October’s vaping ban sees Australia lag even further behind

Asia Pacific’s leading Tobacco Harm Reduction consumer advocacy group has lashed out at the Australian Federal Government for making it increasingly harder for Australia’s 2.3 million daily smokers to quit cigarettes.

“Australia is miles behind many others in the Asia Pacific region, and the UK, when it comes to acknowledging vaping’s key role in beating tobacco. Australia is sadly kowtowing to the World Health Organisation, rather than accepting compelling international evidence,” says Nancy Loucas, Coordinator for the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).

It is illegal to sell liquid nicotine in Australia. Its states and territories possess harsh penalties including very steep fines, in some cases, possible imprisonment for the sale of nicotine vapes without a valid doctor’s prescription.

Many of Australia’s 500,000 vapers have instead been personally importing nicotine vaping liquids via overseas websites. However, that’s all about to change. From 1 October, Australia’s Therapeutic Goods Administration (TGA) is expanding its prescription-only model with customs to clampdown at the border.

“It’s humiliating that all ex-smokers and those desperate to quit will need to seek a medical opinion and doctor’s prescription to access significantly less harmful nicotine vaping products in Australia. It makes no sense when the country’s smokers can buy a pack of cigarettes from any service station or supermarket on a whim,” says Ms Loucas.

What’s more, significant concerns remain over the number of doctors who will be prepared to prescribe, given there are currently no approved nicotine e-cigarettes on the Australian Register of Therapeutic Goods (ARTG).

Doctors will either need to first apply to the TGA for access to the unapproved product or provide a script for three months or less for patients intending to access nicotine vape products through the Personal Importation Scheme.

CAPHRA says Australia and New Zealand’s trans-Tasman rivalry is world-famous but when it comes to Tobacco Harm Reduction policies, Australia is losing.

“New Zealand has legalised and regulated vaping. In contrast Australia is set to strangle smokers’ access the world’s most effective smoking cessation tool. Australia’s total medicalisation approach will cost thousands of lives over the coming decades and urgently needs to be called out at a regional level,” says Ms Loucas.

International evidence also discredits Australian Health Minister Greg Hunt’s claims that the ban will seek ‘to avoid an onramp for non-smokers, especially youth’. CAPHRA says, in reality, it’s the complete opposite – vaping is no gateway to youth smoking, but a leading offramp for adult smokers.

“New Zealand’s 2020 vaping legislation is not perfect. Nonetheless, if you’re over 18, nicotine vaping products are readily available there, with their Ministry of Health strongly supportive of vaping as an effective way to achieving smoke-free,” she says.

World-leading harm reduction expert and advocate, Dr Alex Wodak AM – a Director of the Australian Tobacco Harm Reduction Association (ATHRA) – agrees that it makes no sense to restrict the availability of vaping much more than deadly combustible cigarettes when vaping is a considerably safer option for nicotine.

“The decline in smoking rates has recently begun accelerating in countries supportive of vaping such as New Zealand, the UK, and the US. In contrast, Australian smoking rates have almost flatlined since 2013, despite aggressive tobacco control policies,” says Dr Wodak.

“Try walking through a big Australian city at lunchtime and you can’t help but inhale clouds of second-hand smoke and see office and retail workers puffing on cancer sticks. Having no real alternative is a tragic blemish on an otherwise beautiful country,” says Ms Loucas.

Australia’s Senate Inquiry into Tobacco Harm Reduction last year heard from public health experts, tobacco treatment specialists, and frontline health workers. They told the inquiry that a prescription-only model would never work and only drive vapers back to smoking. Their evidence and experiences were ignored.

CAPHRA says October’s ban will expand the already huge black market for nicotine vape liquids at a time when Australia should be leading the Asia Pacific with progressive health policies to reduce tobacco harm. The Philippines, instead, could soon be the region’s frontrunner with its Senate set to approve landmark risk-proportionate vaping legislation.

“We support pro-vaping Australian MPs, keen to see fewer deaths from smoking, including new Deputy Prime Minister Barnaby Joyce. These MPs are making sure the Government understands the dangerous consequences of its misguided policy. Effectively outlawing nicotine vaping will only drive ex-smokers back to cigarettes,” says Nancy Loucas.

