Govt vaping action gets mixed reviews from health experts

The Australian Government has released the National Tobacco Strategy 2023–2030 which has been designed to reduce smoking and stamp out vaping — particularly among young Australians — through stronger legislation, enforcement, education and support.

Commenting on the illegal sale of vaping products to Australian youths, Health Minister Mark Butler said the government would take “decisive action to stamp out this public health menace”.

“Young people who vape are three times as likely to take up smoking. So is it any wonder that under 25s are the only cohort in the community currently recording an increase in smoking rates?” he said.

The 2023–24 Budget will include $737 million to fund a number of measures to protect Australians against the harm caused by tobacco and vaping products.

The measures complement the development of new proposed national tobacco control legislation first announced by the government in November 2022.

Strong regulation and enforcement

Following public consultation led by the Therapeutic Goods Administration in December 2022, the government is proposing stronger regulation and enforcement of all e-cigarettes, including new controls on their importation, contents and packaging.

The government will work with states and territories to stamp out the growing black market in illegal vaping, including to:

• stop the import of non-prescription vapes;
• increase the minimum quality standards for vapes including by restricting flavours, colours, and other ingredients;
• require pharmaceutical-like packaging;
• reduce the allowed nicotine concentrations and volumes; and
• ban all single-use, disposable vapes.
   

“The vaping industry has lured Australian kids with bright packages, fruity flavours and addictive nicotine,” said Becky Freeman, Associate Professor, School of Public Health, University of Sydney.

“I applaud the federal government’s announcement to end easy access to vapes designed to appeal to young people.

“These new reforms will both protect children and enable access to vapes only by adult smokers seeking to quit,” she said.

The government will also work with states and territories to close down the sale of vapes in retail settings, ending vape sales in convenience stores and other retail settings, while also making it easier to get a prescription for legitimate therapeutic use.

Tackling stealth marketing tactics

Professor Simone Pettigrew, Director of Health Promotion and Behaviour Change at The George Institute for Global Health, said, “For too long we’ve seen [vapes] freely available despite current restrictions, which is fuelling a surge in youth vaping, as we’ve seen in our own research.

Pettigrew’s research, published in the Australia and New Zealand Journal of Public Health, showed that almost half of young people who completed an online survey reported being either current e-cigarette users (14%) or having tried or used them in the past (33%).

“It’s high time that the stealth marketing tactics of the tobacco industry are curbed before we allow them to create a new generation of nicotine addicts," she said.

The Budget will include $63m for a public health information campaign to discourage Australians from taking up vaping and smoking and encourage more people to quit.

More harm than good?

Wayne Hall, Emeritus Professor, National Centre for Youth Substance Use Research, University of Queensland, said, “A ban on sales of disposable vapes is welcomed as a way to deter youth uptake but much more effort will need to be made to ensure that smokers can easily and legally access approved vaping products.”

Professor Ron Borland is Deputy Director of the Melbourne Centre for Behaviour Change at The University of Melbourne and has studied tobacco control over the last 36 years. He is concerned that the government’s new policy will do “more harm than good”.

“I think there is a high likelihood it will result in an increase in the rates of tobacco smoking, even though it will achieve its proximal goal of reducing levels of vaping in the community,” Borland said.

“The ban on any form of recreational vaping in the short term will lead to a significant proportion of those who are dependent on the nicotine to switch to cigarettes, which are still widely available, and there will be a somewhat delayed uptake in smoking among those who are not currently dependent.

“The policy also appears to be reducing the nicotine levels in prescription vapes. If these levels are dropped low enough, it is likely to greatly reduce their effectiveness as smoking cessation aids and thus lead to considerable relapse back to smoking. Furthermore, a proportion of those who quit using vaping need to maintain their vaping over an extended period after they quit, and the prescription model will make this difficult, again likely leading to a resumption of smoking by some.

“There is no reasonable doubt that vaping is a lot less harmful than smoking, and these changes are likely to increase smoking rates and thus increase the burden of ill health and premature mortality in Australia.

“The contrast could not be starker with what is happening in New Zealand, where they are making major efforts to reduce smoking and taking a more tolerant tax approach to vaping. I predict the New Zealand approach is going to have a vast better impact on public health.

“The government’s approach is an extension of the war on drugs to nicotine, but unlike the war on drugs, they are leaving the most harmful form, smoking, readily available.

“The war on drugs failed. It is likely that this policy will fail also,” he said.

Support programs

The government will invest $30m in support programs to help Australians quit, including through enhanced nicotine cessation education and training among health practitioners.

The 2023–24 Budget will include measures to reduce the prevalence of smoking, alongside additional support to improve the health of current and former smokers.

Tax on tobacco will be increased by 5% per year for three years in addition to normal indexation. The government will also align the tax treatment of loose-leaf tobacco products (such as roll-your-own tobacco) with the manufactured stick excise rate to ensure these products are taxed equally.

Both of these changes will reduce the affordability of tobacco, which is consistent with the priorities of the National Tobacco Strategy 2023–2030 (the Strategy).

The Strategy is a new national framework which commits to reducing daily smoking prevalence to below 10% by 2025 and to 5% or less by 2030 and prioritises tackling smoking in First Nations communities.

Together, these changes will raise an additional $3.3 billion over the coming four years, including $290 million of GST payments to the states and territories, helping to support our health system and the health of current and former smokers and vapers.

Cancer screening

$264m will be invested in a new national lung cancer screening program that is predicted to prevent 4080 deaths from lung cancer.

At-risk Australians will be able to get a lung scan every two years, as recommended by the independent Medical Services Advisory Committee.

Lung cancer is the leading cause of cancer death in Australia, and First Nations communities carry a much higher burden of both smoking and cancer, such that cancer is now the leading cause of disease-related death for First Nations people.

“Most Aboriginal and Torres Strait Islander people who smoke want to quit, or wish they never took it up. But approximately 40% of Aboriginal and Torres Strait Islander adults smoke daily.

“These measures are a much welcome step toward accelerating reductions in tobacco use,” said Dr Raglan, Maddox Program Lead, Tobacco Free Program, Australian National University.

Cancer care

$239m will be invested to ensure mainstream cancer care services are culturally safe and accessible to First Nations people, and help build the capacity and capability of the Aboriginal Community Controlled Health Services sector to support cancer care needs on the ground.

The Tackling Indigenous Smoking (TIS) program will be extended and also widened ($141m) to reduce both vaping and smoking among First Nations people.

These measures aim to address the significant threat to public health caused by cigarettes and vaping.

“Vaping is creating a whole new generation of nicotine dependency in our community. It poses a major threat to Australia’s success in tobacco control and the Albanese government is not going to stand by and let this happen,” Butler said.

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