The ban on nicotine vape sales in retail outlets such as vape shops and convenience stores is commendable, preventing ease of access to vulnerable groups such as youth. The potential upside of Pharmacy retail therefore is access to regulated products, in terms of nicotine concentration and plain packaging. However, nicotine vape products are currently an unapproved medicine, and the suggested removal of prescription requirement is asking Pharmacists to sell a product not yet approved for smoking or vaping cessation purposes, with mixed evidence of its success for this purpose.

Nicotine vaping products contain hundreds of dangerous chemicals and the long-term health impacts remain unknown, but the risk of nicotine dependence is evident. The suggested approach would be asking Pharmacists to sell an unapproved medicine for therapeutic purposes. In contrast, current alternative nicotine replacement therapies have undergone rigorous scientific safety trials for this purpose. Placing nicotine vape products on the shelves alongside cold and flu remedies is like placing cigarettes next to paracetamol, making access to highly addictive nicotine products easy.

What is required for the purposes of smoking or vaping cessation, is safe access to regulated products under the guidance of a trained health practitioner with comprehensive ongoing support.

This world first legislation shows Australia has made decisive action in preventing vaping and protecting public health, especially for young people. 

The amended and proposed legislation will end the general retail sale of both nicotine, and non-nicotine vapes, and close loopholes exploited by the vaping industry that made it easy for young people to access addictive and harmful vapes. Vape access will be tightly controlled and all vapes will only be available for sale behind the counter from pharmacies with valid ID.

While it is disappointing that the amended law will now allow vapes to be available as pharmacy-only medicines, instead of requiring users to have a prescription, this legislation remains a world-first approach in preventing easy access to vapes. Monitoring and enforcement will be crucial to ensuring the law prevents retailers from illegally selling vapes.

Our Generation Vape study found that 87% of young people found accessing vapes in Australia, EASY. This legislation means young people will no longer be able to readily purchase vaping products in the very same shops that sell sweets, ice cream, and soft drinks.

Restricting vape access is a public health priority. This law will mean that other vaping prevention efforts, like school-based education and media campaigns, are well supported and more likely to be effective.

It’s important to note that the new legislation will not be going after individual vape users, and a key component of the government’s initiative includes support for people who are addicted to smoking and vaping.

Our own research has shown how dangerous vaping is, these are not innocuous curiosities - these are very well designed nicotine delivery devices, designed to get as many people addicted to nicotine as possible.  

I can only view these proposed changes as an illogical step backwards.  The lack of a prescription now puts the responsibility on a pharmacist to decide who should be able to be dispensed a vape.  Do pharmacists want this responsibility? Are they equiped to deal with the backlash when they say no?  Who pays for the pharmacist's time?   E-cigarettes were a cheap alternative to smoking, and this accelerated their use.  We know that people make choices based on cost, for example Australia had one of the lowest cigarette smoking rates in the world, in part due to the high cost of a packet of cigarettes. If the cost of e-cigarettes at a pharmacist is substantially higher than the black market, the black market will always have customers.  If people can now use a disposable vape with any fear of breaking laws, how will the more expensive pharmacy delivered non-disposable vape be the preferred choice?

The argument made was that a visit to a GP, who may or may not bulk bill, was cost prohibitive, but someone will have to now cover the cost of the pharmacist's time. Of course this might prove to be a lucrative niche area - will tobacconists..ahem.. tobacco-pharmacists be the new norm?  I’m sure if I can see the gap in the market someone else has already thought of the idea: vape only pharmacies.        

There are so many questions.  Without a record of the number of times a person has collected their vape we will have no idea if a person is using these as a quit aid, or as a source of nicotine. What is to stop someone buying from several pharmacies and on selling? Why stop at e-cigarettes, perhaps pharmacists should “dispense” cigarettes too? 

The Pharmacy Guild have now announced that their pharmacies will not participate in the new vaping policy. The developments today represent continuing slow-motion vaping policy collapse, not ‘world-leading policy’ as Minister Butler claims. 

