Australia's vaping prescription model: A failure to replace with regulated retail
Australia is currently facing a challenge to its prescription model for e-cigarettes, a system that was supposed to limit access to vaping products to adults with a medical prescription. However, this model, combined with a retail ban, has proven ineffective in preventing the rise of youth vaping. At the same time, few adults have taken the legal route to obtain vapes, often opting to obtain them illegally.
1. The electronic cigarette: a controversial alternative to tobacco
E-cigarettes, or vapes, work by vaporizing a liquid containing nicotine, allowing users to inhale the substance with far fewer toxins and carcinogens than tobacco smoke. While not risk-free, e-cigarettes are often touted as a safer alternative for adult smokers and a potential tool for quitting smoking. However, health policies vary widely across countries in their regulation, with some focusing on reducing smoking while others, such as Australia, focus on preventing teen vaping.
2. A restrictive approach in Australia in the face of a growing parallel market
Unlike England, which promotes vaping as a smoking cessation aid, Australia has had a much stricter policy since 2016. The retail sale of nicotine-containing vapes is banned and access is restricted to prescriptions, in an effort to prevent young people from introducing themselves to tobacco through vaping. However, this model has failed to curb the popularity of vaping among teenagers and has led to the proliferation of a parallel market. Indeed, only 10% of Australia’s 1,8 million vape users had a prescription in 2023, with the majority turning to illicit sources for their supply.
This prescription system has not encouraged adult smokers to use vapes as a substitute, due to the easy availability of illicit products and the reluctance of doctors to prescribe vapes. The Australian Medical Association and the Royal College of General Practitioners have even advised practitioners against doing so, further hampering the legal use of vapes. As a result, vapes have added to the tobacco black market, which is already well-stocked with contraband cigarettes and untaxed tobacco.
3. An “epidemic” of vaping among young people?
Public debate in Australia is heating up around a supposed “vaping epidemic” among young people. While 35% of teenagers have tried vaping at least once, the proportion of those using it regularly remains low (10% in the last month and less than 6% in the last week). However, the alarmist discourse on this “epidemic” contributes to the stigmatization of young vapers and to an exaggerated perception of the scale of the phenomenon. In a context of increased repression, some schools go so far as to expel students caught vaping.
4. Towards a regulated sales model?
Given the limitations of the prescription model, a strictly regulated retail alternative could be a balanced response. Foreign examples, particularly in the United States, show that it is possible to reduce the use of vaping among young people without banning its sale. Australia could, for example, authorize the sale of vapes in licensed outlets, with strict rules: no promotion, plain packaging, and limited access to adults. Specialty stores could be licensed to sell vapes with stricter age restrictions, the use of video surveillance to monitor sales, and the possibility of sanctions in the event of non-compliance.
At the same time, a public health campaign should emphasize three key messages:
- Don't start vaping if you don't smoke.
- If you are a smoker, consider vaping to quit.
- If you can't quit smoking by vaping, switch to vaping completely to reduce your risks.
This type of regulation would give adult smokers safer access to vapes, while limiting the risk of young people developing addiction. In addition, strong legislation on tobacco sales could help curb the black market for tobacco in Australia.
