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Strict regulation of the adult consumer market is the only way to eliminate the black market in e-cigarettes, Australian experts say

Strict regulation of the adult consumer market is the only way to eliminate the black market in e-cigarettes, Australian experts say

2023-05-02

Dr Colin Mendelsohn, a member of Australia's expert advisory group on smoking cessation guidelines and founding president of Tobacco Harm Reduction Australia, has written an analysis of the country's chances of tackling the current e-cigarette crisis.


Two years ago, e-cigarettes were on the fringes of our collective consciousness - a less harmful product designed to help smokers quit.


In just 24 months, we have reached a situation where e-cigarette abuse headlines are scrawled on the front pages of our newspapers every day.


E-cigarettes have come to be seen as a scourge on society.


E-cigarettes are no longer discussed for their life-saving potential for smokers, but as a product to attract a new generation of nicotine.


What has changed?


Back in 2020, the previous government announced new restrictions on e-cigarettes. Smokers will now need to get a nicotine prescription from a doctor to legally switch to e-cigarettes.


The changes come in the midst of Australia's biggest health crisis and a severe shortage of doctors.


Few doctors are willing to prescribe nicotine, few pharmacists are willing to fill it, and both consumers and overburdened health insurance bear unnecessary extra costs.


At the time, I said these changes were dangerous, would severely discourage adult smokers from trying to quit, and would create a predatory black market.


Now, we are already seeing the results of one of the biggest public health policy failures of the last decade.


The black market is ubiquitous, and low-quality, single-use e-cigarettes are blatantly sold to young people across the country.


E-cigarettes are rampant in our schools. And the people who most need to quit are being left behind by the very government that should be supporting them.


The new government in 2022 sees a great opportunity to finally implement progressive tobacco harm reduction policies and support nearly 3 million smokers and 2 million adult e-cigarette users.


Unfortunately, the federal government fell victim to sensational misinformation and ruled out incremental changes that could address the problems now prevalent in our country.


In the dying days of 2022, they announced a consultation with the Therapeutic Goods Administration (TGA), proposing misguided reforms that they said would tackle the black market and make it easier for smokers wishing to quit.


On the contrary, the TGA's proposed reforms will cause further harm to public health as more adult smokers and ex-smokers are forced into the dangerous black market, unleashing its power and putting more young people at risk.


Without making its recommendations public, the TGA is now working with the federal government to advise on these potential reforms.


To be clear, a heavily regulated adult consumer market is the only way to eliminate the black market.


Any other regulatory approach will fail.


Despite the TGA's recommendations, there have been positive developments in effective nicotine e-cigarette policies at both the federal and state levels.


The National Party is putting its power behind a sensible consumer model.


This is an important step and a strong commitment to evidence-based reforms that will work.


In New South Wales, the Greens have unveiled an election pledge to regulate nicotine vape products as consumer goods.


The Tasmanian Greens are also in favour. The New South Wales Labor Party's philosophy of progressive harm reduction is expected to lead to the implementation of equally effective reforms.


We are also being investigated by the Queensland and Northern Territory parliaments on e-cigarette legislation.


Where the TGA consultation has failed, it is hoped that Queensland and the Northern Territory will introduce evidence-based reforms.


For now, the question of how to regulate these products has become an emotional one.


Sentiment and policy never go hand in hand.


Public policy should be based on evidence.


In fact, we know that e-cigarettes are 95 percent less harmful than smoking.


We know in fact that it is the most effective and popular smoking cessation aid. We know that prohibition always leads to a dangerous black market.


With the right regulations, adult smokers and ex-smokers will get these products from safe and regulated markets, with strict protections in place to keep them out of the hands of teenagers.


We are at a tipping point.


The TGA and the federal health department stubbornly pursue policy objectives that can only fail.


But there is hope. Some of our lawmakers are finally pushing for effective reform.


The decisions they make now will either create a growing public health disaster or turn current e-cigarette regulations into a disappearing black spot in our nation's history.


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