6 Mar 2023

RNZCGP calls for vapes to be prescription-only

2:11 pm on 6 March 2023
Man vaping while driving a car is seen in Gdansk, Poland on 9 July 2019

In Australia, nicotine vapes have been classified as "prescription medicines" since October 2021. File photo Photo: AFP

Doctors, public health experts and schools are among those calling for New Zealand authorities to make vapes prescription only, like in Australia.

However, some warn that hardline approach has simply created a black market.

Australia's Therapeutic Goods Administration is considering further tightening the loopholes to stamp out illicit vape sales and stop them getting into the hands of children.

Royal New Zealand College of General Practitioners (RNZCGP) medical director Bryan Betty would like vapes to be strictly a smoking cessation tool - restricted to pharmacies or available through Quitline, like nicotine patches.

"That way it would be associated with appropriate education, and appropriate discussions as evidence becomes available of potential long-term harm of vaping."

The Health Ministry sees switching smokers to vaping as critical to its goal of making New Zealand smoke-free by 2025.

Smoking-related diseases kill 5000 New Zealanders a year - that is 13 people every day.

However, while vaping is considered to be safer, it is not without risk.

Dr Betty, a Porirua GP, said it could be years before the full health impact was known, but problems were already coming to light.

"A lot of the vapes are high in nicotine, which is very addictive. We're starting to see the emergence of young people who are vaping who are finding it very, very difficult to come off the thing itself."

Dr Bryan Betty of Porirua Union and Community Health.

RNZCGP president Bryan Betty would like vapes to be strictly a smoking cessation tool. Photo: RNZ / Karen Brown

Vaping can make asthma and other lung diseases worse.

"Young women who are on the oral contraceptive we know have a slightly higher risk of deep vein thrombosis or blood clots," Dr Betty said.

"What has started to emerge is that vaping could increase that risk by three times."

In Australia, nicotine vapes have been classified as "prescription medicines" since October 2021.

University of Sydney School of Public Health associate professor Becky Freeman said the industry had found a way to get around the requirement for prescriptions, by selling so-called "non-nicotine" vapes.

"Of course, they are nothing of the kind," Freeman said.

"But the only way to tell the difference between the two is to test them in the lab. And of course that's makes enforcement difficult, you have to go and see the product, take it back to the lab, confirm it breaks the law and then go back and seize all the rest of the product for sale.

"By then the shops has probably moved on to other products. So it's been a complete unfortunate mess."

Freeman, who leads the Generation Vape research project, said the simple answer was to ban imports and sales of all vapes without a prescription.

Australia's Therapeutic Goods Administration has just carried out public consultation on proposed reforms to border controls, pre-market assessment, and banning certain flavours or labelling.

"If we sort of dilly-dally for much longer then I think we will be in the same position as New Zealand, where you have a whole generation full-blown addicted, and we had a chance to shut the door and we didn't," Freeman said.

Asian girls students writing test exams on paper for Admissions in high school with uniform student in row seat School classroom of Thailand,

A national survey of Year 10 school students showed daily vaping increases were especially high for Māori girls. File photo Photo: 123RF

According to the most recent New Zealand Health Survey, the number of young New Zealanders aged 15 to 17 who vape every day tripled in two years, from 2 percent in 2018-19 to 6 percent in 2020-21.

For young adults, aged 18 to 24, daily vaping increased from 5 percent to 15 percent.

Another national survey of Year 10 school students showed these increases were especially high for Māori girls. About one in five Māori girls aged 14 to 15 reported vaping daily in 2021.

Increases in regular vaping (that is at least monthly) were also large, particularly for Māori, with girls going from 19 percent in 2019 to 41 percent in 2021, and boys from 19 percent to 31 percent.

University of Otago tobacco control researcher professor Janet Hoek said vaping was being heavily marketed at young people in New Zealand.

"Disposable vapes are very inexpensive, they're beautifully designed, very colourful and visually appealing and they target young people," Hoek said.

"So I think if we got rid of disposable vapes, we wouldn't be doing a disservice to people who smoke and we could be doing a lot more to protect young people."

Professor Janet Hoek

University of Otago tobacco control researcher professor Janet Hoek says she is keen to see vapes made less available now. Photo: Supplied

While not ruling it out, Hoek said she would like to see more evidence on the impact of Australia's prescription-only regime before endorsing such an approach in New Zealand.

However, she was keen to see vapes made less available now.

"The government needs to take action now to get vapes out of dairies and petrol stations, have fewer vape stores, ban window displays and beef up the age validation process and ban disposable vapes."

Principals Federation president Leanne Otene said schools would welcome any moves to take vapes out of the hands of children.

"Vaping isn't something that we're only seeing in high schools, vaping is prevalent in our intermediates as well. They're vaping on the way to school. Intermediate principals are telling us it's a big concern and one of their daily worries is people are vaping, vaping in bathrooms."

The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) has been lobbying hard against a further crackdown on vaping in Australia.

Executive coodinator Nancy Loucas - who also heads the Aotearoa Vapers Community Advocacy group - said Australia's problems were due to the fact the law had created an unregulated black market.

"Australia is a failure. In New Zealand, what we have is a pretty good robust regulatory scheme. The issue is the enforcement. We need to really work on getting that done," Loucas said.

"Because if the regulations were enforced as written, you and I would probably not be having this discussion."

CAPHRA would support restricting vape sales in New Zealand to specialist shops, where smokers could get informed advice on how to quit, Loucas said.

New regulations for vape retailers requiring strict record-keeping came into play at the beginning of this year, and more red tape is likely on the way with suggestions the government could look at proposals for marketing and locations restrictions.

What do vapers think?

Where once office workers on a quick ciggie break skulked furtively in doorways, vapers are everywhere, lounging on park benches, or trailing clouds of strong-smelling vapour as they stroll along the street.

Wellington woman Michelle Mitchell, who has never smoked in her life, took up vaping two months ago and was shocked by how quickly she found herself hooked.

She supports the idea of making vapes only available on prescription, to people trying to quit smoking.

"Based on how quickly I took it up, a prescription would be ideal," she said.

"If it was prescribed, I wouldn't go through the effort of getting a prescription myself.

"It's extreme the number of people vaping, and lot are like me, they didn't smoke beforehand.

"So it's just the ease of getting it and the availability makes people take it up, but they wouldn't if you couldn't just go down the street and buy one for $10."

However, recreational vaper Leo Fauvel was skeptical a prescription-only regime would curb demand.

"I don't think it's really necessary, it will just form some kind of black market, I feel like people who want vapes are going to get them regardless."

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