Vaping ban: Australian Medical Association calls for measures to prevent 'doctor shopping'

ACT AMA president Walter Abhayaratna. Picture: Jade Harrison-Will
ACT AMA president Walter Abhayaratna. Picture: Jade Harrison-Will

Medical professionals are calling for a crackdown on doctor-shopping to prevent Australians circumventing a new ban on e-cigarette imports.

Australian Border Force agents will be given the power to intercept vaping products sent from overseas from Friday.

But harm reduction advocates are warning the ban, leaving prescriptions as the only means to access the products, will push established vapers towards smoking.

The sale of vaping products without a prescription was already outlawed in Australia, but they were routinely imported from overseas without requiring proof-of-prescription.

ACT Australian Medical Association president Walter Abhayaratna warned doctor-shopping - patients seeking out GPs willing to write a prescription - added another layer to the challenge.

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He said there was limited evidence vaping led to smoking cessation, but described the laws as an attempt to "mop up a poorly-regulated" environment which subverted the intent of prescriptions.

"Without doing that, you're just going to have an illegal market where we won't be able to control anything. Prescription is a way for us to control and regulate," he said.

"It's purely on that basis that doctors, and the AMA, are supportive of having the prescription process for people who are smoking, but are ready and willing to try to quit."

Dr Abhayaratna said prescriptions were designed to work in tandem with behavioural monitoring programs. He conceded assessing whether a patient was using vaping to quit smoking, rather than purely for recreation, would be done "absolutely through trust".

"There is no intention to be doing intensive monitoring of levels of smoking. I'm not sure the patients who are trying to give up would accept that anyway," he said.

Statistics collated by the Alcohol and Drug Foundation showed 11 per cent of Australians had used vapes in 2019, up from 9 per in 2016. But just 3 per cent of current cigarette smokers also vaped daily.

Some clinics were already offering decisions on prescriptions within 24 hours, including offers of a full refund if one was not written. Dr Abhayaratna conceded doctor-shopping was a concern, calling for vapes to be folded into the National Real Time Prescription Monitoring program, a national register monitoring the misuse of medicine.

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He said doctors writing prescriptions should ideally be a patient's regular GP, and also need to oversee the behavioural support. They should have the right not to prescribe it, given given other cessation products were on the market, he said.

The prospect of a child ingesting vaping fluid was also a "disaster waiting to happen", particularly as they often came with appealing packaging, he said.

The UK's National Health Service has actively encouraged e-cigarettes as a smoking cessation tool, saying more than half of cigarette users who switched to vaping were now smoke-free. It said vaping posed "just a fraction of the risks smoking" and switching offered substantial long-term health benefits.

Harm Reduction Australia's Alex Wodak conceded e-cigarettes were not zero-harm, but warned the laws would push established vapers to smoking.

"Why on earth would we make a product that we regard as less risky than smoking more difficult to get than the deadly product?" he said.

"The deadly product kills up to two out of every three long-term smokers, yet cigarettes are available from 20,000 outlets in Australia."

Dr Wodak said the majority of GPs were "hostile or indifferent" to vaping as a stop-smoking intervention.

"People are going to find it very difficult to find a doctor willing to prescribe for them," he said.

"This is repeating the pattern that we saw with medicinal cannabis, where we had decades of hostility to cannabis as a medicine from the establishment."

Dr Wodak said the debate was "extraordinarily similar" those those held over medicinal cannabis, syringe programs to slow HIV, and pill testing.

"It's important to remember that harm reduction has won almost all of those debates, not just in Australia but worldwide. It will win this one too," he said.

This story Warning on Australians circumventing new ban on e-cigarette imports first appeared on The Canberra Times.

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