THE AUSTRALIAN GOVERNMENT has mandated that purchasing e-cigarettes requires a prescription from a general practitioner. This policy aims to regulate e-cigarettes through medical channels to ensure their safe and proper use. However, for e-cigarette companies, promoting their products through medical channels is not easy. This has resulted in a very limited variety of e-cigarette products in the compliant market in Australia, sparking widespread controversy and discussion.

Recently, 2FIRSTS interviewed Australian smoking cessation expert Dr. Colin Mendelsohn, hoping to explore the current status, challenges, and future development direction of Australia’s e-cigarette policies from his perspective. (online article here)

Dr. Colin stated that Australia’s prescription purchasing model for e-cigarettes has hindered legal purchases, leading consumers to turn to the black market and triggering a series of crimes. He pointed out that current regulations are tantamount to a ban, and history has shown that enforcement and border control are ineffective in reducing the supply of illegal e-cigarettes.

He believes that e-cigarettes, nicotine pouches, snus, and heated tobacco should be classified as adult consumer products and sold through age-verified retail outlets, without requiring a prescription, and should be as easily accessible as traditional cigarettes.

Dr. Colin suggested that Australia should classify nicotine e-cigarette liquid as a consumer product, regulated by the Australian Competition and Consumer Commission (ACCC), rather than the Therapeutic Goods Administration (TGA).

The following is the content of the exclusive interview:

2FIRSTS: What is your opinion on the current development of the e-cigarette market in Australia? How has the recent strict regulation of e-cigarettes in Australia directly impacted the market?

Dr. Colin:

The prescription-only model for e-cigarettes in Australia has largely failed. Vapers are required to obtain a nicotine prescription from a doctor and purchase e-liquids and vaping hardware from pharmacies. However, 90% of vapers have rejected this legal pathway, with few doctors willing to write prescriptions. Smokers do not view themselves as needing medical attention, and pharmacies offer a limited range of products at higher costs, further deterring legal purchases.

As a result, most vapers turn to the black market, controlled by criminal networks. This market freely sells to young people, resulting in high rates of youth vaping. A turf war between rival criminal groups has led to firebombing of tobacco and vape shops, homicides, extortion, and intimidation. Vapes have now become the second-largest illicit drug market in Australia, after cannabis.

The regulations have inadvertently increased teen vaping, as the black market has made it easier for young people to access vapes. Vape shops are not allowed to sell e-liquid or vaping devices, causing many to close. The manufacturing industry is also winding down.

The current regulations amount to prohibition and history has shown that further law enforcement interventions and border control have little chance of significantly reducing the supply of illegal vapes.

2FIRSTS: In your opinion, what are the issues with Australia’s current e-cigarette regulations?

Dr. Colin:

The classification of vaping products as medicines is a fundamental problem, creating barriers for adult smokers wishing to quit. Most vapers purchase from the black market, which sells unregulated products, increasing user risk and facilitating youth access. The black market makes it easier, not harder, for youth to access vapes and has led to a rapid increase in youth vaping.

2FIRSTS: You mentioned earlier that the “prescription e-cigarette model is a failure.” Do you still hold this view?

Dr. Colin:

The prescription-only model is a barrier to legal access for adults, resulting in a thriving black market controlled by criminal gangs. It has also increased youth vaping, as young people can easily access black market vapes. The model makes the safer alternative harder to access than deadly cigarettes.

2FIRSTS: In the context of harm reduction in tobacco use, how do you believe e-cigarettes play a role in assisting smokers with the process of quitting?

Dr. Colin:

Vaping is an effective quitting aid, more effective than nicotine replacement therapy and at least as effective as varenicline. It is especially useful for smokers who miss the hand-to-mouth and sensory aspects of smoking. Vaping is a valuable aid for smokers who are unable to quit with other methods. Vaping is the most popular quitting aid in Australia and has the potential to reduce population smoking rates more than any other intervention.

2FIRSTS: How do you assess the difference in health risks between e-cigarettes and traditional tobacco products?

Dr. Colin:

A comprehensive systematic review by the England government in 2022 concluded that “Vaping is “at least 95% less harmful” than smoking, and that “vaping poses only a small fraction of the risks of smoking”.

Most harmful toxins in smoke are absent from vapor or present at much lower concentrations. Biomarkers of toxins and carcinogens in vapers are substantially lower, and health improvements are significant. The risk of cancer from vaping is estimated to be less than 0.5% of the risk from smoking. After 15 years of vaping in numerous countries, there have been no deaths and serious health effects are extremely rare.

