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Please note that the authors are from Australia, where smokeless tobacco and e-cigarettes are banned. It would have been nice if they didn't concede an e-cigarette use ban in workplaces and banning e-cigs that look like cigarettes, but doing so may help sway reasonable Australian MDs to endorse legalizing e-cigs and/or smokeless.
Perspectives
How should we regulate smokeless tobacco products and e-cigarettes?
Med J Aust 2012; 197 (11): 611-612.
Coral E Gartner, Wayne D Hall and Ron Borland
https://www.mja.com.au/journal/2012/197/11/how-should-we-regulate-smokeless-tobacco-products-and-e-cigarettes
Concern has been expressed about the possible increased use of smokeless forms of tobacco, such as low-nitrosamine smokeless tobacco (SLT) and electronic nicotine delivery systems (ENDS), also known as e-cigarettes (Box).1 Domestic sale of SLT was banned pre-emptively in 1991 in response to overseas marketing of these products to youth. Currently, Australians are permitted to import limited amounts of SLT for personal use, but the importation of nicotine cartridges and solutions for use in ENDS is prohibited because nicotine is a Schedule 7 poison. Meanwhile, the most harmful tobacco products — conventional cigarettes — are ubiquitous in Australian retail environments.
Low levels of SLT use have been reported in Australia. According to the 2010 National Drug Strategy Household Survey, 0.7% (95% CI, 0.6%–0.9%) of the population aged 14 years or older had used SLT at least once in the previous year, a marginal increase from the 0.5% (95% CI, 0.4%–0.6%) in the 2007 survey.2,3 This is much lower than the levels of use of illicit drugs, such as ecstasy (3.0%), ....... (2.1%), methamphetamine (2.5%) and ........ (10.3%).4 Unpublished data from the International Tobacco Control Policy Evaluation Study indicate that use of ENDS in Australia is very low....
The death and disability toll from smoking makes the status quo unconscionable. We urge those in the tobacco control community and the government to develop a regulatory strategy that will better serve the public by maximising the potential benefits of these products while monitoring and minimising any negative effects of their use.
Perspectives
How should we regulate smokeless tobacco products and e-cigarettes?
Med J Aust 2012; 197 (11): 611-612.
Coral E Gartner, Wayne D Hall and Ron Borland
https://www.mja.com.au/journal/2012/197/11/how-should-we-regulate-smokeless-tobacco-products-and-e-cigarettes
Concern has been expressed about the possible increased use of smokeless forms of tobacco, such as low-nitrosamine smokeless tobacco (SLT) and electronic nicotine delivery systems (ENDS), also known as e-cigarettes (Box).1 Domestic sale of SLT was banned pre-emptively in 1991 in response to overseas marketing of these products to youth. Currently, Australians are permitted to import limited amounts of SLT for personal use, but the importation of nicotine cartridges and solutions for use in ENDS is prohibited because nicotine is a Schedule 7 poison. Meanwhile, the most harmful tobacco products — conventional cigarettes — are ubiquitous in Australian retail environments.
Low levels of SLT use have been reported in Australia. According to the 2010 National Drug Strategy Household Survey, 0.7% (95% CI, 0.6%–0.9%) of the population aged 14 years or older had used SLT at least once in the previous year, a marginal increase from the 0.5% (95% CI, 0.4%–0.6%) in the 2007 survey.2,3 This is much lower than the levels of use of illicit drugs, such as ecstasy (3.0%), ....... (2.1%), methamphetamine (2.5%) and ........ (10.3%).4 Unpublished data from the International Tobacco Control Policy Evaluation Study indicate that use of ENDS in Australia is very low....
The risks in allowing ENDS to be sold can be managed. These products are designed to look like cigarettes and be used like cigarettes — puffing and exhaling a vapour that resembles smoke. This is why some smokers find them attractive in countries that allow their sale. Some public health advocates oppose their use for this reason, fearing that the tobacco industry will use ENDS to undermine smoke-free policies and counter the denormalisation of smoking.9 It would be prudent to ban use of ENDS in places where smoking is banned and to mandate that ENDS be made to look less like cigarettes — for example, by not having a red glowing tip that lights up when the device is puffed.
Australia currently has among the most restrictive regulation of SLT products and ENDS in the world. Further restrictions would force users of these products to choose between an unregulated black market and continuing to smoke cigarettes. In addition, such a move would be out of step with policy in countries such as New Zealand and the UK,7,10 where the harm reduction potential of these products is being explored. The Australian Government has a valuable opportunity to revise the regulation of these products to benefit public health in the short term and possibly hasten the end of tobacco smoking in the longer term.
The death and disability toll from smoking makes the status quo unconscionable. We urge those in the tobacco control community and the government to develop a regulatory strategy that will better serve the public by maximising the potential benefits of these products while monitoring and minimising any negative effects of their use.
