PROGRESS AGAINST INTERNATIONAL COMPARATORS
Oral tobacco products are sold in the US, Sweden and much of Asia and Africa. In Australia, a ban in place since 1989[238] on the retail supply of oral tobacco products (snuff/snus and chewing tobacco) under the Trade Practices Act 1974 permits individuals to import only small quantities for personal use under the Customs (Prohibited Imports) Regulations 1956. Other oral products, where tobacco is not the primary constituent – such as betel nut, pan masala and other products imported from Africa, Asia and the Indian subcontinent – are not captured. In mid- 2006 the duty payable on these products was aligned with that on loose tobacco. Changes in custom codes over the past few years make it difficult to assess the extent to which imports of these products is increasing. Some health experts, including some in Australia,[239] have called for the wider availability of low-nitrosamine smokeless tobacco.[240-245] Others are more cautious, not least on the basis of the risks from these products themselves, as well as the manner in which they might be promoted.[245, 246] For the moment, most health agencies and advocates[247, 248] support the continuation in Australia of the restricted importation of smokeless tobacco products for personal use, ensuring that current users are not denied access, while deterring non-tobacco users (particularly youth) from commencing.
ALTERNATIVE NICOTINE DELIVERY DEVICES
In the last couple of months a proliferation of new devices providing nicotine in products other than those that need to be lit and inhaled have been launched into various markets around the world. Alternative nicotine delivery devices (ANDS) include products such as sweets, hand gel,[249] mouth washes and electronic cigarettes.[249-251]
Electronic cigarettes consist of a tubing device resembling a conventional cigarette. This heats a replaceable cartridge filled with liquid nicotine and other chemicals (i.e. it does not contain tobacco leaf). The heating process
creates a mist that resembles cigarette smoke and is inhaled by the user. The e-cigarette is marketed by some companies as a healthier alternative; for example, ‘Egar Cigarette can be used legally indoors, in restaurants – ANYWHERE you wish, where traditional smoking is prohibited! ... Beat the smoking ban!’ 27
If e-cigarettes are marketed as an aid in withdrawal from smoking they will be considered a therapeutic good, and would have to be listed on the Australian Register of Therapeutic Goods before they could be imported and retailed in Australia. It seems unlikely that they would meet standards for safety and efficacy. If, on the other hand, e-cigarettes are marketed exclusively as recreational devices, they may not meet the definition of therapeutic use. The Standard for the Uniform Scheduling of Drugs and Poisons (SUSDP) currently categorises all nicotine products that are not tobacco products or are
used for
NRT as falling under Schedule 7, which covers Dangerous Poisons. Therefore, at present, such products (not being clearly a tobacco product or
NRT) would probably not satisfy the stated exceptions, and could not be retailed
under state and territory legislation.
As with smokeless tobacco, health experts have differing views about the usefulness of these products.[252, 253] Concerns are not easily dismissed about the potential of such products to attract young people who would not otherwise have used any form of nicotine, and to then act as a gateway to cigarettes.
Also worrying is the possibility that adults who might otherwise have given up tobacco completely could remain dependent on nicotine, helped by the availability of such products, and return to cigarettes, which are always likely to be a superior delivery device. [248, 254] Modelling of the potential benefits and harms suggests the need for restricting the availability of such products to long-time users who are unable to quit. However, such an approach would have few public health benefits unless large numbers of these smokers knew about such alternative products and were willing to try them. This conundrum will continue to be debated.[242, 244, 245, 255-261]
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