Fog of war: is vaping good for smokers or only for Big Tobacco?

June 18, 2018

Karen Counter isn’t quite sure what side of the law she’s on, but she’s 100 per cent sure she is right. The GP from the NSW north coast is signing up to proliferate electronic cigarettes – a product that has sparked outright war within her profession and disagreements within the government.

E-cigarettes containing nicotine remain banned in Australia without a prescription. Photo: AP

E-cigarettes containing nicotine are illegal in Australia, unless the user has a prescription to help them quit smoking. But very few doctors – perhaps only a dozen nationwide – are willing to do so at present because it contravenes medical guidelines.

Increasingly, Australia stands alone. Vaping nicotine is legal in Britain, the US and Canada, and New Zealand effectively legalised it courtesy of a court decision in May. But in Canberra, Health Minister Greg Hunt remains vehemently opposed.

“The overwhelming medical advice and evidence is that it’s likely to lead to the uptake of smoking and we cannot support that,” his spokesperson says.

But the movement for change is growing. A group of Liberal MPs are intent on prosecuting the case for legalisation and believe they can get the majority of their party onside. Tobacco lobbyists are also on the cause. Meanwhile, others are taking the issue into their own hands.

Counter is one of two doctors partnering with a fledgling firm, Nicovape, to sign prescriptions for clients who fill out an online questionnaire. The firm says the survey is more controlled and more comprehensive than a standard in-person medical exam. Successful patients will receive nicotine in the mail for $10 a pod (equivalent to about 30 paper cigarettes).

Counter works in Wauchope and specialises in smoking cessation. She has many disadvantaged patients with illnesses related to heavy smoking, and is convinced e-cigarettes are the solution for people who have tried other means of quitting.

“I feel it’s my duty of care,” she says. “We can’t sit around and watch people die, waiting for 100 per cent perfect evidence.”

Counter says she would be paid $5 per prescription she signs. Nicovape is yet to get underway, but it has a website that optimistically boasts of saving 1 million Australian lives by 2021. Its founder Ryan Boulton concedes the scheme is in a “grey legal area”, but says he is playing by the rules. He hopes to build an evidence base that e-cigarettes can actually help people quit.

Proponents of e-cigarettes point to recent and substantial research from Public Health England, a British government agency, that found vaping was 95 per cent less harmful than smoking and there were “substantial health benefits” from making the switch.

“No one is saying that there’s any doubt any more about the lower harm profile of these products,” Boulton tells Fairfax Media. “Their concerns are about the efficacy.”

But that’s not strictly true. The new president of the Australian Medical Association, Tony Bartone, has struck a defiant note about e-cigarettes in his first two weeks on the job.

He says the jury is still out on every aspect of vaping, including the health impacts compared to traditional smoking, and warns of “unintended consequences” down the track.

Originally Published by The Katherine Times, continue reading here.

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