Vaping and e-cigarettes might actually help smokers quit, according to new research. What does that mean for Australia’s highly restricted nicotine market?

credit: Getty

• A new study suggests vapes and e-cigarettes could be more effective in helping smokers quit than almost anything else.
• The findings stand in stark contrast to Australia’s inconsistent and restrictive e-cigarette laws, which have led to a grey market for vape liquid and products.
• The vape market is set to be worth US$67.31 billion by 2027, driven largely by demand from Gen Z and millenials.
• Visit Business Insider Australia’s homepage for more stories.

Could vaping be the key to quitting smoking?

The prevailing story around vaping — particularly after a spate of vape-related respiratory hospitalisations and deaths across the US in 2019 — suggested that the promise of vapes and e-cigarettes as clean and consequence-free had been severely misrepresented.

But new research out of the University of Queensland could challenge those assumptions.

Most e-cigarettes are battery operated vessels that mimic the experience of cigarette smoking. Liquid, which can contain nicotine, is heated and inhaled as a vapour.

Since regulation passed in 2017 in almost all Australian states, “personal vaporisers”: e-cigarettes or vape pens, have been regulated as smoking products in Australia, including restrictions around sales, display and marketing, and use in non-smoking areas.

The Therapeutic Goods Administration has ruled e-cigarettes as harmful and not approved them as an aid to help smokers to quit.

However the research out of the University of Queensland has uncovered new evidence that e-cigarettes may be more effective in helping smokers quit than what they call “nicotine replacement therapies”, including products like nicotine patches and gum.

Published in the journal Addictive Behaviours, the study assessed a total of 12,754 participants across 16 different smoking and vaping trials.

Lead author Dr Gary Chan from UQ’s National Centre for Youth Substance Use Research said the expansive study showed more evidence than ever before to support the effectiveness of using e-cigarettes to assist smokers in quitting.

“Our study found e-cigarettes are 50% more effective than nicotine replacement therapy, and more than 100% more effective than the placebo,” Dr Chan said in a statement accompanying the findings.

Electronic cigarettes containing nicotine may be more effective than nicotine replacement products, he said, because “they deliver a small amount of nicotine to alleviate withdrawal symptoms and provide a similar behavioural and sensory experience as smoking tobacco products.”

The study assessed e-cigarettes comparatively to other, approved, nicotine replacements including nicotine patches, gum, lozenges, mouth spray, inhalators and intranasal sprays.

“We reviewed all existing evidence and compared e-cigarettes, traditional nicotine replacement therapy and placebos to find the best substitute for helping smokers quit and make lasting behavioural change,” Chan said.

The findings challenge the current federal and state approach to the e-cigarette market, which since 2017 has imposed increasingly prohibitive restrictions on the sector, which was worth US $12.41 billion as of 2019.

It’s expected to expand by almost 24% from 2020 to 2027 to be worth US $67.31, driven largely by demand from Gen Z and Millenials.

According to the latest national drugs survey, over half a million Australians are current vapers and 2.4 million people have tried it at some point.

Two thirds of current smokers and one in five non-smokers in the 18-to-24-year age group had tried e-cigarettes.

Australian e-cigarette restrictions to be reconsidered this year

Dr Chan said current recommendations by the Royal Australian College of General Practitioners which rate e-cigarettes as a second line treatment to support quitting smoking, but suggested based on the findings, “this recommendation could be re-evaluated.”

Currently, it’s illegal to buy e-liquids or e-cigarettes containing nicotine for personal use from an Australian retailer, as they are essentially classified as a “dangerous poison” under the National Poisons Standard. Despite this, it’s still legal to import nicotine vaping products from overseas, though there are restrictions on the amount one person can legally bring in.

It’s led to a grey market for vapes and liquid, with products sold under the counter and off the grid, and unregulated materials being used that could potentially harm users.

The exception to this rule is if the e-cigarette is for therapeutic purposes, described as ‘smoking cessation’ or alleviation – but it’s a tricky loophole.

As of October 2020, to use a vape for this purpose, the e-cigarette needs to be registered by the Therapeutic Goods Administration (TGA) in order to be lawfully sold, which essentially means only a doctor can prescribe one.

This ruling came after Health Minister Greg Hunt proposed a ban on nicotine vaping imports in June. It was postponed for six months after pushback from the public and Liberal party members, and eventually was scrapped in favour of a committee inquiry. The Select Committee on Tobacco Harm Reduction which will launch an inquiry into vaping with the view to establish clear and standardised e-cigarette laws this year.

Chan said he hopes the findings from the study can be used to better inform policies around e-cigarettes and cigarette smoking,” he said.

“E-cigarettes have the potential to accelerate the decline of cigarette smoking,” he said.

“The evidence needs to be used to reconsider how we could harness their potential to end the cigarette smoking epidemic.”