A licence to vape: Is it time to trial of a nicotine licensing scheme to allow Australian adults controlled access to electronic cigarettes devices and refill solutions containing nicotine?

doi:10.1016/j.drugpo.2015.02.003

International Journal of Drug Policy

Volume 26, Issue 6, June 2015, Pages 548-553

https://doi.org/10.1016/j.drugpo.2015.02.003 Get rights and content

Highlights

•
We discuss the history of regulation of nicotine for vaping in Australia.
•
Current Australian laws provide two options for regulating nicotine for vaping.
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No products have been approved for sale under option 1 (prescription medicine).
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We propose using option 2 (dangerous poison) to trial a nicotine licence scheme.

Abstract

Australia has some of the most restrictive laws concerning use of nicotine in e-cigarettes. The only current legal option for Australians to legally possess and use nicotine for vaping is with a medical prescription and domestic supply is limited to compounding pharmacies that prepare medicines for specific patients. An alternative regulatory option that could be implemented under current drugs and poisons regulations is a ‘nicotine licensing’ scheme utilising current provisions for ‘dangerous poisons’. This commentary discusses how such a scheme could be used to trial access to nicotine solutions for vaping outside of a ‘medicines framework’ in Australia.

Section snippets

Background

E-cigarettes (also known as personal vaporisers or electronic nicotine delivery systems) have been mass-marketed as a ‘cleaner’ form of recreational nicotine than tobacco cigarettes since around 2006 in the USA, UK and Europe. The use of these devices has grown substantially in recent years, suggesting they have wide appeal to smokers (Yong et al., 2014). These devices work by heating a mixture (or ‘juice’) of propylene glycol and/or vegetable glycerine, nicotine and flavourings to produce an

The legal status of e-cigarettes in Australia

The legal status of e-cigarettes in Australia is complicated (Douglas, Hall, & Gartner, 2015). Australia's regulatory framework for medicines and poisons classifies substances into nine schedules. Nicotine falls under different schedules, depending upon its intended use. Nicotine in tobacco intended for smoking is exempt from scheduling and so are therapeutic cessation aids for oromucosal or transdermal use (e.g. gum, lozenges, mouth spray, patches, etc.). All other nicotine preparations for

As a therapeutic good for smoking cessation

One legal way for Australians to access nicotine solutions for e-cigarettes is via the TGA personal importation scheme for unapproved medicines. This is only available if the person uses the nicotine for therapeutic use (e.g. as a smoking cessation aid or to manage the symptoms of withdrawal of tobacco) (Therapeutic Goods Administration [TGA], 2013a). This scheme allows Australians to import up to a 3 month supply at a time of nicotine as an unapproved medicine without any approval required by

Policy options for regulating e-cigarettes and nicotine

There are a number of policy options for regulating e-cigarettes and non-therapeutic nicotine available to the Australian government. The first option is to maintain the status quo, as described above. This current policy can be criticised on ethical grounds because it effectively denies access to a less harmful alternative to smoking while allowing widespread sale of a more harmful product (cigarettes) (Hall, Gartner & Forlini, 2015). It also does not address the growing illicit market in

A nicotine licensing scheme for non-therapeutic nicotine use

In 2005, Chapman and Liberman proposed a ‘smoker licensing scheme’ that would restrict sales of tobacco to licensed smokers (Chapman & Liberman, 2005). In 2012, Chapman elaborated on the merits of this scheme and argued that a smoker's licence would be similar to how a doctor's prescription provides a temporary licence to purchase and use Schedule 4 medicines (Chapman, 2012). In a published debate on how e-cigarettes should be regulated, Chapman proposed the application of a user licence to

Conclusion

Current Australian regulations prohibit the possession and use of nicotine for non-therapeutic purposes without an approval or other authority. The proposed nicotine licensing scheme could potentially provide Australian adult smokers with a way to legally access nicotine for use in e-cigarettes to reduce their health risk under current poisons regulations without the barriers of medicines regulation. It could also address the risk of child poisonings from inappropriately packed and labelled

Acknowledgement

CG is funded by an NHMRC Career Development Fellowship (GNT1061978).

Conflicts of interest: The authors have no relevant conflicts of interest to declare. This work was completed with no specific funding. Coral Gartner is supported by a National Health and Medical Research Council Career Development Fellowship (GNT1061978).

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We conducted a thematic discourse analysis of 13 online discussion forum threads that discussed e-cigarette use during pregnancy. We focused on the major discursive strategies that forum posters used to debate the safety of e-cigarette use during pregnancy.
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Health professionals should be aware that some women may be currently using or considering using e-cigarettes in an effort to quit or reduce smoking. It is important that health professionals are equipped to educate women with accurate, up-to-date, and balanced information about the risks and benefits of e-cigarette use during pregnancy.
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View all citing articles on Scopus

View full text

CommentaryA licence to vape: Is it time to trial of a nicotine licensing scheme to allow Australian adults controlled access to electronic cigarettes devices and refill solutions containing nicotine?

Highlights

Abstract

Section snippets

Background

The legal status of e-cigarettes in Australia

As a therapeutic good for smoking cessation

Policy options for regulating e-cigarettes and nicotine

A nicotine licensing scheme for non-therapeutic nicotine use

Conclusion

Acknowledgement

Addictive Behaviors

Lancet

International Journal of Drug Policy

Qld man fined for selling e-cigarettes

Promise and peril of e-cigarettes: Can disruptive technology make cigarettes obsolete?

The Journal of the American Medical Association

Costs and burdens of medicines regulation for e-cigarettes

Linked electronic medication systems in community pharmacies for preventing pseudoephedrine diversion: A review of international practice and analysis of results in Australia

Drug and Alcohol Review

PAS 54115 PUBLICLY AVAILABLE SPECIFICATION Manufacture, importation, testing, and labelling of vaping products, including electronic cigarettes, e-shisha and directly-related products – Code of practice

Position statement: Electronic cigarettes

EffiCiency and safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: A prospective 12-month randomized control design study

PLOS ONE

e-Cigarettes: Should we inhale? The Law Report. ABC Radio National Broadcast 10 June 2014 5:30PM

The case for a smoker's license

PLoS Medicine

Should electronic cigarettes be as freely available as tobacco cigarettes? No

BMJ

Simon Chapman on e-cigarettes: The best and the worst case scenarios for public health

Ensuring smokers are adequately informed: Reflections on consumer rights, manufacturer responsibilities, and policy implications

Tobacco Control

The relationship between socioeconomic status and ‘hardcore’ smoking over time – Greater accumulation of hardened smokers in low-SES than high-SES smokers

Tobacco Control

Hervey Bay authorities cracking down on illegal e-cigarettes

Online reporting of pseudoephedrine pharmacy sales: Does Australia require a mandatory system?

International Journal of Pharmacy Practice

Commentary
A licence to vape: Is it time to trial of a nicotine licensing scheme to allow Australian adults controlled access to electronic cigarettes devices and refill solutions containing nicotine?