E-cigarettes with nicotine should be legalized in Australia: statement by 40 international experts
- Thursday, 08 September 2016 21:18
By Dr Farsalinos
As many of you probably know, nicotine is classified as a ‘dangerous poison’ in Australia. Therefore, it is illegal to sell, buy, possess or use nicotine other than in tobacco or nicotine replacement products. Recently, New Nicotine Alliance, a consumer group, submitted an application to exempt nicotine containing e-cigarettes (up to the level of 3.6% concentration) from this regulation. A group of 40 international public health experts have signed a letter supporting this application, which was submitted to the Therapeutics Goods Administration in Australia.
The letter is available here.
A press statement was released by Prof Colin Mendelsohn, one of the experts signing the document (available as a pdf file here).
Here is the press statement (below that, you can see the list with the names of the 40 signatories):
Associate Professor Colin Mendelsohn MB BS Syd (Hons)
Tobacco Treatment Specialist
Nicotine for vaping should be legalised in Australia to reduce smoking-related disease, say 40 international and Australian experts
Forty leading international and Australian academics and researchers have written to the Therapeutics Goods Administration in support of an application to make low concentrations of nicotine available for use in electronic cigarettes (e-cigarettes).
In Australia, it is illegal to sell, buy, possess or use nicotine other than in tobacco or nicotine replacement products, as nicotine is classified in the Poisons Standard as a Schedule 7 ‘dangerous poison’. The consumer advocacy group, New Nicotine Alliance has submitted an application to exempt low concentrations of nicotine for use in electronic cigarettes as a safer alternative to smoking.1
Professor John Britton, Chair of the Tobacco Advisory Group, Royal College of Physicians (UK) said ‘Nicotine itself is not a significant cause of disease and death. Allowing smokers easier access to nicotine products without the toxins in tobacco smoke could ultimately save millions of lives’.
‘Lifting the effective ban on low-risk nicotine products will allow Australian smokers to realise the health benefits this approach has already generated in Europe and the United States. I fully endorse this proposal’, he said.
Professor Ann McNeill, from Kings College London and lead author of the Public Health England evidence review on e-cigarettes,2 commented on the paradox of banning nicotine while allowing widespread sale of tobacco.
‘I just don’t understand the logic of having nicotine in the deadly form of tobacco cigarettes widely available, while nicotine in the much safer form of e-cigarettes is outlawed by the Poison Standard. The current situation in Australia protects the cigarette business, encourages smoking and increases the risk of disease’ she said.
According to Tobacco Treatment Specialist, UNSW Associate Professor Colin Mendelsohn, most of Australia’s 2.8 million smokers want to quit but try and fail repeatedly.3 For those who are unable or unwilling to quit smoking, switching to an e-cigarette is a much less harmful and cheaper alternative.4
‘Using an e-cigarette can effectively satisfy the smoker’s need for nicotine as well as providing ‘a smoking experience’ which many smokers miss after quitting and which often leads to relapse’, he said.
‘There is a widespread scientific consensus that the long-term health risks to vapers is unlikely to exceed 5% of the harm from smoking.2,4 On the other hand, up to two out of three Australian smokers will die prematurely from a smoking-related disease if they continue to smoke’, Dr Mendelsohn added.5
E-cigarettes are used almost exclusively by smokers or recent ex-smokers and principally to reduce the health risks from smoking.2,4 Recent data from 2014 shows that 14.6% of Australian smokers are current e-cigarette users.6
Exempting low concentrations of nicotine for use in e-cigarettes from Schedule 7 would bring it within the jurisdiction of the Australian Consumer and Competition Commission (ACCC) under The Australian Consumer Law. This would ensure product safety and quality. The current, unregulated black market products would also disappear.
Background
Tobacco harm reduction is a strategy to minimise the harm in smokers who are unable or unwilling to quit. The rationale is to provide smokers with an alternative way of getting the nicotine to which they are addicted without the tobacco smoke that causes almost all of the adverse health effects.
Other examples of successful harm reduction strategies include clean needles and syringes to intravenous drug users to reduce the risk of infection and promoting condom use by sex workers.
