However, from 1 October, legislative changes will mean people have to obtain a valid prescription from their GP to legally obtain nicotine vaping products from overseas, including e-cigarettes, pods and liquid nicotine.
The Therapeutic Goods Administration (TGA) has urged people to consult with their GP to discuss their smoking cessation options to help prepare for the impending change.
But as the deadline draws near, there are concerns GPs will be left exposed – particularly as the regulator is yet to register any nicotine vaping products, despite reportedly working closely with several potential applicant companies.
Professor Nick Zwar, Chair of the Expert Advisory Group for the RACGP`s Supporting smoking cessation: A guide or health professionals, says this complicates matters for the prescribing doctor.
`Nowhere in the world has a manufacturer of nicotine vaping products yet applied for and been recognised as a therapeutic good,` he told newsGP.
`So no nicotine vaping product has had the full assessment – effectiveness, safety – all of that sort of stuff that a medicine gets when it`s going to go on the register of medicines.`
Vaping products stocked and dispensed by an Australian pharmacy meet the Therapeutic Goods Order (TGO) 110 standard, which ensures the product includes an ingredient list, nicotine concentration, has childproof packaging, and excludes any prohibited ingredients.
However, Professor Zwar says those assurances do not change the fact that GPs would still be prescribing an unregistered product with uncertainties about long-term safety.
`We just don`t know the long-term safety of nicotine vaping products,` he said. `TGO helps a bit on that, but it`s not like a medicine where you produce a generic blood pressure tablet, for example, and it`s going to be tested and proven to be basically the same ingredients.
`There are many, many manufacturers of nicotine vaping products from around the world, so it`s a much broader range than you would get if it was a medicine being produced by the pharmaceutical industry.`
He is also concerned that GPs, at this stage, have not been adequately prepared to prescribe nicotine vaping products.
`Realistically, I think if patients go into their GP at the moment and ask about it, very few will be ready because there has been no widespread education program rolled out for GPs,` Professor Zwar said.
`There`s quite a lot of issues that need to be covered to help GPs to make an informed choice about whether they`re going to prescribe at all, and if so, to whom and with what and for how long, and when should they see the patient again.`
To help bridge the gap and support practitioners, the RACGP is preparing a revised guideline for the use of vaping products and has also been funded to create an education module for its smoking cessation guidelines.
But due to limited evidence, the college`s current guidelines still only recommend nicotine containing vaping products as a second-line treatment.
And while GPs wait for more clarity, Professor Zwar fears they may find themselves in the firing line of some patients, particularly those who have been importing and consuming vaping products for years.
`If it`s not happening already, it`ll be happening soon as people realise - that they need a prescription,` he said.
`GPs will be in a difficult situation of not being familiar with the pathways and whether they want to be involved or not. Unfortunately, it`s likely there`s going to be some pretty uncomfortable interactions between GPs and people.
`But ultimately, it`s not the GPs` fault – we didn`t make this decision; the decision was made by Government and then enacted by the TGA. So if people are unhappy, then it`s not reasonable for them to take it out on their doctor.`The use of nicotine vaping in Australia, up from 9% in 2016 to 11% in 2019.
However, from 1 October, legislative changes will mean people have to obtain a valid prescription from their GP to legally obtain nicotine vaping products from overseas, including e-cigarettes, pods and liquid nicotine.
The Therapeutic Goods Administration (TGA) to consult with their GP to discuss their smoking cessation options to help prepare for the impending change.
But as the deadline draws near, there are concerns GPs will be left exposed – particularly as the regulator is yet to register any nicotine vaping products, despite reportedly working closely with several potential applicant companies.
Professor Nick Zwar, Chair of the Expert Advisory Group for the RACGP`s , says this complicates matters for the prescribing doctor.
`Nowhere in the world has a manufacturer of nicotine vaping products yet applied for and been recognised as a therapeutic good,` he told newsGP.
`So no nicotine vaping product has had the full assessment – effectiveness, safety – all of that sort of stuff that a medicine gets when it`s going to go on the register of medicines.`
Vaping products stocked and dispensed by an Australian pharmacy meet disposable vapes. which ensures the product includes an ingredient list, nicotine concentration, has childproof packaging, and excludes any prohibited ingredients.
However, Professor Zwar says those assurances do not change the fact that GPs would still be prescribing an unregistered product with uncertainties about long-term safety.
`We just don`t know the long-term safety of nicotine vaping products,` he said. `TGO helps a bit on that, but it`s not like a medicine where you produce a generic blood pressure tablet, for example, and it`s going to be tested and proven to be basically the same ingredients.
`There are many, many manufacturers of nicotine vaping products from around the world, so it`s a much broader range than you would get if it was a medicine being produced by the pharmaceutical industry.`
He is also concerned that GPs, at this stage, have not been adequately prepared to prescribe nicotine vaping products.
`Realistically, I think if patients go into their GP at the moment and ask about it, very few will be ready because there has been no widespread education program rolled out for GPs,` Professor Zwar said.
`There`s quite a lot of issues that need to be covered to help GPs to make an informed choice about whether they`re going to prescribe at all, and if so, to whom and with what and for how long, and when should they see the patient again.`
To help bridge the gap and support practitioners, the RACGP is preparing a revised guideline for the use of vaping products and has also been funded to create an education module for its smoking cessation guidelines.
But due to limited evidence, the college`s current guidelines still only recommend nicotine containing vaping products as a second-line treatment.
And while GPs wait for more clarity, Professor Zwar fears they may find themselves in the firing line of some patients, particularly those who have been importing and consuming vaping products for years.
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`If it`s not happening already, it`ll be happening soon as people realise - that they need a prescription,` he said.
`GPs will be in a difficult situation of not being familiar with the pathways and whether they want to be involved or not. Unfortunately, it`s likely there`s going to be some pretty uncomfortable interactions between GPs and people.
`But ultimately, it`s not the GPs` fault – we didn`t make this decision; the decision was made by Government and then enacted by the TGA. So if people are unhappy, then it`s not reasonable for them to take it out on their doctor.`
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