The proposed arrangements still ensure that vaping, a much safer option, is severely restricted while deadly cigarettes remain readily available. This has never made any sense.The primary policy aim has to be reducing smoking-related deaths as fast as possible.

In 2020 New Zealand decided to make vaping more available than cigarettes. Their smoking rate almost halved in the next 4 years, twice as fast as the decline in Australia’s smoking rate. Vapes in NZ are attractive, accessible and affordable. Vapes are sold there from speciality licensed retail outlets with strict age verification. 

Australia has a flourishing vape black market and now has substantial and increasing violence from criminal gangs fighting for control. The ALP and Coalition governments have stuck to a policy which could never work.

This new level of restriction of the sale of nicotine vaping products in the community will benefit the health of many Australians, whilst maintaining access to adults for the purpose of tobacco smoking cessation. Directing access via pharmacies will provide a point of contact for people seeking pharmacotherapeutic support for their tobacco smoking cessation. The removal of prescription requirement for adults via this route will alleviate some perceived barriers from the current approach. However, we will need to closely monitor how this affects youth access of these devices, as clear public health concern for younger Australians and those highly susceptible to the addictive nature of nicotine vaping.

The vaping ‘epidemic’ among young people has been driven by the ease of access to these products and their sheer abundance on the market. The new vaping reform bill passed in parliament today is, unfortunately, unlikely to stem this supply: adults will be able to buy vapes through pharmacies without a GP prescription, which essentially opens a door for continued supply to young people.

Even if young people can only access via prescription (when clinically appropriate), we already know that young people access vapes via older siblings or friends who on-sell them via social media platforms such as snapchat. This new regulation will essentially allow the illicit supply of vapes to young people to continue.

Striking the balance between prevention of youth uptake and reduction of smoking harms via vaping is challenging. We do appreciate that for an important minority of smokers -many of whom already experience significant health, social and financial disadvantage – access to vapes via pharmacies without the additional financial and logistical burden of a GP visit is a win. However, when accessing smoking cessation treatment, discussion with a trained health professional and provision of brief advice is the gold standard, and it remains to be seen if this is going to be feasible in busy community pharmacies.

The Health Minister Mark Butler has announced that Australia’s prescription-only access to nicotine vapes will no longer go ahead and will be replaced by a pharmacy-only model (S3). The THERAPEUTIC GOODS AND OTHER LEGISLATION AMENDMENT (VAPING REFORMS) BILL 2024 appears to have lacked sufficient support to pass in the Senate.
 
This is good news for smokers, vapers and public health.
 
This decision is an improvement over the failed prescription model but is a temporary political solution and is unlikely to be sustainable in the long term. It is likely to be rejected by most vapers due to the limited availability of flavours (tobacco, mint, and menthol), higher costs, and the small selection of supplies in most pharmacies.
 
As a result, the black market, which currently supplies 90% of Australia’s vaping products will continue to thrive and will continue to provide unregulated products to vapers of all ages, including teenagers.
 
Furthermore, the capacity of pharmacists to effectively service the vape market is questionable. Pharmacists have shown little interest in vaping and remain poorly informed about vaping products.
 
The preferred model is for vapes to be sold by licensed retail outlets with strict age verification, like tobacco and alcohol.  This model is implemented in most other Western countries and is supported by the majority of Australian voters.

This will achieve a better balance between two competing goals – improving access to smokers who want to quit using vape, and reducing access to non-smoking youth. From the past few years, we know that the prescription model did not work as intended because it increases the barrier for smokers, but at the same time did not seem to reduce youth access. The next step will be for the government to also restrict access to combustible cigarettes, which is the real killer in our country. It still does not make sense that combustible cigarettes are widely available while access to vapes, a much less harmful product, is more restricted.