2FIRSTS: How do you think the government should strike a balance between public health and regulation of the e-cigarette market?

Dr. Colin:

To balance public health and market regulation, Australia needs to make nicotine vapes accessible for adult smokers while restricting youth access. Regulations should minimise barriers for adult smokers by allowing sale as adult-only products from licensed retail outlets, supporting a wide range of products and flavors, limiting advertising to smokers, and applying low, risk-proportionate taxation.

Strategies to reduce youth access include strict age verification at the time of sale, severe fines, and loss of licenses for sales to youth. Advertising should be restricted and regulated to prevent marketing from appealing to adolescents. Public and youth education should frame vaping as a smoking cessation tool and not for young people or non-smokers. Flavor names appealing to young people should be banned, and packaging should be simple and devoid of bright colors and youth-appealing images. Honest and accurate education on vaping risks should be provided, and mandatory CCTV at points of sale should ensure compliance.

2FIRSTS: What support should the government provide to consumers of e-cigarettes, especially smokers seeking help to quit smoking?

Dr. Colin:

The government should provide accurate information about the relative risks of vaping compared to smoking, encouraging adult smokers to switch if unable to quit with other methods. Practical advice on how to switch and support for vape shops, which offer expert advice and improve quit rates, is essential.

2FIRSTS: You are calling on the government to provide safer alternatives for smokers, including e-cigarettes. Can you share some specific suggestions or plans?

Dr. Colin:

E-cigarettes, nicotine pouches, snus, and heated tobacco products should all be made available as adult consumer products sold from licensed retail outlets with strict age verification, similar to tobacco or alcohol. These products should not require a prescription and should be at least as accessible as combustible cigarettes. Different smokers respond to different treatments, so a diverse range of products is necessary.

2FIRSTS: In your opinion, how should Australia adjust its e-cigarette regulations to more effectively promote public health?

Dr. Colin:

Australia should classify nicotine e-liquid as a consumer product and regulate it by the Australian Competition and Consumer Commission, not the medicines regulator, the Therapeutic Goods Administration. Regulations should balance legal access for adult smokers with restrictions for youth. A tightly regulated consumer model with licensed retail outlets and strict age-of-sale verification is preferred. Vaping products should be at least as accessible as cigarettes, and regulations should reflect the lower risks of vaping.

2FIRSTS: What is your prediction for the future development of the e-cigarette market in Australia?

Dr. Colin:

Under current regulations, the black market will continue to dominate, providing easy access for young people to unregulated and more harmful products. Adult smoking rates will decline slowly, criminal activity will persist, and more smokers will die prematurely.

2FIRSTS: Comparison of Australia’s e-cigarette regulatory policies with other countries? What international experiences are worth learning from?

Dr. Colin:

Australia’s prescription-only model is out-of-step with other Western countries, which regulate vaping products as adult consumer products. Where data are available, this model has led to accelerated declines in smoking and generally lower youth vaping rates.

Australia should look to New Zealand for guidance. New Zealand and Australia have similar tobacco control policies and similar demographics. However, since New Zealand legalised and regulated vaping in 2020, the adult smoking rate declined by 43% from 2020-2023, over twice as fast as in Australia. The decline in smoking has been particularly impressive for the Indigenous Māori population and the most disadvantaged populations. Youth vaping rates had increased prior to regulation and have now started to decline. There is no significant black market in New Zealand and the government collects substantial tax revenue.

 

About the Interviewee

Dr. Colin Mendelsohn was the Founding Chairman of the Australian Tobacco Harm Reduction Association (ATHRA). This physician-founded organization is a health promotion charity focused on raising public awareness about the risk-reducing potential of alternatives to combustible tobacco.

With over 40 years of experience as an expert in tobacco treatment and harm reduction, Dr. Colin Mendelsohn has served as an Associate Professor in the School of Public Health and Community Medicine at the University of New South Wales. Additionally, he was a key member of the Expert Advisory Group for the Royal Australian College of General Practitioners’ National Smoking Cessation Guidelines. In this role, he has provided valuable insights and guidance for the development and updating of cessation guidelines, helping doctors and healthcare professionals more effectively support smokers in quitting.

THE UNPRECEDENTED DECLINE IN SMOKING in New Zealand since vaping was legalised and regulated in 2020 was highlighted in a presentation at the E-Cig Summit in Washington last week. The presentation by New Zealand ASH Director Ben Youdan showed how Australia is falling further behind in tobacco control.

