Why the Northern Territory should urgently embrace vaping nicotine
Posted on April 11, 2023 By Colin
THE NORTHERN TERRITORY GOVERNMENT is seeking submissions on vaping for a Parliamentary Inquiry. This is long overdue. Vaping could help to reduce the shamefully high smoking rate in the Territory especially for Aboriginal smokers, but was completely overlooked in the Northern Territory Tobacco Action Plan 2019 – 2023.
The Northern Territory has the highest smoking rate in Australia. In 2019, 14.9% of Territorians smoked daily, compared to the national average of 11%. People living in the Northern Territory are more than twice as likely to suffer from a tobacco-related disease than people living anywhere else in Australia.
It is essential that all options to help smokers quit are on the table, especially for smokers unable to quit with conventional treatments and for disadvantaged populations.
The Indigenous smoking crisis
Tobacco smoking is especially deadly for Aboriginal Territorians of whom 50% smoke daily (18+). In 2017, 49% of Northern Territory Aboriginal mothers smoked in the first 20 weeks of their pregnancy
Smoking is responsible for 20% of the Indigenous-non-Indigenous health gap.
Aboriginal people in the Northern Territory have a life expectancy 15 years less than the general population, with the gap unlikely to be eliminated for a further 60 years.
Lessons from New Zealand
Since vaping was legalised and regulated in New Zealand in August 2020, daily smoking in Māori people declined by an unprecedented 30% (28.6% in 2020 to 19.9% in 2022), largely due to vaping
Similar results could be expected if vaping was available to Aboriginal Territorians
The overall smoking rate in New Zealand adults (15+) fell by an unprecedented 33% from 11.9% in 2020 to 8% in 2022 and vaping was a major contributor to this decline. In contrast to this, the daily smoking rate in Australia declined by 1.7% per year from 2013-2019.
Submissions to the Inquiry
The Inquiry seeks information on specific issues, in particular for young people
1. Vaping rates
The key measure of concern is "frequent vaping by never-smoking youth". No data are available for the Northern Territory. However, a recent study in NSW found that current vaping by young people aged 15-30 who have never smoked is rare. Less than 1% (8/1,006) of non-smokers had vaped once or more in the last month.
Studies in other countries have found most vaping by never-smoking adolescents is occasional and transient. Frequent vaping by never-smokers is rare and is mostly <2%
Population and modelling studies suggest that rather than being a gateway to smoking, vaping is diverting young people away from smoking.
2. The health impact of vaping
It is well established that vaping nicotine is substantially less harmful than smoking. Smokers who switch to vaping have substantial improvements in health.
The UK Royal College of Physicians and Public Health England estimate vaping to be no more than 5% of the risk of smoking
The precise long-term risk of vaping will not be fully known for decades, but it is highly likely that it will be substantially less harmful than smoking
There is no evidence that vaping nicotine causes serious harm in young people. Most use by young never-smokers is infrequent and short-term and is therefore associated with lower exposure and risk than regular or sustained vaping. Young smokers who switch to vaping are likely to see health benefits.
In animal studies, nicotine has been shown to harm the adolescent brain but there is no evidence for this in humans. A small minority of non-smoking youth develop nicotine dependence but vaping is not creating a “new generation addicted to nicotine”.
3. The effectiveness of vaping
A review of 171 studies of all quit smoking treatments by the UK National Institute for Health Research concluded that vaping was the most effective singe therapy available
The latest Cochrane Review found high-certainty evidence that vaping is more effective than nicotine patches and gum.
4. Discouraging youth uptake
Appropriate messaging to youth should be honest and proportionate (see here). There is no place for exaggeration or scare campaigns. Appropriate messages for youth include
- Vaping is an adult quitting aid
- Young people should not smoke or vape
- Vaping can have harmful health effects especially with long-term use but vaping is far less harmful than smoking
- Vaping nicotine can cause dependence but it is less habit-forming than smoking
- If you are already a smoker, vaping can help you quit
5. Best practice regulation
Regulation should make quality vaping products easily available to adult smokers, while restricting access for young people.
The preferred approach is an adult consumer model, regulated tightly and proportionate to risk. Vaping products should be sold to adults smokers and vapers without a prescription by licensed retail outlets.
There should be strict age verification and harsh penalties and loss of licence for underage sales. The rampant black-market would diminish and access to vaping products for young people would reduce.
Submissions to the Inquiry
Please make a submission to the Inquiry. The deadline for submissions is Friday 26 May 2023.
Guidelines for making a submission