Join the next Asia Harm Reduction Forum on 28 June: https://fb.watch/6gH6Yo51y9/

Consumer groups in the Asia-Pacific region have also launched a petition at change.org/v4v-petition that urges the World Health Organisation (WHO) to respect consumer rights and to stop demonizing Tobacco Harm Reduction options ahead of the next biennial meeting of the WHO Framework Convention of Tobacco Control (WHO FCTC) in November.

Time left for Australia vape buyers is not much in 2021

Australia will level up the difficulty to purchase vapes from China in October 2021. According to news from December 2020, Australians will need a doctor’s prescription to import liquid nicotine from October 2021 under changes expected to affect hundreds of thousands of vapers.

If you’re located in Australia, you’d better stock up enough vapes before the date, in case it gets too hard importing vapes after October 2021.

Key points

  • A prescription will also be required to access nicotine e-cigarettes from October 2021
  • Child-resistant closures for liquid nicotine will also be mandatory
  • The Federal Health Minister says the decision will help to prevent teenagers who were unlikely to take up smoking from turning to vaping instead

The Therapeutic Goods Administration (TGA) has decided that from October 1, 2021 a prescription will also be required to access nicotine e-cigarettes, while child-resistant closures for liquid nicotine will be mandatory.

Federal Health Minister Greg Hunt said the decision would help to prevent teenagers who were unlikely to take up smoking from turning to vaping instead, as well as clarifying the law for people who imported vaping products.

“Nicotine containing e-cigarettes are currently illegal to sell in every state and territory and possession in all jurisdictions (except South Australia) is also illegal without a valid medical prescription,” he said.

“That means that there is a current situation that legally imported materials are then illegally possessed under state law.

“This decision will both reduce the risk of an onramp for teenagers… while rectifying the issue of legal importation but illegal possession.”

Changes resisted by vapers

According to the latest national drugs survey, more than 500,000 Australians are vapers and 2.4 million people have tried it at some point.

Some people who vape have credited it with helping them to quit smoking, and previously warned forcing users to get a doctor’s prescription could encourage them to return to regular cigarettes instead.

They have also expressed concerns that only 14 doctors across the country are currently registered to prescribe liquid nicotine.

Mr Hunt said more doctors could register with the TGA to become an “authorised prescriber”.

“It is important to note that any doctor may currently prescribe nicotine-containing e-cigarettes that can be used by consumers for personal importation,” he said.

“This is not widely understood, and it is an important matter of public information that over 30,000 GPs may currently, and in the future, prescribe nicotine-based e-cigarettes for smoking cessation.”

New Study Analyses How Vapes Are Depicted to Australian Pharmacists


Titled, “How are nicotine vaping products represented to pharmacists? A content analysis of Australian pharmacy news sources,” the current study recognizes that with the growing popularity and use of nicotine-containing vaping products (NVPs), it is of utmost importance that pharmacists have the correct evidence-based information on the products. News media, add the researchers, naturally play a central role in shaping the attitudes and opinions about such products.

“Health effects and safety issues of NVPs were the most frequently mentioned topic appearing in a total of 79% of the stories, followed by NVP-related regulatory issues (47%).”

The research team analysed four leading Australian online pharmacy professional news sources, for articles published between 2007 and August 2019. A combination of qualitative and quantitative research methods was used to identify how the safety, efficacy and regulation of NVPs was communicated.

“We identified and analysed 103 relevant articles. Academic research findings and/or expert opinions were either cited or referenced most often, appearing in a total of 59% of articles analysed, followed by government sources quoted in 41% of articles. Health effects and safety issues of NVPs were the most frequently mentioned topic appearing in a total of 79% of the stories, followed by NVP-related regulatory issues (47%),” read the study Abstract.

Most pharmacy news sources portrayed vape products negatively

“Australian pharmacy news media have more often reported the potential risks than the potential benefits of NVPs. Such portrayal is likely to contribute to misperceptions about the relative harm of NVPs.”

