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In a move that surprised many, the Royal Australian College of General Practitioners have now included nicotine vape juice and vaping as one of the options for nicotine replacement therapy. Under the new guidelines, GPs and other health professionals can not only introduce, but actually recommend and prescribe vaping as a legitimate tool for quitting smoking.
In the past, GPs who support the use of vaping and nicotine e liquid were reluctant to prescribe and recommend it as a smoking cessation tool because of the lack of approval from the authorities. But now with the RACGP including it in the list of approved cessation tools, it opens up a whole new chapter to those who have been wanting to quit and were previously unsuccessful in doing so.
This move gives Australians who were scared to try vaping due to it being illegal a real shot at quitting cigarettes. This opens the doors to safer and legal ways to purchase nicotine e-juice and protection from black-market products.
“Those who use e-cigarettes are more likely to try to quit and quit successfully than those who do not use e-cigarettes.”
Back in 2009, Australia banned the use, possession and sale of electronic cigarettes that contain nicotine. The main reason for this ban was that that aside from the traditional nicotine replacement therapies, every form of nicotine was considered to be a poison in all preparations except for:
At this point in time, most electronic cigarettes were a far cry from the modern devices of today. Devices from 2009 mostly resembled tobacco products and were marketed as a cessation aid and thus were banned even though they did not contain nicotine. This was due to that fact that cessation aids were required to be registered with the Therapeutic Goods Administration (TGA).
While it was legal for doctors to provide prescriptions for nicotine under the National Poisons Standard, it wasn’t widely prescribed as there wasn’t a full consensus from the RACGP on whether it was an effective cessation tool or not. In fact, it was only last year that Dr. Nick Zwar, Chair of the RACGP Smoking Cessation Group, said that widespread consumption of e-cigarettes could open a “Pandora’s box” of new harms.
This all changed when the latest Supporting Smoking Cessation guide came out.
“Those who use e-cigarettes are more likely to try to quit and quit successfully than those who do not use e-cigarettes.”
This was one of the conclusions of the report released by the RACGP entitled, “Supporting Smoking Cessation – A Guide for Health Professionals, Second Edition.” This echoes what pro-vaping advocates have been saying for years that e-cigarettes are an effective cessation tool and are a safer alternative to traditional cigarettes.
There seems to be a consensus, albeit a misinformed one, that nicotine is the culprit behind all of the diseases linked to smoking. This is not true. The real culprits are the chemicals that are added to the processing of the tobacco and the chemicals that are being released when that tobacco is burned.
Nicotine in itself is a mild stimulant and is present in many items, including food. Even medicinal nicotine in the form of sprays, patches or gums in replacement therapies have proven to be safe and non-carcinogenic. There is negligible risk in moderate intake of nicotine in healthy individuals. Some might even argue that nicotine can have some sort of therapeutic effect as evidenced by some studies which use nicotine in early cases of Alzheimer’s.
The real danger from nicotine is that it is habit-forming and addictive. There is no one in the vaping industry and medical field that will argue with that point. Yes, nicotine is addictive and habit-forming, but that is also why vaping as a smoking cessation tool is so effective. Using nicotine vape juice deliver the same amount of nicotine as a traditional cigarette so the transition from smoking to vaping becomes easier.
One thing is for sure: There is no debate that smoking is deadly and causes all sorts of health problems. In fact, smoking is the biggest preventable cause of mortality in developed nations. This is why the decision by the RACGP to include vaping as a smoking cessation tool is a very welcome development.
In light of arguments that vaping is still harmful, this inclusion of vaping and the use of nicotine e liquid into nicotine replacement therapy by the RACGP shows their commitment to stop or at the very least, reduce harm from tobacco-related health problems. While it isn’t proven to be 100% safe, many studies have shown that vaping is at least 95% safer than traditional tobacco products and two-times more effective than traditional therapies.
A study that was released in Harm Reduction Journal states that
“e-cigarettes can substitute the physical, psychological, social, cultural and identity-related dimensions that were previously enjoyed about tobacco smoking, and thus may uniquely support long-term smoking relapse prevention”
This was also echoed in the RACGP smoking cessation guide when they quoted studies from the United States and UK showing that the uptake of combustible tobacco products has gone down with the increase in usage of nicotine vape juice.
A point that is being pointed out by legislators and pundits with regard to the banning of vape products is that nicotine vape juices come in many different flavors, and that these flavors might lead the younger generation to start vaping. Yes, these different flavors are delicious, but that is also one of the key reasons why those who have transitioned to vaping are more successful in permanently quitting than those who rely on traditional replacement therapies.
A majority of vapers who were formerly smokers will tell you that once they have tried the different flavors of nicotine e-juice, then going back to smoking will be something that they will view with disgust. People who used to think that the smell of cigarette smoke was “normal” and “bearable” will now react the same way as non-smokers do, with disgust.
This is the body’s natural reaction when confronted scents that are not good for us. See the big difference? Non-smokers will first physically react to the vapor being exhaled as this is the natural reaction to “smoke” but there is usually no physical reaction to the smell of the vapor coming from nicotine e-juice, some even like it outright.
Since it is an established fact that nicotine is addicting, going cold turkey only leads to withdrawal symptoms and more often than not, leads to smoking relapse.
In the latest iteration of the Supporting Cessation Guide, the RACGP stated that “Reducing cigarette intake without a nicotine supplement is not recommended and has little proven health benefit.” This is good news for those who were on the fence about trying nicotine vape juice as a part of their cessation journey. This acknowledges the need for nicotine e-juice for those who are really serious about quitting cigarettes.
The beauty with nicotine e-juice is that they come in a variety of concentrations. From 50mg/mL all the way down to zero mg/mL. This means that those who are totally motivated to quit smoking and beating their nicotine addiction can taper down to the point where they are no longer addicted to nicotine and can completely stop.
While the retail of nicotine vape juice within Australia is still deemed illegal to this day, this recommendation by the Royal Australian College of General Practitioners is a real welcome development.
“Royal Australian and New Zealand College of Psychiatrists supports the legalisation and regulation of nicotine-containing e-cigarettes and other vaporised nicotine products to facilitate their use as harm reduction tools”
Their support for legislation and (hopefully fair!) regulation of e-cigarettes and nicotine vape juice is a step in the right direction in supporting those who need to kick the habit. Even though it is last on the list of recommendations, the 15th to be precise, it is worth noting that the mere fact that nicotine eliquid is on that list for smoking cessation means that they recognize the value that vaping brings to the table. Thousands, if not millions, of Australians have already gone through that list of recommendations and failed to quit smoking and now they have a real chance of quitting with the use of nicotine vape juice.
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