Australia and New Zealand have shared similar tobacco control policies but New Zealand has traditionally had higher smoking rates. However, that has changed in recent years, reflecting the diverging views on vaping in the two countries:

The New Zealand Ministry of Health encourages smokers to quit with vaping and provides practical information on how to succeed. Vapers are treated with respect and support. Youdan said, “In Australia, vapers are treated as criminals or sick people incapable of self-determination”.

Youdan pointed out that in Australia, only 8% of vapers have a prescription, and the vast majority source their supplies from an increasingly violent and dangerous black market. He noted the irony of deadly cigarettes being available at every corner shop and petrol station.

Since vaping was legalised and regulated in New Zealand in 2020, adult smoking rates declined by 43% over the next 3 years, more than twice as fast as in Australia

Daily smoking in NZ and AU (source NZHS 2022, NDSHS 2022/23)

Over this time there was a dramatic decline in Māori smoking rates, as the following figure shows for Māori women. In contrast, smoking by Aboriginal and Torres Strait Islanders has fallen only marginally over the last decade.

Smoking in Māori  women (NZHS 2023)

Youdan pointed out that access to vapes is a social justice issue. People in low socio-economic groups have high smoking rates and high nicotine dependence. It is especially pleasing that the decline in smoking has been notable in the lower SES groups as well.

Youth vaping increased prior to regulation in 2020. Since then there has been a significant decline, while Australia’s youth vaping rate continues to climb.

Youth current vaping (NZHS 2023; NDSHS 2022-23)

It is also important to note that under the current regulations, Youdan said that New Zealand does not have a significant criminal market for vapes – in stark contrast to Australia

Finally, Youdan pointed out that New Zealand is on target to achieve its smokefree goal by 2025. That goal for Australia remains a long way off.

Full presentation

Ben Youdan. Pathways to smokefree New Zealand and Australia. E-cig Summit, Washington. May 2024

AUSTRALIA’S DE FACTO PROHIBITION of vaping has created a rampant black market run by criminals, a sharp rise in youth vaping, and a barrier for adult smokers wishing to quit. The proposed Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024 will only make things worse. Following from the recent Senate Inquiry, Alex Wodak and I have written an open letter to federal MPs asking them to reject the Bill for the following reasons (full letter here).

1. Failure to Protect Our Youth

The current prescription-only model for vaping products has inadvertently created a thriving illicit market that has made it easier, not harder, for young people to access vapes. As a result, unregulated and potentially harmful vapes are freely sold to young people. Youth vaping rates are increasing in Australia and are higher than in most Western countries where vapes are sold as adult consumer products with strict age verification.

2. Escalating Black Market and Organised Crime

The prescription model has unintentionally placed the control of the vaping market into the hands of organised crime, leading to nearly 80 firebombings so far, homicides, and other violent crimes linked to turf wars among criminal gangs. Dr. James Martin, a criminologist from Deakin University, highlighted at the recent Senate Hearing that the model has turned vapes into the second-largest illegal drug market in the country. With law enforcement admitting their inability to effectively control this illegal market, it is clear that a new approach is necessary.

3. Public Support for Regulation Over Prohibition

Recent findings from the April 2024 Redbridge survey reveal overwhelming public support for regulating vapes as an adult consumer product, similar to tobacco. With 82% of voters favouring adult-only regulation and 75% recognizing that the current ban has failed to prevent underage access, it is evident that Australians are calling for a change.

4. Ignoring Expert Advice

The Senate Committee’s decision to ignore submissions from global experts on tobacco harm reduction is deeply concerning.

In her submission to the Inquiry, Professor Nancy Rigotti from Harvard Medical School advised

“Australia should consider switching to a risk-proportionate, adult consumer regulatory model, as other Western countries have done”.

Former Director of the World Health Organisation, Professor Tikki Pangestu wrote “Evidence from many countries where vapes are regulated (e.g. New Zealand, USA, UK), have shown significant reductions in youth vaping numbers. Regretfully, such reductions have not been observed in Australia”.

5. Lessons from New Zealand

In contrast to Australia’s restrictive stance, New Zealand’s regulation of vapes in 2020 as adult consumer products has led to an unprecedented decrease in adult smoking. Youth vaping rates have also declined over the last 2 years. This has not only improved public health outcomes but has also curbed the involvement of criminal elements in the vape market.