Sadly, concluded the study, the majority of the articles portrayed vaping products negatively rather than positively, placing emphasis on the concern that NVPs have the potential to addict youth to nicotine, rather than highlighting their smoking cessation potential

“Australian pharmacy news media have more often reported the potential risks than the potential benefits of NVPs. Such portrayal is likely to contribute to misperceptions about the relative harm of NVPs. Pharmacy staff need access to unbiased and evidence-based guidance on how to handle customer enquiries regarding NVPs.”

Nicotine import ban

Adding fuel to the fire, last June the Federal Health Minister of Australia Greg Hunt, said that the Department of Health was working with the country’s Border Force towards a ban on the importation of vape liquid containing nicotine. The measure was to go into effect on July 1st, and anyone caught violating this regulation was to be fined $220,000.

This ban would have meant that while vapers would have technically still been able to obtain nicotine e-liquids via a doctor’s prescription, in reality not many would have managed, as only a handful of Australian doctors are willing to write nicotine prescriptions under current laws. Moreover, given the complex and time-consuming requirements of the new plan, even fewer doctors would have been inclined to write prescriptions following these changes, and the findings of the above study confirm this even more.

As soon as this measure was announced, there was outrage and a number of organizations and entities who have harm reduction and public health, as well as 28 Coalition MPs spoke up against the ban. Australian Senator Matthew Canavan and MP George Christensen started a petition to overturn the import ban and to instead have it legalized and regulated.

Ban delayed for six months

Thankfully, in response to these actions Health Minister Greg Hunt has decided to delay the ban by six months. Australian Tobacco Harm Reduction Association Director Dr Colin Mendelsohn said it is a welcome delay. “I think the outrage from the community was just extraordinary. It makes no sense to make a far safer product hard to get.”

Hunt said that the delay to January 1st gives smokers enough “time to talk with the GP, discuss the best way to give up smoking, such as using other products including patches or sprays”. He said that “if still required”, vapers may still get the products by prescription.

Kiwis Urge NZ Authorities to Encourage Australia to Legalise Vaping



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Australia’s Cigarette Sales Plummet While Vapor Rises


Cigarette sales in Australia are plunging faster than any time in history as smokers turn to less-risky alternatives like vaping. There were 410 million fewer smokes sold in the country than two years ago.

Dr Murray Laugesen, a trustee of the End Smoking NZ charity, analysed tobacco company returns that are published by the Ministry of Health and found a remarkable drop in sales, according to an article on NZherald.com. About 2132 million cigarettes were sold last year – 193 million fewer than 2018, and following a 217 million drop the previous year.

The trend is driven by factors including cost and alternative products like vaping e-cigarettes – but needs to be accelerated if the December 2025 goal of less than 5 percent smoked tobacco prevalence is to be met. A 25-pack of cigarettes was Aus16.39 in 2011 and is now about Aus41.89 ($32).

“Continuation of a 9.5 percent annual per-capita decline in tobacco use, suggests the goal will still not be met until at least 2029, four years overdue,” said Dr George Laking, an oncologist and chair of End Smoking NZ. “Success in the goal would imply a further reduction of tobacco imports by 5 per cent per year from 2021 onwards.”

Laking said increasing the cost was one of the best ways to drop smoking rates, but prices had reached a point where doing so might create more harm than good. “Hardship experienced by disadvantaged people is so severe … if everyone in New Zealand enjoyed a middle class standard of living then we would not be in a grey area – we would say, ‘this is the most effective tool that we have,” he said.

Setting aside cost, Laking added that other effective measures would be to reduce to availability of tobacco, and offer hardcore smokers an acceptable alternative. The latter had advanced from nicotine patches and gums to e-cigarettes and “heat not burn” devices, which heat tobacco to lower temperatures than cigarettes.

“Although electronic cigarettes and heat not burn products are not perfect – the best thing is to not use any of these products at all – actually, if we were to convert our smoking epidemic into a situation of people using reduced-harm products, that would actually be a much better situation.”

This month, legislation banning advertising and restricting e-cigarette flavors was passed, 620 days after Associate Health Minister Jenny Salesa promised to regulate the industry in November 2018. The bill will come into effect in November, and will also allow the Ministry of Health to recall products, suspend them and issue warnings.

Laking noted the new legislation sought to strike a balance between helping people quit smoking, and avoiding uptake of vaping and new products by non-smokers including young people.

