New national vaping laws kicked in this week in Australia, meaning nicotine vapes will be available to adults without a prescription at pharmacies. However, at least two states, Tasmania and Western Australia, have vowed to keep them as prescription-only products. But should vapes be available beyond pharmacies? That’s the topic our opponents are tossing around in today’s Friday Fight.
Arguing for the negative team we have professor of pharmacy Kathryn Steadman and making the case in the affirmative is criminologist James Martin.
Australia is unique in treating vapes as therapeutic devices restricted to behind-the-counter sales at pharmacies. Under our current system, to access a vape a “patient” must first have a consultation with their pharmacist in which their medical history is considered. They will not be supplied a vape unless they have previously tried an alternative cessation treatment or if they want a vape for any other purpose than to quit smoking.
Critically, many pharmacies are refusing to stock vapes. Those that do are limited to selling mint, menthol and tobacco flavours, which are the least popular among adults and ex-smokers who vape.
This cumbersome process will do nothing to attract the 1.5 million Australians who currently vape, almost all of whom currently source their products from the black market. Black market vapes are more dangerous than legal ones because they have much higher levels of nicotine and some have dangerous adulterants.
Government policies about vapes are very different in other countries. In New Zealand, for example, a regulated consumer vaping market was legalised in 2020. Since then, daily smoking rates have plummeted by over 40% and are now lower than they are in Australia. There’s a similar success story in the UK, where the National Health Service gives away free vapes to smokers to help them quit.
So how did we get here? And what might be a better approach?
Australia’s highly restrictive approach to vaping is built on a number of pervasive myths, particularly around vaping among teenagers.
The first of these is the so-called “teen vaping epidemic”. Regularly repeated by the government and sensationalist media, the actual prevalence of youth vaping is much lower than many people realise.
According to the most recent National Drug Strategy Household survey — widely considered the gold standard in health research — over 70% of teens aged 14-17 in Australia have never tried a vape. Most teens who do vape do so occasionally, consistent with casual experimentation. Just 3.5% of teens vape daily, which is fewer than the proportion who were smoking daily a decade ago.
Far from being a “youth” phenomenon, the overwhelming majority of Australians who vape are over the age of 18. Many are either current or former smokers, for whom vaping is by far the less risky option.
The other big myth is the so-called “gateway effect” This claims that vaping leads people to take up smoking. While there have been some studies that have shown that teens who vape are more likely to try smoking, this does not mean that one causes the other. A much more likely explanation is what we call “common liability”. Common liability means that teens who are likely to engage in one type of risky behaviour (like vaping) are more likely to engage in other types of risky behaviour (like smoking or taking illicit drugs).
The best evidence that we have against the gateway effect comes from large-scale population surveys. If vaping led to smoking, as gateway proponents claim, we would expect to see rates of smoking increase as vaping becomes more popular. In fact, we see the exact opposite — record reductions in smoking as vaping has increased, and not just in Australia but around the world. This is very strong evidence that, at the population level, vaping is not leading people to smoke but rather that vaping is displacing smoking.
There are legitimate concerns about the health effects of vaping. However, the research we do have suggests that it is much less harmful than smoking. According to a recent review by the UK Royal College of Physicians — the same organisation that first alerted the world to the link between smoking and lung cancer — there is “clear evidence that e-cigarettes [vapes] cause less harm to health than combustible tobacco”.
Vaping isn’t perfect. But it doesn’t have to be to help us quit our most deadly habit.
We shouldn’t leave vapers to the mercy of the black market. We shouldn’t reduce the appeal of vapes by banning flavours that adults and ex-smokers tell us are important in helping them to quit. And we shouldn’t impose more restrictions to accessing vapes than we do for cigarettes, which remain the nation’s leading cause of preventable death.
The pharmacy model is set for failure. When it falls in a heap, let’s try something else, something that’s already worked well in other countries very similar to our own. That is, treating vapes the same way as other adult consumer products that are sold by specialist licensed vendors, in plain packaging, and with strict age verification.
This pragmatic, harm reduction approach would ensure safer access for adults who choose to vape whilst making it easier for more smokers to quit for good.
Read the opposing argument by Kathryn Steadman.