Conclusion

The proposed Vaping Reform Bill does not address the underlying problems with vaping in Australia. Instead, it risks exacerbating them. Australian policymakers must consider the evidence and the successful models employed by other Western nations. Rejecting this bill and moving towards a regulated model that allows adult smokers to access safer alternatives while protecting youth is not just a legislative choice—it is a moral imperative aimed at improving public health and safety.

Full letter

Mendelsohn CP, Wodak A. Open letter to MPs and Senators: End Australia’s Dangerous Prohibition Vaping Laws. 21 May 2024

THE SENATE INQUIRY INTO VAPING has recommended that the vaping bill be passed (report here). What does that mean, and what’s next?

The Committee voted in favour of the Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024. If passed in a Senate vote, the bill will ban the importation, domestic manufacture, supply, commercial possession and advertisement of vaping goods.

Voting against the bill was largely driven by the perceived harms of vaping, especially to youth, rather than by the benefits to adult smokers.

The Senate vote

The Senate will vote on the bill either in the current sitting period by the end of next week, or in the next sitting period in June.

Who supported the bill?

The majority vote of the Committee voted to pass the bill. It was no doubt supported by Labor party MPs, but details of other votes are not available.

Reasons for support

The Committee gave these reasons for supporting the bill in its report:

The Committee was “reassured to hear from enforcement agencies that the legislation will “significantly enhance” the ability of law enforcement and health authorities to crack down on imported vaping goods”.

Australian Greens: seeking amendments

The Greens will seek to propose amendments to the legislation, but have not committed to voting either way so far. However they expressed opposition to the bill in principle.

The Coalition: undecided at present

The Coalition appears to be opposed to the bill but remains officially uncommitted and will discuss the bill further in the party room. They said, we “reserve our final position while this policy makes its way through our internal processes”.

The Coalition noted that “the illicit vaping market in Australia is out of control” and involves organised crime. They also noted that vaping models in other OECD countries “to strictly regulate, control, and tax vaping products as an adult consumer product have been proven to control the market and reduce youth vaping”.

Coalition members of the Committee expressed many concerns about the bill:

The Coalition had serious concerns about the process taken by the Committee, such as:

The Nationals: strongly opposed

The opposition of the Nationals was very clear and consistent with its past position. In it’s view:

No doubt there will be considerable internal party discussions over the next week or more, and probably some back-room deals before a final decision is made.

My prediction?

In the upcoming vote in the Senate

I am cautiously optimistic at this stage but political deals could result in a decision going either way.

Report

The Senate Community Affairs Legislation Committee report on the Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024

EMERITUS PROFESSOR SIMON CHAPMAN AND COLLEAGUES are predicting that illegal vapes will virtually disappear in Australia because the Chinese government requires “all exporters to obey the laws of the countries to which they are exporting”. [link Sub 208, Sub 62] A Chinese government report showed that the number of vapes leaving China for Australia fell by 93% in the first 2 months of 2024 after the disposable ban was introduced. [link]

According to Chapman, this is the ‘smoking gun’, and its “All over, red rover”. [link]

Seriously? There is so much wrong with this prediction.

Deliveries from China will continue

Deakin University criminologist Dr James Martin, who specialises in illicit markets says,

”I think it’s beyond doubt that Chinese suppliers will continue to supply the black market here much as they have always done, regardless of the domestic bans”

”Chinese government agencies have a long history of producing statistics that fit with desired government narratives rather than reflecting any empirical reality. [link] The notion that official Chinese government statistics are accurately reporting a decrease in vape exports into Australia is completely fanciful.”

“They certainly haven’t shown any interest in stemming the flow of vapes into the United States despite their restrictions. [link]. This is consistent with Chinese state behaviour in a range of other areas, such as intellectual property protections, where the Chinese formal position is that they respect international law, but they then simultaneously go and violate those laws on an industrial scale.”

Market forces will prevail

Powerful market forces will ensure that the supply of illicit vapes to Australia will continue, just as it does for other illicit drugs, in spite of vigorous and expensive enforcement efforts.

“Illicit drug use is overwhelmingly a demand problem. If demand persists, it’s going to find ways to get what it wants”
Donald Rumsfeld [link]

In the absence of a Chinese government crackdown, Dr Martin thinks vape distributors will continue to ship vapes directly from China. However, if that becomes an issue, deliveries can be reshipped via other countries such as New Zealand.