“You have to strike a balance between those two things, and the question is, where do you strike it and how do you strike it?,” he asks. “Those of us who support vaping-to-quit do often feel somewhat overwhelmed by the barrage of claims asserting the risks of vaping, that are, scientifically, very poorly constructed.”



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Australia Rejects Tobacco Heating Products


The Therapeutic Goods Administration (TGA) in Australia rejected an application from Philip Morris (PM) that would have allowed the sale of heated-tobacco products.
 
This follows the Australian government’s ban on the import of nicotine-based e-cigarettes. Health Minister Greg Hunt planned to implement the ban beginning July 1 of this year, but the ban has now been pushed back to the beginning of 2021 to allow those who have been using e-cigarettes with nicotine to quit smoking combustibles to get prescriptions and end their addiction.
 
The ban would make the import of vaporizer nicotine and e-cigarettes allowable only with a doctor’s prescription.
 
There were 82 submissions in the TGA decision that supported heated-tobacco products, and the U.S. Food and Drug Administration concluded that PM’s tobacco-heating product “is expected to benefit the health of the population as a whole.” The TGA received submissions from the Lung Foundation, Cancer Council Australia, Australian Council on Health and Smoking, and the National Heart Foundation, though, that stated their concerns regarding public health risks of heated-tobacco products. The TGA ultimately decided there were “significant safety concerns with heated-tobacco products,” according to news.com.au.
 
“Study after study shows that scientifically substantiated smoke-free products that do not generate smoke, while not risk-free, are a much better alternative for adult smokers who would otherwise continue to smoke cigarettes,” said Tammy Chan, Philip Morris managing director. “It’s time Australian authorities recognize that many adult smokers will continue to smoke cigarettes—the most harmful way of consuming nicotine—unless the government rethinks its tobacco control policy. Smoke-free products can play a role in reducing smoking rates.”
 
According to Chan, Australia’s stance on smoke-free products is at odds with other countries; heated-tobacco products are available in 50 other countries.



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Australia announces delay on liquid nicotine import ban


Australian health minister Greg Hunt has delayed the ban on liquid nicotine imports that was due to start on July 1.

The ban was postponed until 2021 following backlash from vaping advocates and coalition MPs.

The minister said that the ban will now take effect on January 1, with a ‘streamlined process’ provided for vapers to get a prescription from their GP. 

Nationals George Christensen and Matt Canavan campaigned against the ban on social media.

Meanwhile, Liberals Trent Zimmerman, Tim Wilson and James Peterson spoke to the media to voice their opposition to the ban as they feared it may push smokers back to cigarettes.

A total of 28 coalition MPs and Senators signed a petition opposing the ban which would apply a fine of $200,000 for those who import liquid nicotine without having a prescription in place. 

Vape advocates and advocacy groups including Legalise Vaping Australia, Vaping Bogan, Grimm Green and Legion Vapes all spoke out in a campaign to reverse the ban.

Legalise Vaping Australia tweeted: 

‘@GregHuntMP’s Vaping ban has been postponed! We could not have done it without the support of thousands of vapers like you. The fight is far from over, but this is a HUGE win!”

In a press statement, Mr Hunt said that the sale of e-cigarettes containing vaporised nicotine was banned because of the health dangers reported by Australia’s medical experts and the fears that non-smokers could be introduced to nicotine for the first time through vaping.

Hunt said the ban was introduced in response to medical advice “by ensuring that nicotine based e-cigarettes can only be imported on the basis of a prescription from a doctor”

“However, there is a second group of people who have been using these e-cigarettes with nicotine as a means to ending their cigarette smoking.

“In order to assist this group in continuing to end that addiction we will therefore provide further time for implementation of the change by establishing a streamlined process for patients obtaining prescriptions through their GP.”

The delay will give vapers a chance to speak to their GP to either obtain a nicotine prescription.

Coalition MP, James Paterson welcomed the change, saying:

“Vapers will be relieved to hear they will not be cut off on 1 July from a product that helped them kick the habit.

“Six months gives us the time to put in place a system that ensures anyone who needs access to these safer alternatives can get it.”

Australia’s smoking rate dropped by just 0.2 percent between 2013 and 2016, compared to five percent in England and three percent in New Zealand.

