Australia’s vape crackdown was supposed to curb youth use—but in practice, it has created prohibition by proxy. While still legal, access to nicotine vapes is tightly controlled and choice is so severely limited that over 90% of all vapes in Australia are purchased on the black market.
In this episode of GFN Interviews, Australian GP Dr. Carolyn Beaumont examines how this system frustrates access to safer nicotine—from restrictive product approvals to medical guidelines that offer little real support for harm reduction.
Featuring:
DR. CAROLYN BEAUMONT, MD
Australian General Practitioner/Family Physician
Transcription:
00:02 - 01:10
[Brent Stafford]
Hi, I'm Brent Stafford and welcome to another edition of RegWatch on GFN.tv. Two years ago, the Australian government embarked on a sweeping plan to stem the tide of the so-called youth vaping epidemic by implementing a nationwide ban on all nicotine vapes except those sold at the pharmacy. The fallout from Australia's vape ban has been severe, leaving smokers with few choices. Make do with limited safer nicotine options available through pharmacies, purchase nicotine vapes from the black market, or return to smoking. Joining us today to discuss these tough choices is Dr. Carolyn Beaumont. Dr. Beaumont is an Australian general practitioner and family physician working on the front lines of tobacco harm reduction. She is one of the few medical doctors in the country willing to prescribe nicotine for smoking cessation. Dr. Beaumont, great to see you again. Thanks for coming back on the show.
01:11 - 01:13
[Carolyn Beaumont]
Hi Brent, great to be here. Thanks for having me back.
01:14 - 01:23
[Brent Stafford]
So Dr. Beaumont, when we last had you on the show, we discussed how you prescribe nicotine vaping products to your patients. Are you still seeing strong demand for that?
01:24 - 01:42
[Carolyn Beaumont]
Not really, but my telehealth service, Smoker Health, hasn't been active for over a year now for a variety of reasons, but I certainly still see a number of smokers in my clinic. There are still several online vape prescribers available and they dispense products as well. They do report sales as being modest.
01:43 - 01:45
[Brent Stafford]
So in your opinion, have things kind of slowed down?
01:46 - 02:08
[Carolyn Beaumont]
Well, they had never really ramped up, to be honest. The online vape sales have never been strong for all the various prohibition by proxy reasons. So look, they've just been low from the start and they're still quite low, to be honest. There's a stable trickling market of regulars, but that's probably about it.
02:09 - 02:20
[Brent Stafford]
So before we get into Australia's current policy, I understand you're working on a new book, Unfiltered, interviews with doctors about the harms of smoking. Tell us about that.
02:21 - 04:18
[Carolyn Beaumont]
Yes, look, it's been a project in my mind for about almost four years now, but becoming a reality in the past year. Essentially, look, it's based on the fact that most readers have the attention span of a goldfish. So anything that someone reads, it's got to be entertaining. Each chapter needs to be short, relevant. This has to get to the point. But the idea is that it's written assuming a doctor is reading it, but it's actually designed for the general public as well. And I want it to both uncouple nicotine from smoking related harms, but also to portray a much deeper picture of the harms of smoking and in a way that extends far beyond lung cancer lung disease, heart disease. Of course, those things are crucial, but those things can seem less relevant to younger smokers. The 20 to 40 year old smoker sort of thinks, maybe I'll stop when I'm 40. In reality, there are many, many smoking harms happening all across the lifespan. And so it's an interview collection. I'll be interviewing probably about 10 various specialists in Australia and other 10 overseas. And it's across various fields, so general medicine, So vascular surgery, cardiothoracics, we're looking at respiratory medicine, oncology, reproductive medicine, trauma surgery, really covering the expanse. Also looking at the medical guidelines about why doctors unfortunately can't trust them in terms of smoking cessation. We're going to do a deep dive into the public health, the consensus issues, Bloomberg, World Health Organization, all the things that should know about, but we never get taught about.
04:18 - 04:28
[Brent Stafford]
So based on your understanding of doctors' knowledge, are they very in tuned with tobacco harm reduction in the role of safer nicotine products?
04:29 - 05:07
[Carolyn Beaumont]
Well, in Australia, no, not at all. So Look, certain sectors of healthcare professionals are very receptive, those working in mental health. As you can expect, they have a much more real world understanding of things that they see the real impact of chronic use of all sorts of substances, really. And I found one-to-one conversations with doctors. Again, they're receptive. They know me. They're receptive. But it's hard to get that mass reach. And unfortunately, there's just not the support of the main medical guidelines.