Reshipping of illicit drugs is standard practice according to Dr Martin. For example, Australia’s annual Illicit Drug Data Report shows that the single largest source for cocaine entering Australia is the UK, not Columbia or Peru where the drugs originate [link].

Large volumes of Chinese vapes can be easily ordered online through wholesalers, for example here.

Some suppliers even offer free shipping if vapes are intercepted at the border, eg here.

Interceptions are uncommon

Only a small fraction of illegal vapes are intercepted at the Australian border. Finding vapes amongst the millions of shipping containers and parcels arriving each year from China is like finding a needle in a very large haystack.

Mango vapes are a low priority for the Australian Border Force. They are more concerned about dangerous contraband such as fentanyl or firearms. They simply do not have the time or resources to detect more than the occasional illegal vape shipment.

Dr Martin says that the criminals only have to get 2 out of 10 shipping containers through customs to make a profit. With odds like that, it is likely supply will continue for a long time.

AUSTRALIA’S HARSH DE FACTO PROHIBITION of vapes has failed to reduce youth access. The youth vaping rate in Australia is higher than in most other countries where vaping is regulated as an adult consumer product.

A review of current youth vaping rates in nearly 50 countries is summarised in the following graph (vaping in orange):

See the bottom of the page for study details*.

If Australia switched from the prescription-only regulations to an adult consumer model, it would make legal vapes more readily available for adults and reduce the black market which is supplying young people.

International trends

Youth vaping continues to rise sharply in Australia.

In contrast, youth vaping is declining in the US, Canada and New Zealand and has plateaued in Great Britain.

What about youth smoking?

Current smoking rates across all countries are at historical lows, as shown in the graph (in yellow), ranging from 2-3.4%. Part of this decline is due to diversion of youth to vaping and away from smoking.

Daily smoking has almost disappeared and ranges from 0.3% in Australia (ASSAD) to around 1% in the other countries, except in the Europe/Central Asian region.

Implications for policy

Australia’s de facto prohibition of vaping is driven by a moral panic about youth vaping but has not been effective in restricting youth uptake which continues to rise

The harsh restrictions have also created a range of serious unintended consequences

The benefit of legalising and regulating the sale of vapes as adult consumer products sold from licensed retail outlets has never been clearer. It would reduce youth vaping, give easier access to adult smokers, reduce the black market and generate government revenue.


Footnotes

* Studies included

The most recent and largest official youth surveys in Australia, the US, England, New Zealand and Canada:

A large survey by the World Health Organisation published in April 2024 from 44 countries in Europe, Central Asia and Canada (data collection 2021-2022), n=279,117

Note that direct comparisons between the surveys can’t be made as they use different age ranges, definitions and are taken at different times.

Exclusions

These studies were not included due to small sample sizes:

THREE EXPERT WITNESSES have told the Senate Inquiry into Vaping that the current vaping black market will continue unabated under the proposed legislation. No level of enforcement can restrict the established illicit trade and reduce its profitability.

All three witnesses recommended that vapes be regulated as adult consumer products sold from licensed retail outlets as they are in other Western countries.

 

Mr Scott Weber, Chief Executive Officer of the Police Federation of Australia, representing 60,000 Australian police officers explained that illegal vape sales are just “not on our radar”.

Government policy “has created a crime” and “law enforcement doesn’t have either the propensity or the inclination to actually enforce it at the present moment.” Police do not have the training or funding to intervene and “don’t know what to do”. Police struggle under “extremely hard workloads”.

He explained their priorities were domestic violence, cybercrime, break-and-enters and that police simply do not have the time to assess and intervene with illegal vape sales.

He said the new reforms will not change anything.

Submission 12

Dr James Martin, criminologist from Deakin University explained that vaping had generated a classic case of moral panic that has led to a “de facto” ban. “The consequences of this ban have been disastrous, with nine out of 10 vapers having already rejected the prescription model and instead sourcing their products from the black market”. Further restrictions “will do nothing to increase the appeal of the prescription model.”

Law enforcement does not and cannot restrict access to the point that consumers who want these products will be precluded from getting them. Rather, markets adapt, and supply goes underground, where it is even more difficult to police. The illegal products that are supplied by the black market are unregulated, meaning that they are more potent, more addictive and more dangerous than their legal alternatives. Increasing penalties and heavier policing do not stop criminal actors from entering the market. They simply allow them to charge more for their services and increase the profits available to organised crime.”

