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0:00 - Intro with Joanna Junak
0:26 - Dr Colin Mendelsohn discusses recent proposals for further nicotine restrictions in Australia
2:28 - The Australian Medical Association [AMA] calls for increased restrictions on nicotine products
4:56 - Designate vaping devices as medicinal products, say the AMA
6:00 - Flavour bans and a reduction in maximum nicotine content of vape liquids are proposed for Australia
7:45 - Closing remarks


Joanna: Hello and welcome. I'm Joanna Junak and this is GFN News on GFN.TV. The Australian medicines regulator has recently conducted a consultation process on reforms to the regulation of nicotine vaping in Australia. Submissions were received from over 4000 stakeholders, including the Australian Medical Association, and a review of this submission is underway. Dr Colin Mendelsohn is an academic and researcher in tobacco treatment. We have asked Dr. Mendelsohn to explain why this consultation was established and his views on the AMA submission. Thank you Colin, for joining us today. First of all, why did the TGA establish this consultation process?

Colin: Hi Joanna. Since the 1 October in 2021, nicotine liquids been classified as a prescription only medicine in Australia, which can only be legally purchased from Australian pharmacies or from overseas if the individual has a valid doctor's prescription. Australia is the only country to classify nicotine vaping products as prescription only medicines. In all other western countries, nicotine liquid is classified as a consumer product sold to adults from general retail outlets. Now, the Australian model has been an embarrassing failure. The regulations were designed to allow adults to access nicotine vapes with a doctor's support and to prevent youth vaping. However, they've had the opposite effect. Very few doctors are prepared to prescribe nicotine liquid and it's almost impossible for vapours to get a prescription legally. And this has predictably created a thriving black market which sells unregulated mislabeled nicotine products to adults and to young people. And as a result there's been a skyrocketing of youth vaping. The regulator has admitted that this model is not working.

Joanna: The Australian Medical Association has made a submission to the consultation process. Broadly speaking, what is it proposing?

Colin: Well, the AMA is arguing for a doubling down on the current harsh approach with increased restrictions. However, this is the very approach which has failed and further bans and restrictions will only drive the sales of nicotine vaping products further underground. Their approach is essentially now amounting to prohibition.

Joanna: Why is the AMA taking this approach?

Colin: Well, firstly, they claim there's a lack of evidence that Vaping is an effective quitting aid. In fact, Vaping is the most effective and most popular quitting aid in Australia and globally. The Cochrane review found there was high certainty evidence that Vaping is more effective than nicotine replacement therapies. And a recent analysis by the UK National Institute for Health Research concluded that Vaping was the most effective single therapy for quitting smoking, followed by varenicline and nicotine replacement. Vaping is also the most popular quitting aid in Australia and it's accelerating the decline in smoking in many countries. Secondly, the AMA incorrectly claimed that vaping has serious health risks and has become a public health crisis. They say that vaping causes popcorn lung and Evali, two very serious lung diseases, but neither of which are caused by nicotine vaping. The truth is that vaping is substantially less harmful than smoking and it's a life saving remedy for current smokers who otherwise are unable to quit. Thirdly, they incorrectly claim that vaping is a gateway to smoking for young people. But we know this is not true. There's no evidence that vaping causes young people to take up smoking and to become regular smokers. In fact, the evidence suggests it's diverting young people away from smoking. And as increases in youth vaping have been seen, they've been accompanied by an accelerated decline in youth smoking. And that's been seen across a number of countries.

Joanna: What policies is the AMA recommending?

Colin: Well, the AMA is recommending a range of harsh policies which will only harm public health. They want to continue with the failed prescription model, which has been rejected by doctors and vapors. They believe that all vaping products should be registered as medicines by formal applications to the medicines regulator, while deadly combustible products, of course, remain virtually unregulated. Now, this is an onerous and costly process, and no other country requires this. And no vaping product has been registered as a medicine anywhere in the world and gone to market. And this is because vapes are not medicines, they're consumer products. Vaping is about replacing one pleasurable consumer behavior with another far less harmful one. The AMA also wants to ban the importation of all vaping products by consumers, which will only boost the black market.

Joanna: And what other measures is the AMA recommending?

Colin: Well, the AMA wants flavors to be restricted, even though flavor bans in other countries, such as the US. Have been counterproductive and have led to increased smoking in youth and adults. Flavors are an important part of vaping, and they make switching from smoking to vaping much more appealing. And they've been shown to increase quit rates and reduce relapse to smoking. The AMA wants to reduce the maximum concentration of nicotine to 20 milligrams per mill. Now, this is ineffective in popular disposable and pod devices, which require high nicotine levels, and it's too low for many heavy smokers. Furthermore, lower concentrations of nicotine lead to higher volumes of vapor production and release more harmful chemicals. The AMA also wants nicotine to be prescribed only by the patient's own doctor and not by other providers. And this is ineffectively almost completely prohibits vaping, as very few doctors will issue prescriptions. So overall, the AMA recommendations will fuel the black market. They'll increase youth access and lead to more smoking. Even fewer smokers will be able to purchase vapes legally, and the government will also lose millions of dollars in taxes. The winners will be the black market and the criminal gangs behind the illegal imports.

Joanna: Thank you, Colin. That's all for today. Tune in next time here on or on our podcast. You can also find transcriptions of each episode on the GFN TV website. Thanks for watching or listening. See you next time.