Skip navigation

Vaping: complicated, conflated and confusing

July 2022

“Everything you think you know about addiction is wrong” – Johann Hari

So, it’s happened again. A really important public health issue in the realm of addiction is a bit complicated, aspects are being conflated, scientists disagree and we’re all terribly confused.

Let’s break it down just a little bit.

Firstly, smoking cigarettes is still the biggest single cause of disease and death in Australia - more than road accidents, alcohol, illicit drugs, overdose and suicide put together.

Approximately 24,000 people die each year in Australia from smoking related illnesses – that is a lot of avoidable human misery.

Secondly, although this is a bit simplistic the following is true:

Tobacco (used daily) is extremely harmful. Nicotine alone (used daily) is MUCH LESS harmful (UK Royal College of Physicians estimates that vaping is 5% as harmful as smoking, though this is contested.)

Thirdly, there are two quite separate issues at play:

Issue A
Vaping of nicotine is now a well-proven method of reducing harms from tobacco for people who are already addicted to cigarettes. Vaping nicotine is proven to reduce cigarette use significantly on average, often to zero. Vaping nicotine is far more effective for smoking cessation (reducing or quitting) than patches or gum, both of which are products of Big Tobacco.

There is a lot of peer-reviewed research on this, and it is being led in Australia by the Australian and New Zealand College of Psychiatrists (with First Step’s own Dr Basanth Kenchaiah heavily involved), because this is the field of addiction.

Issue B
There is concern in the community that children who would not otherwise have commenced smoking are vaping. The existence of child-friendly flavours (like berry) adds enormous credence to this perspective. It is, however, almost impossible to prove that kids are vaping who wouldn’t be smoking, and the data about trends is unclear.

Society also has a history of getting a bit hysterical about new ‘drug types’, forgetting that the old ones had great potential to harm.

I’m not saying for a second that the ‘kids are vaping who wouldn’t be smoking’ argument isn’t true, in fact I think it almost certainly IS true: it’s a question of how many people and how much harm is this creating.

The conflation of these two issues unfortunately means that there is more legislation around pure nicotine vaping than is helpful, considering its therapeutic benefits for people who smoke cigarettes.

- Anyone over 18 can buy as many cigarettes as they like from tens of thousands of locations in Australia, but
- You need a prescription to vape nicotine which is MUCH safer than cigarettes.

I’m not going to attempt to promote public policy here and now, but barriers to smokers accessing nicotine vaping products (like the need for a prescription) will slow any reduction in annual deaths, prolonging suffering in thousands of Australians and cost the system billions.

This needs a tailored response from legislators, unsullied by the influence of Big Tobacco or tax revenues from cigarettes.

Watch this space. Please.

#lifewithaddiction #firststep 

Patrick Lawrence
Chief Executive Officer