“There is no level of government intervention that is feasible that can impact the profitability of the illicit trade in vapes and tobacco. It’s an absolute disaster, and I don’t think it [enforcement] is feasible in any sense.”

“If those [vape] businesses were able to go back to a previous arrangement or, even better, something along the lines of the New Zealand model, that would decrease the demand for black market products.”

Submission 25

Dr Alex Wodak AM has had considerable experience with illicit drug markets. He explained that expecting the prescription model to work is “a complete fantasy, and it’s a fantasy on several levels”. If there is a strong demand for some substance and if it is easy to subvert the controls, the trade will flourish, and that’s exactly what we are seeing here.” Police are unable to intercept illegal sales even with unlimited resources.

He added that severely restricting a much less dangerous option for nicotine users while a deadly option is available from 40,000 outlets makes no sense.

Simply, the black market can’t be stopped and the new regulations are “unenforceable”

Submission 33

IN MY INTRODUCTORY SPEECH to the Senate Vaping Inquiry on 2 May 2024, I cover two major concerns about Australia’s vaping policy and comment on the blatant misinformation presented to the Inquiry.

 

1. The current de facto ban is not working and will not work with the proposed changes

Ninety percent of vapers have rejected the legal pathway and only a small number of doctors will prescribe nicotine. Supplies are very hard to access through pharmacies.

This has predictably created a thriving and dangerous black market controlled by criminal networks selling high nicotine, unregulated products. This has led to escalating violence as criminal gangs compete over market share.

The black market has created the sharp rise in youth vaping. It has made it easier for young people to access vapes, not harder.

History has shown that further enforcement and border control has minimal effect on the supply of illicit drugs. The only way to significantly reduce a black market is to replace it with a legal, regulated one.

The preferred model is that used in New Zealand, the United Kingdom and other Western countries. In these countries, vapes are sold as adult consumer products from licensed retail outlets with strict age verification, like cigarettes and alcohol. This would reduce youth access, improve access for adult smokers and greatly reduce the black market.

2. We haven’t got the balance right between protecting youth and helping adult smokers

In Australia, vaping policy is driven by a moral panic about the relatively small harms of vaping to a small number of young people

But we need to also remember that smoking is the leading preventable cause of death and illness in adults and vaping is the most effective and by far the most popular quitting aid (2x NRT.

Vaping is a huge opportunity to improve public health

Policies that make adult vaping less accessible, less appealing, less effective will keep people smoking

3. Misinformation presented to this Committee

 I have been appalled at the misinformation presented to the inquiry by health organisations who must know better

 Here are some of the many examples

My written submission to the Inquiry

Mendelsohn C. Submission on Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024

Hansard for Hearing 2 May 2024 (page 9)

THE SENATE INQUIRY INTO VAPING has been inundated with submissions from respected Australian health organisations and academics. However, a closer analysis reveals that many of these submissions are rife with misleading or exaggerated information and lack evidence-based support.

I analysed the submissions from 7 organisations and 3 academics (# 3, 8, 29, 56, 57, 59, 60, 61, 65 and 71). [link] Some of the most common and most egregious claims are described below.

The overriding flaw is that policy recommendations are driven by the trivial harms from youth vaping when youth make up only 5% of the Australian vaping population. [link]  However, policy should be based on achieving the best overall impact on public health. The substantial health benefits of vaping for the adults who make up 95% of the vaping population must not be overlooked.

1. Moral panic about youth vaping

Most anti-vaping submissions emphasise the “alarming” rise in youth vaping. However, the true prevalence is far less worrying. Most vaping by young non-smokers is experimental and transient. Only 3.5% of 14-17-year-olds vape daily, and a significant portion of these are smokers or former smokers. Of all kids who try vaping, half do it only once twice (14.2%). Another 6.3% vape occasionally. [link]

Most youth vaping is experimental or occasional

The risks of youth vaping are also greatly exaggerated. Vaping only carries relatively minor health risks for young people as the dominant vaping pattern is occasional and short-term vaping. [link] There is no good evidence the common claim that vaping causes adolescent brain damage [link] or mental health disorders, except for anxiety and depression during withdrawal. [link]

Concerns about nicotine dependence are also overblown. Rather than a “new generation addicted to nicotine”, only 3-8% of 14-17-year-olds may be addicted. [link]

The widespread alarm about increased vaping by young adults 18-24 years ignores the fact that smoking rates are falling  faster in this group than any other age group, as vaping diverts young people away from smoking. [link]

It should be noted that young people have easy access to vapes because the failed prescription-only model has created a thriving black market [link]

Youth vaping would be greatly reduced if vapes were regulated as adult consumer products, sold from legal, licensed retail premises with strict age verification.