05:08 - 05:15
[Brent Stafford]
So let me ask you, is prohibition now the law in Australia when it comes to nicotine vaping?
05:15 - 05:41
[Carolyn Beaumont]
No, it's not the law. I mean, look, there are strict laws prohibiting the marketing, the advertising of any nicotine-containing product. But it's, again, it's what I call prohibition by proxy. So via several mechanisms, yes, essentially they're prohibited. So mechanisms such as the public health consensus against it, again, the advertising restrictions, the lack of education.
05:41 - 05:49
[Brent Stafford]
prohibition by proxy, that's a pretty good way to describe it, actually not just in Australia, but in other countries too as well.
05:50 - 06:30
[Carolyn Beaumont]
Yes, yeah. I mean, there are other similar terms, but it's, you know, it encompasses all of the mechanisms which aren't by themselves prohibitive but when you put them all together the the outcome is a prohibition and it also it's um and it's it becomes a very clever way for the government to say look we're not prohibiting these substances we've got perfectly reasonable measures in place to help reduce youth uptake, but also address smokers' needs. But in reality, this prohibition by proxy just means that smokers' needs never get met.
06:32 - 06:38
[Brent Stafford]
Is that the intended outcome, is to do everything but actually prohibit it?
06:40 - 07:18
[Carolyn Beaumont]
Well, it's... always hard to know what discussions are actually happening behind closed doors and you know one suspects there must be a mix of um zealotry some may argue idiocy and hubris um some may argue uh over reliance on tobacco excise but for whatever reason There are a number of policies that ultimately lead to a very prohibitive, very negative narrative about the role of vaping and the whole category of reduced risk products for smoking.
07:18 - 07:29
[Brent Stafford]
So you live in Australia. You happen to be a vaper. You want to participate in the legal system. Describe for us what that process looks like. Where do you go? What's available?
07:30 - 08:49
[Carolyn Beaumont]
Well, the first thing is you need to even know that the legal system exists. And that's the first massive barrier. So, you know, over the years through my telehealth and now just through general work in a clinic, so many discussions I have with smokers or people who use the black market vapes, they have no idea that pharmacy vapes exist. No idea whatsoever. And they're amazed when they know about it. And when I just briefly described the safety differences between the black market vapes and the pharmacy vapes, let alone the safety differences between vaping in general. and smoking. The next step is where you can go to a physical pharmacy in theory and pick up a vape. And there are some that you can get without a script. So even though we say script is needed, there are some you can get if they're under 20 milligrams without a script, but that assumes the pharmacist is participating in the program. Not many do. So there are quite a few online prescribers and they're an only one prescription and pharmacy set up. And they're not hard to use, again, once you know who they are. But again, they can't advertise. So that's the problem. Once I point people in the right direction, it's really straightforward. But it's knowing they exist. That's the problem.
08:49 - 08:54
[Brent Stafford]
So when it comes to the legal products, are we talking about real choice or is it limited?
08:55 - 10:00
[Carolyn Beaumont]
Yeah, again, it's that's it. that difference between what is allowed on paper and all the prohibitive policies that lead to what's actually available. So on paper, there's approximately 10 authorised brands available, up to 50 milligrams per mil, which is very reasonable and very generous. We can get them in tobacco, mint or menthol. And across those different brands, there's quite a nice variety across the different flavours. So someone can have quite a crisp menthol or a much milder, sweeter menthol or mint. So it It's not bad. Obviously, we don't have other flavors, but given other countries are similar, maybe we're not much worse. But unfortunately, because of various, you know, contractual elements, maybe with some of the larger vape products and large pharmacy chains, only one main brand is really available in the pharmacies is occasionally a second or a third one. So of the 10, Very few can be accessed except through these online pharmacies.
10:02 - 10:05
[Brent Stafford]
So what about mango and strawberry and dessert flavors?
10:06 - 10:58
[Carolyn Beaumont]
No, no, no, no, no, no such luxuries exist in Australia, unfortunately. And I say unfortunately because flavor choice is fundamental to the satisfaction of vaping, the smoking cessation. Doesn't need to be a crazy range of flavors. So we've got tobacco, mint or menthol. But in reality, many experienced vapers will buy unflavored nicotine up to 50 milligrams through the online pharmacies, and then they'll order their own flavors often through food supply shops or various other sources. But that doesn't really apply to new people to vaping. So current smokers who might be transitioning across, they're not going to be comfortable and I'm certainly not going to be comfortable advising them to explore DIY flavours.