Allowing people to buy e-cigarettes without prescription from the pharmacies will downplay the continued efforts by tobacco control advocates in recent years. Restricting to the adults-only will not justify the importance of tackling this new tobacco product. Lifting the restriction will pose risks of making e-cigarettes available to non-smokers, who could be the first-time users of tobacco, then shifting to traditional cigarette smoking.

E-cigarettes are deemed to be an effective smoking cessation aid which is also promoted by the tobacco industry, whereas scientific evidence has not provided any evidence so far that smokers were able to quit successfully. Rather they became dual users of smoking and e-cigarettes users. Therefore, having the prescription will regulate the use, so that GPs can make the clinical decision of prescribing e-cigarettes when smokers have tried all other proven NRTs. Such a political decision by the Government will facilitate tobacco industries to be active again and undermine the success of tobacco control in Australia.

This is a missed opportunity to maximise the impact of e-cigarette bans to reduce youth vaping. The watered-down policy will still be important to reduce underage access to e-cigarettes, and the Albanese Government is to be congratulated on taking long overdue action on this issue. However, the change forced by the Greens will weaken the laws, pushing the problem down the line when further action will be needed to address high rates of nicotine addiction among young adults. Nicotine is a highly addictive substance and vapes enable the delivery of large amounts of nicotine. Making such products available without prescription is likely to result in ongoing vaping problems in Australia for the foreseeable future. Australia is a world leader in tobacco control, but is missing the opportunity to be a world leader in vaping control. Our young people will be the ones to suffer the consequences.

Minister Butler should be applauded for finding a workable solution that ensures health practitioner oversight of vaping product supply while reducing a key barrier for people who smoke from accessing products that can help them quit smoking.
 
Pharmacists were at the frontline of the Covid response by delivering vaccines in a way that maintained patient safety while reducing the burden on GPs. Pharmacists are trusted healthcare professionals who will supply vaping products for smoking cessation purposes to adults who smoke, rather than selling to kids as has happened with general retailers supplying vaping products.
 
The Government should also provide resources to enable pharmacies to invest in delivery of comprehensive smoking cessation support to accompany this model for therapeutic vaping product supply.
 
This option should also encourage manufacturers to seek full medicines approval from the TGA for their vaping products to participate in supply without a prescription via pharmacists.

The huge good news is that the cheap, disposable, sickly-sweet flavoured and colourful vapes that magnetically attracted huge numbers of Australian kids will be outlawed, with anyone selling them subject to brutal, deterrent penalties.  All promotions and advertising will also stay illegal. This is a weapons-grade advance.

But the hugely disappointing bad news is that the Greens have flushed the prescription-only access component of the reforms down the public health toilet. Stand by for armies of 18+ entrepreneurs hovering outside pharmacies and buying vapes for kids for a fee. If your child is vaping after these reforms, thank the Greens who feel they knew better than every significant health and medical body in the country.  My heart goes out to visionary health minister Mark Butler, who must be bitterly disappointed.

Mark Butler’s leadership in the vaping arena has been commendable and it’s so disappointing to see that, due to lack of support for vaping reform, his proposed legislation has now been watered down.
 
It seems nicotine vape products will be sold as a schedule 3 drug in a pharmacy. This means no longer will the doctor or nurse practitioner just prescribe the vape drug. Neither will they provide expert guidance regarding their use as a last-line smoking cessation device. Instead, they will be able to be bought by anyone over the counter.
 
Our elected members had a critical opportunity to make these a prescription-only vaping drug. This approach would have made these vaping drugs accessible to people who want to quit smoking while keeping them out of the hands of younger people.
 
It seems that an opportunity to prioritise community health has been lost!

It is disappointing that the Vaping Reforms Bill developed by the Labor Government failed to receive support in its tabled form, especially given the Bill was backed by public health and supported by almost 80 health organisations and experts. A silver lining is that the reforms regarding the retail sale of vapes remain untouched and that from July 1 it will be illegal for unscrupulous retailers to sell any vape or related product, regardless of nicotine content. These products are harmful, especially to those who have never smoked. We must control access to ensure they are kept out of the hands of children.