The Australian federal and state health ministers have shown their intention to continue to persecute vaping, at this week's Council of Australian Governments (COAG) meeting. This is an ominous sign for Australian vapers.

The COAG Health Council released a Communique stating:

"Ministers expressed deep concern at emerging evidence of serious health risks associated with e-cigarettes and the international evidence of e-cigarette uptake by non-smokers and, in particular, by young people. They reaffirmed their commitment to maintain existing restrictions on nicotine vaping products. Ministers agreed to immediately refer the safety of non-nicotine vaping and e-cigarettes to Chief Medical Officers for urgent review to report back to Health Ministers."

Health Minister Greg Hunt repeated these concerns in an interview yesterday saying: 'there is deep concern that these (e-cigarettes) are both an on-ramp for young people to smoking and that they are also potentially dangerous to young people directly'

ATHRA believes this assessment is not evidence-based and is deeply concerning. It exaggerates the risks of vaping nicotine and completely ignores the huge public health benefit of vaping as a tobacco harm reduction and quitting aid

The concerns raised by the Health Ministers are in stark contrast to the latest evidence-based assessment by UK authorities.

Three issues raised

1. "Serious health risks"

It appears the Health Council is conflating the harms from contaminated, black market THC oils purchased from street vendors with nicotine vaping supplies from reputable vendors.

Recent reports from the UK Royal College of Physicians and Public Health England have confirmed that the vast majority of the US vaping-related lung injuries are linked to bootleg cannabis products. No cases have been linked to nicotine vaping.

Public health England says that 'we are as certain as ever that e-cigarettes are far less harmful than smoking' and that vaping is an effective quitting aid.

2. "Uptake by non-smokers"

Vaping by never smoking adults is rare and regular use is very rare, across international surveys, for example:

• England: currently 0.5% of never smokers report being current e-cigarette users (ASH 2018); long-term use of an e-cigarette by never smokers was 0.1% (Jackson 2019)
• New Zealand: never smokers reporting low ever use (2.8%) and no regular use (Oakly 2019)
• United States: Only 0.3% of never smokers currently used e-cigarettes at the time of survey (Zhu 2017); Current e-cigarette use is extremely low among never cigarette smokers (0.4%) and daily e-cigarette use is 0.1% of never smokers (Delnevo 2015); 1.4% of never smokers were current vapers, and only 0.2% were daily users (Mirbolouk 2016)
• European Union: current daily use of e-cigarettes is 0.08% among never smokers (Farsalinos 2017)
• Germany: only 0.3% of persons who had never smoked were current consumers of e-cigarettes. (Kotz 2018)
• Iceland: the percentage of people who never smoked traditional cigarettes but are now vaping is 0.4% (Directorate of Health 2018)
• Greece: Only 0.2% of never smokers were current e-cigarette users (Farsalinos 2018)

3. "Gateway to youth smoking"

Although young people who vape are more likely to later try smoking, there is no evidence of causation, ie that vaping causes the young person to smoke when they otherwise would not. A much more plausible explanation for the association is a common liability to take risks. Furthermore

• Most young people who vape have smoked first
• Most vaping is experimental and short-term
• Many do not use nicotine
• Population smoking rates for youth are falling faster than ever in the US and UK. It is likely that vaping is diverting young people from smoking.

Even in the US where youth vaping has been increasing, only 1% of young people who have never smoked, vape frequently ie 20 or more days per month (NYTS 2018).

ATHRA's media response to the COAG communique

"The outcomes from today’s COAG Health Council meeting threatens to increase the number of tobacco related deaths and further reduce access by Australian smokers to scientifically proven harm reduction products.

It is deeply concerning that public health officials continue to ignore the growing evidence that clearly shows that nicotine vaping is a far safer alternative to smoking and is helping many smokers to quit. This is nothing more than ideological scaremongering.

Furthermore, statements made by the Minister for Health, Greg Hunt that vaping is a gateway to smoking are false and misleading and need to be called out. There is no evidence that vaping is causing young people to smoke who would not otherwise have done so.

That fact remains that Australia is still the only western democracy to ban the sale and use of nicotine for vaping. Smoking rates in Australia have stalled since 2013 and smoking claims the lives of more than 21,000 Australians each year. Smoking remains the leading preventable cause of death and disease in Australia.

In contrast, smoking rates are falling faster than ever in countries such as the UK and US where vaping is a central part of their quit smoking strategy. Vaping is a far safer alternative for smokers who are unable to quit with conventional treatments and is actively encouraged by the UK and New Zealand governments. It is perplexing that Australia remains the only western democracy to deny smokers a far safer alternative."

References

COAG Health Council Communique. 31 October - 1 November 2019

Interview with Greg Hunt MP. Hunt lauds progress at health ministers' COAG. 1 November 2019

Posted by Colin Mendelsohn, colin@athra.org.au

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