Addictive and harmful vapes must never be sold as a consumer good

Strengthening Australia's regulatory framework to ensure all vaping products are only available through a prescription pathway is both a public health priority and a smart policy In his article, Hall [1] proposes abandoning Australia's prescription-only access to vaping products in favour of a consumer product model where vapes could be sold through 'licensed adult retailers (such as tobacconists)'. A consumer model approach would be a costly mistake and would only serve to benefit the very same retailers that have been flouting Australia's vaping laws. We know from our aptly named Generation Vape research study that young people find vapes very easy to access. To clarify the misinformation in Hall's article [1], our study, funded by the Australian Department of Health and Aged Care, New South Wales (NSW) Ministry of Health, Cancer Institute NSW, Mindaroo Foundation and Cancer Council NSW, also includes young adults age 18 to 24 years old, not solely teenagers. The young adults in our study, the population with the highest vaping rates in Australia [2], and most commonly access vapes by purchasing them from a physical retail store, with the majority citing a tobacconist as their last place of purchase [3]. With 81% of young adult vapers in our latest wave of data collection reporting using nicotine-containing vapes, and only 7% saying they have a prescription for their nicotine vape, retailers are illegally selling these products to young adults. Likewise, tobacconists were the most common retail outlet from where 14 to 17 year olds purchased their last vape. We fully agree that young adults are a significant population in vaping regulations, and it is essential that public health prioritises actions that are supported by young adults themselves. Young adult support for policies that restrict where and what type of vapes can be sold has been strong across the Generation Vape waves and has only increased with time. In the latest wave of Generation Vape data collection (February 2024), 86% of young adults either supported or did not oppose, (neutral position) policies to ban the sale of all vapes in retail outlets, a significant increase of 6% from wave 2 (February 2022) [3]. This support has also significantly increased among young adults who vape at least monthly from 60% to 69% and among young adults who smoke at least monthly from 62% to 71%. The Australian Therapeutic Goods Administration permits nicotine vapes to be prescribed by doctors as an unapproved medicine, but these vapes must then be purchased from a pharmacy [2]. This is not a new law, in fact, vapes that contain nicotine have never been legal to sell as consumer goods in general retail shops, like convenience stores, petrol stations and tobacconists. This is because nicotine is classified as a scheduled poison, which means manufacturers cannot simply add nicotine to consumer products, like sweets, soft drinks or mints, and then sell them in shops. Hall reasons that so few people access vapes through the prescription pathway because 'medical authorities discourage their use'. However, the prescription pathway is being actively undermined by retailers who are exploiting a legislative loophole. Non-nicotine vapes have fallen into a regulatory black hole. Vape retailers all across the country, and online, have falsely been selling so-called 'non-nicotine' vapes for years [4]. This has made the prescription-only pharmacy access to vapes system completely unenforceable and unworkable. Why would anyone bother to source a prescription for a nicotine vape, when it is so easy to purchase one from a local shop? The introduction of reforms to close this non-nicotine loophole and treat all vapes the same was made to Parliament at the end of March and will be voted on by the Senate in June 2024 [5]. If the law is passed, it means the end of vape shops, and the end of convenience stores and petrol station selling illegal goods in broad daylight. Vapes will still be available by prescription to smokers who are using them to quit. This will also help to ensure smokers are supported by a health professional, which will increase their chances of a successful quit attempt [6]. Despite the howls of protest from vape retailers, this law is not prohibition. Enforcement will finally be possible, because authorities will no longer be forced to undertake time-consuming and expensive testing of vapes for nicotine before they can seize products and fine retailers for ignoring the law. Earlier this year, the Government successfully banned the importation of all non-pharmacy vapes into Australia, this final phase of the law changes simply closes loopholes and makes enforcement achievable. Authors BF and CW contributed equally to the drafting and finalising of the article text. C.W. has received funding from the Australian Government Department of Health and Aged Care, NSW Ministry of Health, Cancer Council NSW, Cancer Institute NSW and the Minderoo Foundation. B.F. is an Expert Advisor to the Cancer Council Tobacco Issues Committee and a member of the Cancer Institute Vaping Communications Advisory Panel. These are unpaid roles. She has received relevant competitive grants that include a focus on e-cigarettes/vaping from the National Health and Medical Research Council (NHMRC), Medical Research Future Fund, NSW Health, the Ian Potter Foundation, VicHealth and Healthway WA; relevant research contracts from the Cancer Institute NSW and the Cancer Council NSW; relevant personal/consulting fees from the World Health Organization, the Hong Kong Special Administrative Region Department of Health, BMJ Tobacco Control, the Heart Foundation NSW, the United States Food and Drug Administration, the NHMRC e-cigarette working committee, NSW Health, and Cancer Council NSW; and relevant travel expenses from the Oceania Tobacco Control Conference and the Australia Public Health Association preventive health conference. Data sharing not applicable.