10:59 - 11:05
[Brent Stafford]
Dr Beaumont stepping back are the anti-vaping forces in Australia winning right now?
11:06 - 12:03
[Carolyn Beaumont]
Look yes I'll say they're winning but what is their definition of winning? You know it's true that youth vaping rates have decreased over the last few years from their sort of COVID pandemic peak And if that's their sole goal, then yes, well done to them. Snaps. But anecdotally, you know, youth believe that vaping is as bad or as worse than smoking. That's not a win. And adult smokers and illicit users deny the information and access to regulated vapes. Smoking rates have effectively plateaued. And this is in stark contrast to comparable countries such as the UK and Canada and New Zealand. So to me, winning is ultimately a smoke-free country, whatever it takes. That's where the true health gains will be made. So it's simple. You need to just keep that one goal as a sole driver of policy and everything else will naturally follow. And so in that sense, no, the anti-vaping forces aren't winning.
12:04 - 12:08
[Brent Stafford]
Can you characterize the way in which they're fighting the battle?
12:08 - 12:47
[Carolyn Beaumont]
So I'd say they're fighting a virus. A very well coordinated campaign of misinformation and fear mongering about both vaping and nicotine itself and at the expense of not talking about the harms of smoking. And the degree of coordination, the similarity of language across various public health campaigns, the posters you see, the signs at the bus stops, the school education campaigns, what the Lung Cancer Society is saying, it is so lockstep that there has to be some sort of coordination of messaging.
12:49 - 12:54
[Brent Stafford]
And is that essential to their prohibition by proxy plan?
12:54 - 13:35
[Carolyn Beaumont]
If one were to argue that it is a definite plan, Yes, I mean, let's say any campaign needs to have consensus and unity of message, doesn't it? Whether it's a political campaign or a military campaign or any other. So yes, they've got it down to a very well-honed art that vaping leads to smoking, that vaping is addictive, that vaping leads to mental health issues, that vaping is damaging to your lungs. they just keep saying it over and over and it becomes ingrained almost like a Pavlovian response.
13:36 - 14:06
[Brent Stafford]
So you mentioned that the youth vaping rates in Australia have started coming down, which of course, youth vaping is the justification for Australia's so-called vape ban. So let's take a look at this vaping epidemic. I've got an article here by The Guardian from last November. The headline, teenage vaping has turned a corner in Australia, says Mark Butler, as data shows falling rates. Dr. Beaumont, who is Mark Butler?
14:07 - 14:38
[Carolyn Beaumont]
So Mark Butler is Australia's Federal Health Minister since 2022. But he wears a number of hats. He's the Minister for Health and Ageing and Disability in our National Disability Insurance Scheme, as well as being Deputy Leader of the House. He inherited the vape script model from his predecessor, Greg Hunt, but Butler tightened the script requirement. And I guess in a hugely impactful measure, he removed the overseas importation as well.
14:39 - 15:01
[Brent Stafford]
So the government is pointing to data from the Cancer Council's Generation Vape Study, which is showing that youth vaping has fallen from 17.5% in early 2023 to 14.6%, and more recently among 14 to 17-year-olds. Let me ask you, is that significant?
15:02 - 15:24
[Carolyn Beaumont]
Sure, it is. And it certainly points to look, there's a modest decrease and it points to a certain effectiveness of their campaign. As I said earlier, at what cost? It's likely that there's probably less experimental use, but it's yet to be seen if that experimental use would have ever translated into a long-term dependency, let alone being a gateway to smoking.
15:24 - 15:43
[Brent Stafford]
In reviewing the ABC's coverage on this, which I dare say has got to be worse than the Guardian's, there was one article from about a year or two ago where they said that many teens are now starting to stop vaping and they feel very embarrassed that they ever did.
15:44 - 16:33
[Carolyn Beaumont]
Yes, look, I'm hearing that as well, actually, which is interesting. And what I'm also starting to see is a few patients who are in their early 20s and they're now wanting to stop their vaping use. So I anticipate we'll start to see more of that in the coming years. And you're right, I think, you know, that... They are a bit embarrassed. They realise it was just a bit of a silly teenage phase. I guess what I'm not seeing are maybe the more seasoned vapers who probably would have been smoking instead because they're not coming to me wanting to stop. They're just going on with what is quite a satisfying habit.