Source: Guardian

Header Image: Donn Gabriel Baleva on Unsplash





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Australia: Melbourne Council to Vote on Vape Ban in Smoke-Free Zones


Earlier this year, Melbourne’s City council had proposed an amendment that if passed, would ban vaping in the city’s 11 no-smoking areas. Lord mayor Sally Capp, had said that the ban would align the city with the rest of the state, where sadly e-cigs are subjected to the same regulations as cigarettes.

The council will be voting on whether the definition of smoking should include vaping, which would mean that vaping would automatically be banned in non-smoking areas.

“E-cigarettes are relatively new but we know that there is a possible link to serious lung disease and growing evidence that e-cigarettes can lead young people to start smoking regular cigarettes,” she erroneously said at the time.

The non-vaping areas would include Bourke Street Mall, the Causeway, Howey Place, Block Place, Equitable Place, Goldsbrough Lane, QV Melbourne, the Tan and Princes Park running tracks, Collins Way and Fulham Place.

Councillor Beverley Pinder inaccurately stated that while e-cigarettes are marketed as smoking cessation tools, there is no evidence to support these claims. “But health experts agree that there simply isn’t the evidence to support these claims,” she said. “E-cigarette liquids contain a range of chemical ingredients and flavours that haven’t been proven safe to inhale, and aren’t regulated, so you really don’t know what you’re inhaling.”

Subsequently, the council will be voting on whether the definition of smoking should include vaping, which would mean that vaping would automatically be banned in non-smoking areas, including the 11 smoke-free zones in the CBD and surrounding areas.

CLA: There is no evidence that second hand vapour poses health risks

Arguing against the measure, Civil Liberties Australia (CLA) said that the council is interfering with people’s choices, and their mandate does not extend to ‘lifestyle control’. Additionally, in a submission to council, the CLA said there was no evidence that brief exposure to e-cigarette vapour in open air harms the health of others.

“The local government role and mandate does not extend to lifestyle control, already exhaustively covered by prohibitionist legislation at the Commonwealth and state levels,” said the CLA submission. “Restricting vaping in the Melbourne CBD would be an additional unjustified intrusion into consumer free choice and autonomy. There is no defensible scientific or medical basis for additional bans and controls and the proposal should be rejected.”

The imminent nicotine importation ban

Sadly, Australia has become synonymous with an unreasonable forbidding stance against vaping, amongst harm reduction experts. Last month, the Federal Health Minister of Australia Greg Hunt infamously announced ongoing talks with the country’s Border Force, about a ban on the importation of vape liquid containing nicotine. The measure was to go into effect on July 1st, and anyone caught violating this regulation was to be fined $220,000.

This ban would have meant that while vapers would have technically still been able to obtain nicotine e-liquids via a doctor’s prescription, in reality not many would have managed, as only a handful of Australian doctors are willing to write nicotine prescriptions under current laws. Moreover, given the complex and time-consuming requirements of the new plan, even fewer doctors would have been inclined to write prescriptions following these changes.

As soon as this measure was announced, there was outrage and a number of organizations and entities who have harm reduction and public health, as well as 28 Coalition MPs spoke up against the ban. Australian Senator Matthew Canavan and MP George Christensen started a petition to overturn the import ban and to instead have it legalized and regulated.

In response to these actions Health Minister Greg Hunt has decided to delay the ban by six months, at least giving vapers a grace period to find alternative smoking cessation aids.  Australian Tobacco Harm Reduction Association Director Dr Colin Mendelsohn said it is a welcome delay. “I think the outrage from the community was just extraordinary. It makes no sense to make a far safer product hard to get.”

Read Further: Mail Online

Australia: Hunt Hardens Opposition to E-Cigs Following US Lung Disease Cases 



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PMI Blocked From Selling Iqos in Australia


It has been estimated that approximately 239,000 people are using e-cigarettes in Australia, 178,000 of whom are vaping more than once a month. This remains a challenge for most, as the devices are legal, but the use of nicotine-containing refills is not. Local public health experts and liberal party MPs alike, have long been efforting to overturn the current nicotine ban.

Studies have indicated that while HTPs are less safe than vapes, they are still safer than combustible cigarettes.