E-cigarettes are battery-powered devices that heat a liquid into an aerosol for inhalation, without combustion or smoke. The liquid solution contains water, nicotine (0.3-3.6%), propylene glycol, vegetable glycerine and flavourings.
-- ENDS --
Media enquiries
Associate Professor Colin Mendelsohn (Aust) Mob 0415 976 783 | Email This email address is being protected from spambots. You need JavaScript enabled to view it.
Professor John Britton (UK) Mob 0011 44 7798 611 231 | Email This email address is being protected from spambots. You need JavaScript enabled to view it.
Professor Gerry Stimson (UK) Mob 0011 44 7872 600 908 | Email This email address is being protected from spambots. You need JavaScript enabled to view it.
References
1. New Nicotine Alliance, http://nnalliance.org.au/48-application-to-make-e-cigarettes-with-nicotine-legally-available-in-australia.
2. McNeill A, Brose LS, Calder R, Hitchman SC, Hajek P, McRobbie H. E-cigarettes: an evidence update. A report commissioned by Public Health England. PHE publications gateway number: 2015260 2015. Available at https://www.gov.uk/government/publications/e-cigarettes-an-evidence-update (accessed February 2016)
3. Cooper J, Borland R, Yong HH. Australian smokers increasingly use help to quit, but number of attempts remains stable: findings from the International Tobacco Control Study 2002-09. Aust N Z J Public Health. 2011;35(4):368-76
4. Royal College of Physicians. Nicotine without smoke: Tobacco harm reduction. London: RCP, 2016. Available at https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0
5. Banks E, Joshy G, Weber MF et al. Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Med. 2015;13:38.
6. Preliminary results from the Australian arm of the International Tobacco Control 4 country survey 2014 (unpublished). 2016.
This amendment is supported by the following academics and researchers
Professor David B. Abrams
Department of Health, Behavior and Society,
The Johns Hopkins Bloomberg School of Public Health
Professor of Oncology
The Georgetown University Medical Centre,
Lombardi Comprehensive Cancer Center (adjunct).
United States of America
Professor Frank Baeyens
Centre for Psychology of Learning and Experimental Psychopathology
KU Leuven
Belgium
Scott D. Ballin, JD
Health Policy Consultant
Former Vice President and Legislative Counsel, American Heart Association (1986-97)
United States of America
Clive D. Bates
Director
Counterfactual Consulting Limited
Former Director Action on Smoking and Health UK (1997-2003), London
United Kingdom
Professor Linda Bauld
Professor of Health Policy,
University of Stirling
UK Centre for Tobacco and Alcohol Studies
United Kingdom
Associate Professor Yvonne Bonomo
Physician in Addiction Medicine & Adolescent Medicine
University of Melbourne
Australia
Professor John Britton
Chair, Tobacco Advisory Group, Royal College of Physicians
Professor of Epidemiology;
Director, UK Centre for Tobacco & Alcohol Studies,
Faculty of Medicine & Health Sciences
University of Nottingham
United Kingdom
Professor Ric Day
Professor of Clinical Pharmacology
St Vincent's Hospital Clinical School and Pharmacology
School of Medical Sciences, Faculty of Medicine
University of New South Wales
Australia
Professor Jean-François Etter
Institute of Global Health
Faculty of Medicine
University of Geneva
Switzerland
Conjoint Associate Professor Nadine Ezard
Addiction Medicine specialist
Medical School, University of New South Wales
Australia
Dr Karl Fagerström
President
Fagerström Consulting AB, Vaxholm
Sweden
Dr Konstantinos Farsalinos, M.D.