2. Debunking the gateway to smoking

One of the most persistent myths surrounding vaping is its alleged role as a gateway to smoking. However, empirical evidence contradicts this assertion, with smoking rates plummeting in regions where vaping is prevalent. Rather than serving as a gateway, vaping acts as a diversion, steering young individuals away from traditional tobacco consumption—a development that should be lauded for its public health implications. [link]

Youth smoking rates are declining as vaping increases

3. A public health opportunity

Many of the submissions frame vaping as a threat to public health that will undermine progress in tobacco control. This is arrant nonsense. In fact, vaping is a huge opportunity for public health. Vaping has proven efficacy as a smoking cessation aid, driving quit attempts and reducing smoking rates at a population level. The small harms in young people pale in comparison to the benefits for adult smokers. [link]

Modelling studies that compare both the benefits of adults quitting and the harms of youth vaping consistently conclude that vaping is beneficial overall to public health and will save lives. [link]

4. Tackling the black market

Many submissions naively claim that increased policing and border control will effectively cut off the illicit supply. However, law enforcement experts say that a crackdown will have little effect on supply and use of vapes and that the black market will continue to thrive. [link]

Several submissions argue that Australia’s regulations are not a ban or prohibition. However, the harsh regulations amount to prohibition in practice as the overwhelming majority of vapers have rejected the prescription model and source supplies from the black market. [link]

5. Dispelling exaggerated risks

Misconceptions about the risks of vaping abound, often fueled by sensationalised claims and cherry-picked data. Many submissions highlight the presence of “harmful chemicals” without acknowledging that most are at very low levels, and in most cases are below the level that causes harm. [link | link]

Some submissions raise false fears about the serious lung disease EVALI and lung injury, which are not caused by nicotine vapes. [link] The risk of respiratory [link] and cardiovascular disease are exaggerated and misrepresented. There is no evidence that vaping causes seizures as many claim [link] or that it leads to mental health conditions. [link]

6. Reliance on flawed reports

Most anti-vaping submissions lean heavily on the Banks ANU [link] and NHMRC [links] reports. Critical analysis reveals the misinformation and scientific inaccuracies embedded within these reports, rendering them unfit for informing policymaking decisions. Both have been harshly critiqued in peer-reviewed articles [Banks | NHMRC].

A harsh critique of the NHMRC position statement on vaping

The World Health Organisation is also widely quoted, although its credibility on vaping has been severely challenged recently. [link]

7. Disentangling vaping from the tobacco industry

Many submissions attempt to vilify vaping by associating it with Big Tobacco. They claim that vaping is not harm reduction but is a Big Tobacco invention designed to addict children to nicotine.

This, of course, is complete nonsense. Big Tobacco did not invent vaping and only controls 26% of the global vaping market (EcigIntelligence). Vaping is an existential and disruptive threat to the lucrative cigarette monopoly and tobacco companies are transitioning to safer nicotine alternatives in order to compete. This is a good thing. None of the devices used by Australian youth are made by Big Tobacco. [link]

8. Youth vaping in other countries

Some submissions point to an increased vaping rate in Canadian and New Zealand teens since the adoption of regulation to legalise and regulate vaping.

Canada

Canadian youth vaping increased after legislation was introduced in 2018, and opponents claim that legalising and regulating vapes caused this increase. However, this explanation is highly unlikely. The increase is more plausibly be explained by the following:

Youth vaping and smoking in Canada

New Zealand

A similar sharp increase in youth vaping in NZ mostly occurred before the 2020 legislation to legalise and regulate vaping. After the legislation was enacted, youth vaping has started to level out. Critics fail to mention that youth smoking in NZ has almost disappeared (daily smoking was 1% in 2023). Furthermore, the adult smoking rate has declined by 14% per year since 2020, compared to 9.5% per year in Australia. [link]

9. Addressing the environmental impact

Currently most vapes are sold illegally on social media and at retail outlets. Recycling is not an option for these illegal sales.

