Senior health officials misinformed about vaping at the Senate Estimates Hearing
Posted on October 27, 2020
The TGA’s Professor John Skerritt and Professor Brendan Murphy, Secretary of the Department of Health were questioned on vaping at the Senate Estimates hearing on 27 October 2020. Some of their replies were less than accurate.
ATHRA is concerned that two of the most senior health officials in Australia are so misinformed about the issue of vaping. Smoking is still an important public health issue in Australia and vaping has the potential to be an important part of the solution.
The video recording of the 20 minute session is available here.
We examine several of the most misleading statements.
1 “We have seen in the US some deaths associated with vaping” (BM)
In 2019, there was an outbreak of serious lung injury (EVALI) in the US in people who had recently vaped. This condition has now been clearly associated with black-market cannabis oils contaminated with Vitamin E Acetate, purchased from street dealers. Not a single case has been linked to commercial nicotine vaping to stop or reduce smoking. This epidemic, which ended in early 2020, highlights the importance of regulating vaping markets.
2 “Nicotine is a dangerous poison” (JS)
Pure nicotine (100%) is highly toxic, however vapers use dilutions of 0.3-5%. There is minimal risk of harm from vaping low concentrations of nicotine as vapers titrate their nicotine intake (like smokers). Serious adverse effects from nicotine vaping are extremely rare and there has not been one confirmed death from correct use.
The vast majority of cases of ingestion (swallowing) of nicotine liquid are mild, symptoms are short-lived and do not routinely require treatment. Even in children, there have been only four reported cases globally of fatal overdose, two involving highly concentrated nicotine 100mg/ml. An international review of adult nicotine overdose reported only 13 fatal cases from 2010-2020.
3 “There are a number of studies in humans indicating that nicotine vaping can be quite harmful especially in adolescents” (JS)
There is no evidence that nicotine vaping causes harmful effects in human adolescents.
Nicotine has been linked to harmful effects on the adolescent brain in animal studies. However, most animal studies use chronic, high-dose exposure to nicotine which does not accurately reflect the nicotine exposure that would occur from vaping in humans. The same effects found from nicotine in animals are also found in animal tests with caffeine.
4 “There is a big industry push to make it a consumer product for non smokers to get them addicted” (BM)
This is absurd. In general, the vape industry is very responsible and careful to avoid sales to young people. There is support for making vaping nicotine a consumer product in Australia as it is in almost all other western countries. But the suggestion that industry is pushing to get non-smokers addicted is laughable.
5 The new regulations will have “Absolutely no impact on their (vape) business unless they are willfully breaking the law” (JS)
Totally wrong. Vaping businesses will be decimated by restricting sales of nicotine liquids to pharmacies. Currently, most Australian vapers purchase concentrated nicotine from overseas and mix it with nicotine-free flavoured juice from the vape shop. If vapers purchase premixed nicotine liquid from the pharmacy, there will be no need to purchase nicotine-free juices which vape shops rely on to survive.
6 “The harm that is being done is Canada NZ, UK is very concerning. They are very worried about the huge uptake of vaping in non-smoking young people” (BM)
Current vaping rates by non-smoking youth are low and most use is experimental and transient. Only frequent vaping by non-smokers is of public health importance and this is rare.
In the United States, 3.9% of non-smoking youth had vaped once or more in the last 30 days and only 0.4% of never-smokers vaped regularly (≥20 days in the last 30 days) in 2018. In 2020, vaping rates in high schoolers declined by 30%.
In New Zealand in 2019, 4.7% of non-smoking year 10 students reported currently using an e-cigarette (at least monthly) in the annual survey by ASH. Only 0.8% of non-smokers reported daily use.
In the United Kingdom in 2019, in young people aged 11-18 years old who have never smoked, only 0.8% were current vapers, only 0.1% vaped more than once a week, and not a single never-smoker reported vaping daily.
Vaping rates were higher in Canada. In 2018-19, 8.4% of never smokers in grades 7-12 had vaped in the last 30 days, although the frequency was not reported. In comparison, 44% had used alcohol with 25% reporting high risk drinking behaviour, 18% had used cannabis and 7% had used psychoactive pharmaceuticals to get high in the previous year.
Posted by Colin Mendelsohn, firstname.lastname@example.org