In August 2016, several public health activists amongst which the New Nicotine Alliance (NNA), had submitted proposals to local regulator Therapeutic Goods Administration (TGA), to remove nicotine concentrations of below 3.6% from the Poisons Standard. However, in February 2017, the TGA rejected the application and upheld the nicotine ban.

Sadly, in another stand against harm reduction, the TGA has now also rejected a request for the introduction of HTPs. While the vaping industry itself remains sceptical about the products, since they are manufactured by tobacco companies, studies have indicated that while HTPs are less safe than vapes, they are still safer than combustible cigarettes. And public health experts have long pointed out that the wider selection of safer alternatives available on the market, the better the chances of success for smokers seeking to quit.

Heated tobacco products emit less carcinogens than cigarettes

A recent study comparing the amount of carcinogens between regular cigarettes and heated tobacco products, found that the latter contain about 10- to 25-fold lower carcinogens than cigarettes. On the other hand the TGA claimed that the products would be of “no public health benefit”, had a high potential to cause harm, and were just a new way of delivering nicotine rather than a “quit smoking” product.

Philip Morris spokesman Simon Breheny said the decision was disappointing for Australia’s millions of smokers. “It puts Australia at odds with many other countries who have decided to regulate heated tobacco and smoke free alternatives,” he said. On the contrary, senior from Sydney University’s School of Public Health, Becky Freeman, said that this was the right decision. “The right decision was made,” she said. “They are not some miracle product that reduces smoking.”

The availability of HTPs in Japan, decreases smoking rates

Meanwhile, recent data from Japan, the world’s ninth largest cigarette market, has indicated that the introduction of HTPs has had a remarkable effect in decreasing local smoking rates. “The decline in smoking rates among adults in Japan is astoundingly impressive when you realize that this has only come about rapidly with the introduction of HTPs,” said Nancy Loucas, Executive Director of the Coalition of Asia-Pacific Tobacco Harm Reduction Advocates (CAPHRA).

Read Further: ABC News

Australia’s Vape Ban Delayed Following Protests



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The Vaping Weekly Podcast: Chelsea Boyd of R Street Institute; IQOS MRTP; Australia Update


15 July 2020

The Vaping Weekly Podcast with Michael McGrady is back for Return #3, with Chelsea Boyd.

In this third episode of our second season, I speak with Chelsea Boyd of the R Street Institute. We also chat IQOS approvals and modified risk product approvals.

Also, we dive into the current state of the Australia situation and VAPORESSO’s parent SMOORE International Holdings Limited is one of the first vaping manufacturers to be listed on the Hong Kong Stock Exchange.

For more information, visit www.vapingpost.com.

You can listen to Vaping Weekly on Spotify, Apple Podcasts, Google Podcast, PocketCasts, or wherever you listen to podcasts.



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The Black Market of Vaping

Australia is facing a potential increase to liquid nicotine restrictions, but will this actually reduce harm? Some liquid nicotine users don’t think so.

Fraser is adamant about what’ll happen if he can’t access liquid nicotine: smoking is the last option. “I would figure out a way to get either the nicotine salt, or whatever, to add to liquid, or just go to a place and buy it,” he laments.

“I would still rather go through that than smoke.”

It’s been a stressful three weeks for Fraser. On June 19, the Federal Government announced its intention to further restrict liquid nicotine — which Fraser uses for vaping. Currently, it’s illegal to buy or sell liquid nicotine in Australia, but a loophole exists, via the Therapeutic Goods Administration’s (TGA) Personal Importation Scheme, which allows anyone to import prescribed, but unregulated, medicine from overseas.

Despite never being prescribed, Fraser’s been importing liquid nicotine for the past four years, a measure that’s allowed the 27-year-old to break a six-year smoking habit.

“The goal was to not ever smoke a cigarette,” he explains.

Under the proposed plan — initially set for July 1, now delayed to January 1, 2021 — only a health practitioner or pharmacist can import liquid nicotine on behalf of a patient, strictly as a last measure for smoking cessation.

A decision hitched upon the emerging concerns of e-cigarettes, like how they’ve become increasingly popular with young people in the US and Canada, and how some research suggests e-cigarettes couldincrease smoking rates.

