E-cigarettes with nicotine should be legalized in Australia: statement by 40 international experts

 

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

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