16:33 - 17:10
[Brent Stafford]
Dr. Beaumont, I want to turn back again to that Guardian article with the teen vaping rates being lowered. The next line I found to be very disturbing, and that is overall rates for people aged over 15 reduced by more than a third, while vaping rates among the 30 to 60-year-old age group also dropped by half. Let that sink in for a moment. Australia's vape ban, intended to restrict nicotine vapes for youth, has led to a 50% reduction in use by adults between the ages of 30 to 60.
17:11 - 18:35
[Carolyn Beaumont]
People should be outraged by this, at the very least they should be questioning. So regardless of how true those statistics are, and we know that any stats can be moulded to suit the narrative, We need to be asking what is that 50% reduction of adult vaping being replaced by and at what cost? So in my clinical work, I have many discussions with adult vapers and smokers. I've got a very good sense of the realities of high smoking and vaping areas such as construction, hospitality and casinos. have a very good sense that, look, some might want to reduce their vaping or quit completely. But what I'm mainly hearing is that illicit vapes are too expensive. They're not vaping, the pharmacy vapes, for all the prohibition by proxy reasons I've talked about. So they're switching from illicit vapes to illicit tobacco. Or they're going from their vaping back to smoking. So they're either... Never smokers who've picked up vaping, but have then now picked up smoking. And that's not an argument that vaping is a gateway to smoking. That's an argument that prohibition by proxy policies mapping leads to smoking. So this is tragic. People should be outraged.
18:36 - 18:58
[Brent Stafford]
Well, we know the black market in Australia has certainly expanded significantly. A combination of the vape ban and sky-high tobacco taxes has created an ideal environment for organized crime, with reports of more than 200 fire bombings and related attacks since 2023. How serious has this situation become?
18:58 - 19:57
[Carolyn Beaumont]
It has become shockingly serious, Brent. So look, I spoke to a couple of Australian experts in this. One of them is Hayley Van Loon. She's the CEO of Crime Stoppers International. And another one is the economist Sinclair Davidson. And what's been really just generally unveiled is that there's a direct link between terrorist groups and Hamas. So for the first time, this direct link has become apparent. And this is to the extent that last year our Prime Minister actually expelled the Iranian ambassador over these things. So this is the degree of seriousness. The firebombing has now expanded beyond just tobacconists to the other businesses owned by them. This is putting the public more at risk than ever. So recent examples include a nail salon, an ice cream parlour in a busy tourist strip. cafes, even major storage facilities are having their warehouses bombed because that's where the illicit products are stored.
19:59 - 20:24
[Brent Stafford]
Dr. Beaumont, as you know, the 13th edition of the Global Forum on Nicotine, the annual conference on safer nicotine products and tobacco harm reduction, takes place again this year in Warsaw, Poland, from June 3 to 5, 2026. The conference theme is prohibition and public health. In your mind, is there a public health consensus on nicotine prohibition?
20:25 - 20:50
[Carolyn Beaumont]
Yes, I believe there is. So if we look at the main players, they're groups like our pharmacy and medical colleges, prominent public health campaigners, the Lung Cancer Foundation, Quitline. They all align with a predominantly anti-vaping and anti-licotine approach using very similar language. I think a marked exception though is our psychiatry college and they are in support of vaping products.
20:51 - 20:59
[Brent Stafford]
So let me ask you then, what are some practical steps that could move Australia away from the prohibition approach and more toward a workable model?
21:00 - 22:37
[Carolyn Beaumont]
Look, I'm both a realist and an idealist. So I keep the ideal goal in mind. And to me, that is for a smoke-free Australia with regulated consumer adult markets for safer nicotine alternatives, complete with massive health improvements that will naturally float. But I'm a realist and I know that this requires a gradual understanding and acceptance of the full toolkit of alternatives for smokers. So for me, say over a two-year period, I've got nine steps that could work. Firstly, let's remove the prescription model for vapes. Let's keep vapes as pharmacy only for now, available on the shelf alongside existing NRTs, restrict to over 18s. The third one would be to keep a strictly regulated model as per the current TGA requirements. Let's add in a small range of flavours, maybe vanilla, mango and berry for starters, for example. Let's test the waters with that. Let's ensure the vapes remain affordable and with a tax proportionate response that reflects the risk reduction. Let's have accredited education programs available from the medical and pharmacy colleges. Let's revise the GP College and Pharmacy Guild guidelines to reflect the broad evidence base regarding the effectiveness and relative safety of reduced risk products. Let's provide a toolkit of resources for healthcare providers and patients to incorporate these products into a smoking cessation toolkit. And public health campaigns should be run without the lies and the fear mongering. They should return the focus to the harms of smoking.