For users, the announcement was met with both rage and panic, Fraser himself purchasing $500 of liquid nicotine in preparation, a supply that’ll last him at least six months.

The delay is a small relief for users like Fraser, but this proposal is just another instance in the much-larger, and heavily politicised, e-cigarette debate. A polarising topic, where one side lauds e-cigarettes as a public health miracle that’ll end smoking, while the other forewarns the unknown, and potential health risks.

But while both sides argue tendentiously about proof and emerging research, the popularity of e-cigarettes in Australia is certain, with estimates suggesting there are at least 97 000 daily users nationwide. People who, for whatever reason, have embraced liquid nicotine and whose access comes from bending the law.

One criticism of these proposed restrictions is they could produce unintended consequences, such as the spawning of black markets or migration to tobacco. Rachel, a 24-year-old from Sydney, told The Feed that she’d rather just buy tobacco, despite transitioning to an e-cigarette eight-months-ago over health concerns, than have to hassle with sourcing liquid nicotine.

“We’ll see increased harms, and I have no doubt about that,” says Dr Alex Wodak, an addiction medicine specialist currently on the Australian Tobacco Harm Reduction Association’s Board of Directors.

But considering the known harms and high cost of tobacco, the emergence of illicitly-created liquid nicotine — a product that’s remained largely neutered by importing — may be the natural response to these restrictions. A scenario that’s concerning, healthwise.

Last year, the US saw a sudden boom of vaping-related lung disease, with over 2800 cases and 68 confirmed deaths as of February 2020, according to the Center for Disease Control and Prevention.

But the majority of these cases, according to studies, weren’t found to be the result of liquid nicotine use, but exposure to vitamin E acetate — an oil used to cut liquid THC. One study from February this year tested the lung fluid of 51 vaping-related lung disease cases. 48 tested positive for vitamin E acetate.

Tainted liquids are one of the infinite potential outcomes that come with a black market. A point not lost on the vaping community, further fueling the frustration towards these restrictions. Even with the risk, for many users, illicit liquid nicotine is the lesser evil, and a more tangible option than quitting nicotine — a difficult habit to break, even with medication.

“At the moment, I have the choice to avoid low-quality juice,” says Drew, a 31-year-old from Sydney. “This ban means I wouldn’t have that choice. And low-quality juice is still a better alternative [than] carcinogenic cancer sticks.”

“If I could actually get a prescription and buy it from a pharmacy: no problem for me,” explains Nicole, a 51-year-old from the ACT. “If not, I’d be perfectly happy to go black market. Risks and all.”

“I’ve stocked up on legal nicotine, so I would be set for at least a year,” says 31-year-old Sam Parsons, a vaping influencer also known as the Vaping Bogan. “After that? I wouldn’t stop vaping nicotine, that’s for sure.”

“You see, I’m transgender. I need [hormone replacement therapy] to be me.” explains Pippa. “If I smoke, my doctor will not, and can’t, prescribe me HRT.”

It’s important to note that liquid nicotine will still be accessible under these proposed changes. If a GP or pharmacist felt liquid nicotine was necessary, they could submit a request to the TGA.

According to a TGA spokesperson, the average length of time for an urgent response to a Special Access Scheme Category B submission, the same form used to request liquid nicotine, has been two to three days over the last 12 months. But that response may not be an approval.

“[It can take] like five working days to get approved, but it’s pretty common to get rejected,” explains a pharmacist who spoke to The Feed anonymously about the Special Access Scheme. “Or, you just don’t hear back for weeks.”

The federal government has expressed their intention to streamline this process, but this also relies on health practitioners actually prescribing liquid nicotine which, considering its illegality and the potential harms that orbit its use, isn’t commonplace.

“[My doctor] told me that under no circumstances would he write me a prescription [for liquid nicotine], and that I shouldn’t be using nicotine in my vape,” says Graeme, a 51-year-old from New South Wales, who’s been using liquid nicotine for two years.

It’s a point that illuminates what few options exist for users beyond a black market, tobacco itself, or quitting altogether. A choice that for users like Fraser, is obvious.

“It’s kind of, the option of what would definitely kill me, and what might kill me,” Fraser summarises. “And I would take the ‘what might kill me option’ any day of the week.”