Approximately 2.4 million Australians smoke cigarettes daily and it has been estimated that two out of every three smokers will die prematurely due to their smoking. Given these stark figures, reducing the number of Australians who smoke is one of the nation’s most important public health objectives.
This Committee has spent close to a year examining whether E-cigarettes could assist in meeting that objective.
The Standing Committee on Health, Aged Care and Sport has a long history of delivering consensus and bipartisan reports. On this occasion that has not been possible and I find myself in the unusual position as Chair of authoring a dissenting report.
The Committee has been presented with starkly conflicting views during this inquiry and I respect those Committee members who have formed different judgements to my own. I do, however, strongly disagree with the conclusions reached by the majority of my colleagues.
Australia has been a global leader in developing tobacco control policies such as plain packaging, advertising restrictions and anti-smoking mass media campaigns. This approach has been very successful — between 1991 and 2013 the proportion of Australians smoking daily dropped from 24 per cent to 12.8 per cent. In recent years, however, progress has stalled with the daily smoking rate only dropping from 12.8 per cent to 12.2 per cent between 2013 and 2016. It is highly unlikely Australia will reach its 2018 target of reducing smoking to 10 per cent of the population.
In these circumstances, a new approach is needed for those smokers who have been unable to quit smoking using the assistance currently available. We need another weapon in the arsenal. The familiar hand-to-mouth movement and the ‘hit’ of nicotine provided by E-cigarettes may appeal to those hardened smokers who have struggled to quit using traditional nicotine replacement therapies. While the evidence base regarding E cigarettes is still emerging, there are clear indications that E-cigarettes are significantly less harmful to human health than smoking tobacco cigarettes. If long term smokers who have been unable to quit smoking tobacco cigarettes switch to E-cigarettes, thousands of lives could be saved.
One medical researcher whom the Committee met in New Zealand put the choice starkly. If a patient has earnestly tried existing ways of quitting but failed, then knowing the consequences of that patient continuing to smoke, how could a medical practitioner morally and ethically not recommend they consider E‑cigarettes?
Despite the potential health gains, Australia’s public health community has been resistant to the idea of making nicotine E-cigarettes legally available. This stands in contrast to many of their counterparts in the United Kingdom and New Zealand who gave evidence to the Committee. While Australia should always set its own course, it was striking that similar organisations and experienced public health officials in those nations drew very different conclusions.
In part this is understandable; Australia has had considerable success in making smoking a less visible activity and reducing its appeal to young people. Many members of the public health community are concerned that legally available nicotine E-cigarettes may reverse these gains and make vaping, and by extension smoking, attractive to young people once more.
In those countries where nicotine E-cigarettes are legally available, however, there has not been an increase in youth smoking. In fact, smoking rates among young people continue to fall in jurisdictions where E-cigarettes are available.
Further, despite Australia’s current restrictions on nicotine E-cigarettes, nicotine E‑liquid can easily be purchased online from overseas. This unregulated ‘black market’ poses risks regarding product quality and safety, and could also see people under 18 years of age purchasing E-cigarettes and liquid for these devices online.
Australia’s approach to E-cigarettes is also marked by inconsistency. E-cigarettes not containing nicotine are legally available in most states and, despite the domestic prohibition on sale and purchase, can be legally imported by individuals through the Therapeutic Goods Administration’s Personal Importation Scheme with a prescription. There is also something obviously inconsistent about cigarettes being legally available while a less harmful nicotine product is not.
This is why in a dissenting report I argue that, in order to assist the millions of smokers struggling to quit tobacco smoking and improve their quality of life, nicotine E-cigarettes should be made available as consumer products. At the same time, regulatory restrictions should be imposed to limit the appeal of E-cigarettes to young people and non-smokers. This includes prohibiting the sale of E‑cigarettes to people under 18 years of age and sales and marketing restrictions similar to those in place across the European Union (where E-cigarettes are legally available). Product safety and labelling requirements are also key regulatory considerations. At the same time, research into, and monitoring of, the health impacts of E-cigarettes and E-liquid should be undertaken in parallel, to inform future policy and regulatory decisions.
I would like to thank all the organisations, academics and agencies who participated in this inquiry, as well as the many individuals who shared their personal stories regarding their experiences using E-cigarettes. The Committee also heard from witnesses from the United Kingdom and I thank them for the insight they provided regarding the UK’s experience with E cigarettes.
I would also like to extend the Committee’s thanks to the members of the New Zealand Government, Parliament and public health community who kindly made time to meet with the Committee’s delegation in New Zealand. Their willingness to share their expertise and experiences with the Committee in the spirit of cooperation continues to underpin the close relationship between Australia and New Zealand. In addition, I would like to thank Australia’s High Commission to New Zealand for its assistance to the Committee.
The Committee has been again exceptionally well served by the Committee staff led by its Secretary, Stephanie Mikac. The Committee records its thanks for their work.
Finally, I would like to thank my Committee colleagues for their consideration of the evidence during this inquiry.
Mr Trent Zimmerman MP
Chair