be considered for people who have failed other approved pharmacotherapies and are still motivated to quit smoking.
Prescriptions for nicotine vaping products need to specify the nicotine concentration and type of product, and consumers will only be able to access products with a concentration matching that specified in their prescription.
There are three main pathways for patients to access nicotine vaping products with a prescription: the Authorised Prescriber (AP) Scheme, the Special Access Scheme (SAS), and the Personal Importation Scheme. The Personal Importation Scheme allows individuals to import certain medicines from overseas for personal use or the use of an immediate family member, subject to conditions and a valid prescription from an Australian-registered medical practitioner.
It is crucial to understand the damaging effects of vaping, as evidence continues to emerge on the risks associated with these products. Vaping has been linked to respiratory issues, cardiovascular problems, and potential harm to young people and pregnant individuals. The marketing and appeal of flavoured vaping products have also raised concerns about their potential to attract and addict young people to nicotine. As a society, we must prioritise public health and safety and be vigilant in regulating nicotine vaping products to prevent harm.
TGA. (2022). Nicotine vaping products: Information for prescribers. [online] Therapeutic Goods Administration (TGA). Available at: https://www.tga.gov.au/resources/resource/guidance/nicotine-vaping-products-information-prescribers#:~:text=From%201%20October%202021%2C%20all.