Researcher
Onassis Cardiac Surgery Center, Athens Greece
University of Patras,
Greece
Trish Fraser MPH
Director, Global Public Health, Glenorchy
New Zealand
Associate Professor Marewa Glover
School of Public Health
Massey University
North Shore, Auckland
New Zealand
Dr Robert Graham
Staff Specialist in Addiction Medicine
Blacktown and Mt Druitt Hospital
Western Sydney, New South Wales
Australia
Professor Peter Hajek
Wolfson Institute of Preventive Medicine
Queen Mary University of London
United Kingdom
Dr David Helliwell
Foundation Fellow
Australasian Chapter of Addiction Medicine
Royal Australasian College of Physicians
Australia
Professor Martin Jarvis
Emeritus Professor of Health Psychology
Department of Epidemiology & Public Health
University College London
United Kingdom
Dr Jacques Le Houezec
Consultant in Public Health,
Président SOVAPE, Paris
France
Professor Lynn T. Kozlowski
Professor of Community Health and Health Behavior
School of Public Health & Health Professions
University at Buffalo, SUNY
United States of America
Conjoint Professor Nicholas Lintzeris
Division Addiction Medicine
Faculty Medicine, The University of Sydney
Australia
Professor Ann McNeill
Professor of Tobacco Addiction
King’s College London
UK Centre for Tobacco and Alcohol Studies
United Kingdom
Professor Klim McPherson FFPM FMedSci HonFRCP
Visiting Professor of Public Health Epidemiology
New College, Oxford University
United Kingdom
Professor Bernd Mayer
Chair Department of Pharmacology and Toxicology
University of Graz
Austria
Conjoint Associate Professor Colin Mendelsohn
School of Public Health and Community Medicine
The University of New South Wales, Sydney
Australia
Professor Marcus Munafò
Professor of Biological Psychology
MRC Integrative Epidemiology Unit
UK Centre for Tobacco and Alcohol Studies
School of Experimental Psychology
University of Bristol
United Kingdom
Professor Raymond S. Niaura
Department of Health, Behavior and Society,
The Johns Hopkins Bloomberg School of Public Health
Professor of Oncology,
The Georgetown University Medical Centre,
Lombardi Comprehensive Cancer Center (adjunct).
United States of America
Dr Joel L. Nitzkin, MD, MPH, DPA
Principal Consultant, JLN, MD Associates, LLC
Senior Fellow for Tobacco Policy, R Street Institute
4939 Chestnut Street, New Orleans
United States of America
Professor David Nutt
Centre for Neuropsychopharmacology
Hammersmith Hospital
Imperial College London
United Kingdom
Professor Riccardo Polosa, MD
Professor of Internal Medicine
University of Catania
Italy
Professor Emeritus James G. Rankin
Dana Lana School of Public Health
University of Toronto, Toronto
Canada
Professor Robyn Richmond
Associate Dean (Postgraduate Coursework)
UNSW Medicine
Professor of Public Health
School of Public Health and Community Medicine
University of New South Wales
Australia
Dr Sally Satel
Addiction Psychiatrist
Resident Scholar American Enterprise Institute
Washington DC.
Lecturer, Yale School of Medicine
United States of America
Dr Catherine Silsbury
Staff Specialist Addiction Medicine
Westmead & Cumberland Hospitals
Western Sydney Local Health District, NSW
Australia
Professor Andrzej Sobczak
Head of Department of Chemical Hazards and Genetic Toxicology
Institute of Occupational Medicine and Environmental Health, Sosnowiec
Poland
Professor Gerry Stimson
Emeritus Professor, Imperial College London;
Visiting Professor, London School of Hygiene and Tropical Medicine
United Kingdom
David T. Sweanor J.D.
Adjunct Professor, Faculty of Law,
Centre for Health Law, Policy & Ethics
University of Ottawa
Honorary (Consultant) Assistant Professor, University of Nottingham
Legal Counsel, Non-Smokers’ Rights Association, 1983-2005
Canada
Dr Natalie Walker
Hon Associate Professor in Population Health,
NIHI Programme Leader – Addictions,
Associate Director, Centre for Addiction Research, Faculty of Medicine and Health Sciences
The National Institute for Health Innovation
University of Auckland
New Zealand
Professor Ian W. Webster AO
Emeritus Professor of Public Health and Community Medicine,
The University of New South Wales, Sydney
Australia
Dr Alex Wodak AM
Emeritus Consultant, Alcohol and Drug Service, St Vincent's Hospital, Sydney, NSW, Australia
President, Australian Drug Law Reform Foundation
Director, Australia21
Australia