A recent survey of pharmacies across New South Wales highlights the failure of the new regulations intended to make low-nicotine vapes (≤20mg/mL nicotine) available without a prescription as Schedule 3 medicines.
Despite promises from Health Minister Mark Butler, a survey of 47 pharmacies revealed that none had low-nicotine vapes available for walk-in customers. Only one low-nicotine vape offered to order them upon request, illustrating the widespread lack of participation.
The survey was commissioned by me and was conducted in metropolitan and rural areas in NSW during the first two weeks of October 2024, following the introduction of the new regulations on October 1, 2024.
The regulations aimed to provide adult smokers with easier access to nicotine vapes, after the failure of the prescription model. The prescription model has been largely rejected by vapers – only seven per cent of vapers had a prescription in 2023 – and few doctors are willing to write nicotine prescriptions.
Increasing violence
I believe this has inadvertently fuelled an increasingly violent black market resulting in a wave of firebombing of vape and tobacco shops and three contract killings since March 2023. Additionally, the black market has made vapes easily accessible to young people, leading to a recent surge in youth vaping.
However, the new prescription-free initiative faced significant challenges from the outset, primarily due to a lack of industry consultation with the pharmacy industry and strong opposition from the Pharmacy Guild of Australia. As a result, many pharmacy chains and individual stores opted out of the scheme entirely.
Further compounding the issue is the prohibition on pharmacies advertising nicotine vape availability, which makes it difficult for adult vapers to identify participating locations.
A survey of ten online Australian pharmacies selling vapes revealed that only one offered products without a prescription through online channels. The main obstacle is the need for an in-depth consultation with the pharmacist, which is impractical to conduct online.
Prohibition
The current regulations are tantamount to prohibition and deny NSW’s smokers and 587,000 adult vapers (total includes the ACT) legal access to the most popular and most effective quitting aid. As a result, some vapers are returning to smoking, while the majority will continue to source unregulated products from the black market.
Youth vaping
The black market further undermines public health by offering unrestricted access to vapes to young people. These illicit products often contain dangerously high nicotine levels and lack safety standards, and are responsible for a recent spike in youth vaping.
This situation is a public health crisis. Smoking remains the leading preventable cause of death and illness in NSW. Adult smokers and vapers must have reasonable access to this safer alternative.
How to sell a vape
Vapes should be sold as adult consumer products from licensed retail outlets with strict age verification protocols, like cigarettes and alcohol, as they are in other Western countries. If adult smokers and vapers have easy, legal access to regulated products, they will prefer them over blackmarket options, leading to a significant reduction in illegal sales.
The solution is straightforward, but the politics are complex. Only by making vaping products accessible and regulated can the government address the current crisis and improve public health outcomes.
Dr Colin Mendelsohn is an academic, researcher, and clinician working in smoking cessation and tobacco harm reduction for over 40 years. He was a member of the Expert Advisory Group that developed the RACGP Australian national smoking cessation guidelines.
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