An industry-funded recycling plan could be introduced under government stewardship if vapes are legalised as adult consumer products sold from licensed retail outlets. This would include mandatory recycling at point-of-sale, incentives for consumers, public education and collection by approved recycling companies. [link]

Conclusion

Many anti-vaping submissions to the Senate Inquiry confuse correlation with causation, exaggerate risks, cherrypick data, draw false conclusions and rely on discredited sources.

The Committee needs to carefully review the information provided and not be misled by rhetoric which does not reflect the growing evidence base. Respected health organisations and academics should be treated with skepticism until proven to be grounded in empirical data and rigorous analysis.

HARSH GOVERNMENT RESTRICTIONS on vaping products amount to prohibition and have created “an extraordinarily large, uncontrollable, and dangerous black market”. Attempts to restrict the market further will almost certainly fail according to leading experts in criminology and law enforcement, Dr James Martin and Mr Rohan Pike.

Dr Martin is a Deakin University criminologist, with special expertise in illicit markets and criminal supply networks. Rohan Pike is a law enforcement consultant who established the first Tobacco Strike Team which later expanded into becoming the Illicit Tobacco Task Force. Both have made submissions to the Senate Inquiry into Vaping (see below).

This IS prohibition

According to Dr Martin, “the current restrictions on vaping amount to prohibition”. Mr Pike calls it “de-facto prohibition”

The prescription model has been rejected by the overwhelming majority of people who vape. However, some anti-vaping advocates still argue that vaping products are not prohibited because you can legally access them with a prescription. Dr Martin says this argument is flawed.

An alcohol prescription for Winston Churchill from the US Prohibition period

“Alcohol was available via medical prescription during the United States’ failed experiment with alcohol prohibition. However, the availability of medical prescriptions did not make alcohol any less prohibited for the vast majority of consumers for whom the black market represented a more easily accessible, affordable, and attractive alternative.”

Booming black market

Dr Martin says “government restrictions on vaping products have resulted in a large and growing domestic black market” which is now the second largest illegal drug market in the country (after cannabis).

“The second largest illegal drug market in Australia”

This highly lucrative market has attracted organised crime groups who specialise in the trafficking and distribution of illegal goods. This has led to “major levels of criminal violence and intimidation, with dozens of firebombings and several homicides associated with the sale of illicit vaping and tobacco products over the past 12 months” Dr Martin wrote.

However, in New Zealand where vapes are sold as adult consumer products from retail outlets, there is very little evidence of an illicit vape market (ASHNZ Senate submission 106). “There is little incentive to operate a supply chain at any commercially viable scale due to effective competition from the legal marketplace”.

A crack-down won’t work

Both experts agree that further law enforcement interventions have little chance of significantly reducing the supply of illegal vapes

“This is because when demand for an illicit good is high, as is the case with non-prescription vapes in Australia, it is not possible for law enforcement interventions to be mounted at such a scale as to sufficiently undermine the profitability of groups engaged in supply” Dr Martin explained.

“The Australian Border Force is already stretched well beyond capacity, with the vast majority of illegal drugs sent to Australia successfully making it past border controls. The Australian Federal Police and state law enforcement agencies have a long list of more pressing crime problems to prioritise” Dr Martin said.

Dr Martin further explained, “Even when criminal networks can be disrupted, the promise of extraordinary profits mean that there are always new criminal actors ready to step in and supply the market”.

Mr Pike agrees. He said “It would be a fallacy to assume additional resources provided to the Australian Border Force and the Therapeutic Goods Administration will have a significant effect on the availability of vapes in this country”.

Other expert groups agree

Conclusion

The prescription model amounts to prohibition and has predictably failed. As Mr Pike said, further restriction in the proposed legislation will only “fuel a black market that creates more harm than good”.

The solution is to establish a legal, regulated market with vapes sold as adult consumer products from licensed retail outlets with strict age verification, like cigarettes and alcohol. A regulated market will ensure a supply of safe, regulated products, reduce access for young people, allow legal access for adult smokers to help them quit and generate tax revenue. The only losers from this model will be the criminal gangs.

We need to learn from history and not make the same mistakes all over again.

Resources

Dr James Martin. Senate submission 25

Mr Rohan Pike. Senate submission 24

Mendelsohn CP, Wodak A, Martin J, Richter R, Pike R. Briefing on the Prohibition of Vaping and Organised Crime. 12 February 2024

Wodak A. The abject failure of drug prohibition. Australian & New Zealand Journal of Criminology. 2014

Werb D. Effect of drug law enforcement on drug market violence A systematic review. Int J Drug Policy 2011


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