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Chapters:

0:00 - Intro with Joanna Junak
0:18 - Colin Mendelsohn brings us the latest Australian THR updates
0:52 - Nicotine restrictions in Australia
1:57 - What is Australia's National Health and Medical Research Council?
2:27 - NHMRC accused of promoting misleading vaping information
2:52 - NHMRC statement claims that vaping is not an effective aid to quitting smoking
4:50 - Vaping ≠ gateway to smoking
5:31 - NHMRC rejects evidence of vaping benefits
6:38 - Restricting access to safer nicotine products puts smokers' health at risk
7:32 - Antivaping bias from the NHMRC?
8:13 - Impartial review of vaping evidence in Australia needed
8:41 - Closing remarks

Transcription:

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Hello and welcome. I'm Joanna Junak and this is GFN News on GFN.TV.



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Australia's National Health and Medical Research Council is the country's top health and



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medical research organization. Its advice guides national health policy on various issues.



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In 2022, the NHMRC published a position statement on electronic cigarettes.



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Last week, a review of this document by leading scientists was published in the journal Addiction



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and was highly critical of the NHMRC document. Dr Colin Mendelsohn was the lead author of



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the review and will tell us more about their assessment.



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Hello Colin. Firstly, can you tell us about the state of vaping in Australia?



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Hi Joanna. Australia has taken a precautionary approach to vaping. So vaping is opposed by



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all levels of government and almost all health and medical organizations. And the media is



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also hostile to vaping. Australia's got the most restrictive regulations in the Western



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world. Nicotine liquid is only available legally with a prescription from a doctor and can



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be legally purchased only from a pharmacy or by importation from overseas.



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However, even the government has acknowledged that this approach has failed miserably. 90%



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of vapers do not have a prescription and there's a thriving black market which freely sells



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unregulated products to adults and children. In response to this, the government appears



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to be planning to ban all imports and restrict vaping even further.



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What is the role of the National Health and Medical Research Council?



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The NHMRC is Australia's leading government health and medical research body and is highly



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respected. It provides grants for medical research and develops position statements



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to guide national health policy. Well, last year it released a statement on vaping which



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is widely used to justify the anti-vaping narrative in Australia.



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You recently led a review of the NHMRC statement. What was your assessment of it?



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Our review found that the NHMRC document was seriously flawed. It contained misinformation



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and was biased against vaping. We concluded that it fails to meet the high standard expected



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of a leading international scientific body. What were some of your concerns about the



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document? Well, firstly, it exaggerated the risks of



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vaping and failed to compare them to the alternative, tobacco smoking. For example, it emphasised



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the presence of chemicals in vapour without making it clear that most of these chemicals



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are at low or trace levels and that most are far lower than in tobacco smoke. It also exaggerated



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the long-term risks of vaping. However, we are confident that long-term vaping is highly



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likely to be far less harmful than smoking, based on the substantial reduction in toxic



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chemicals and biomarkers, and because of the improvements in the health of many smokers



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and in health conditions when smokers switch. It also incorrectly claims that vaping nicotine



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causes seizures, the serious lung conditions, EVALI and so-called popcorn lung, when there



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is no evidence for any of these conditions. Secondly, the NHMRC incorrectly claimed that



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there is weak evidence that vaping is an effective quitting aid. Well, this is in contrast to



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the 2022 Cochrane review of randomised controlled trials, which concluded that there is high



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certainty evidence that electronic cigarettes are more effective than NRT. It also dismissed



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the findings from other studies that support the randomised controlled trial results, such



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as evidence from the UK Stop Smoking Services, observational studies, population studies,



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and a decline in national smoking rates where vaping is freely available. And when you take



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all this evidence together, the argument is compelling that vaping is an effective quitting



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aid for both individuals and at the population level.



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What did the NHMRC say about youth vaping? Well, the statement gave strong support to



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the gateway theory that vaping causes young people to go on to smoke. However, we now



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know that the opposite is more likely to be true. As youth vaping has increased, we've



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seen an accelerated decline in youth smoking in many countries. There's growing evidence



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that vaping is diverting more people away from smoking than encouraging them to smoke.



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Most importantly, it doesn't appear that youth vaping leads to sustained cigarette



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use, which is the main public health concern. Did the NHMRC acknowledge the effect of vaping



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on smoking rates? The NHMRC dismissed the clear evidence that



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vaping is already having a positive net public health effect. Numerous studies have found



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that vaping is associated with more frequent quit attempts and greater quit success than



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other methods, and that the decline in smoking has accelerated since vaping became available.



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For example, in New Zealand, in the two years after vaping was legalised in 2020, the adult



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daily smoking rate fell by an unprecedented 33% in two years. In comparison, in Australia,



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the smoking rate declines by about 2% per year.



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But most importantly, vaping is the most popular aid for quitting or reducing smoking in Western



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countries. And because of its proven effectiveness and wide reach, it's likely to have a far



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greater population effect than any other cessation therapy.



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What was their view about the precautionary principle?



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The NHMRC statement argues that we should follow the precautionary principle and not



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allow vaping because of uncertainty about long-term risks. However, the precautionary



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principle requires a comparison of the risks of introducing a new product with the risks



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of delaying its introduction. Now, in the case of vaping, the relatively small risks



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of harm will be far outweighed by the substantial known harms from delaying access to current



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smokers. And while there's some uncertainty about vaping, it's well established that



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up to two in three smokers who smoke long-term will die prematurely from smoking. And many



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of these could be prevented by vaping.



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Was there any evidence of bias in the NHMRC report?



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Yes, look, we were very concerned about the make-up of the Working Committee. Three members



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of the Committee have published papers opposing vaping. Other members represent organisations



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which have made strong public anti-vaping statements. No experts who take a positive



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view on the potential of vaping or even smoker or vapour representatives were included.



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Having a strong position on vaping can influence how people interpret the evidence to support



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a predetermined policy position.



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And what were your conclusions from this review?



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We concluded that the report should be withdrawn and that an impartial review of the evidence



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was needed by a balanced committee with an independent chairperson with no predetermined



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views. Also, we think there should be a review on how such a flawed report was issued by



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a leading government health organisation.



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Thank you, Colin. That's all for today. Tune in next time here on GFN TV or on our



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GFN TV podcast. You can also find transcriptions of each episode on the GFN TV website.



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Thanks for watching or listening. See you next time.