• Nicotine vaping can be a remarkably effective way of helping ex-smokers stay smoke-free. The typical patient I see is a 40 – 60 year old ex-smoker. They started smoking as a teenager, became strongly addicted and smoked heavily, and unsuccessfully tried for many years to quit using a combination of nicotine replacement therapies, medication such as Champix, and counselling or hypnotherapy. Typically they have come across vaping in the past few years, and they generally report being able to stop smoking almost immediately and permanently. They generally report a wide range of health improvements since stopping smoking.
• Nicotine addiction can develop quickly and persistently, and unfortunately for some smokers it is simply impossible to quit smoking using the current first-line therapies (nicotine replacement therapy and/or pharmacotherapy).
• In my experience as a prescribing doctor to ex-smokers, I have found the following: it is almost never simply a lack of ‘willpower’ that prevents you from stopping smoking. The power of nicotine addiction is unfortunately much stronger than even the greatest will-power. There will always be those fortunate people who, despite much exposure to nicotine via smoking, are able to successfully and persistently give up smoking without great difficulty. But sadly, there are many many more who have the best of intentions, and the strongest desire to stop smoking, but find the physical and mental effects of nicotine withdrawal simply devastating. It is for these people that vaping nicotine e-liquid can be the only thing that keeps them smoke-free. 

No one is saying that nicotine vaping is 100% safe. There is no long-term data on the safety of nicotine vaping. However, there is a substantial and growing body of evidence that supports the relative safety and effectiveness of nicotine vaping, compared to smoking tobacco.

The World Health Organization provides a balanced assessment of the role of nicotine vaping. Click here for the full report. Essentially, although the lack of long-term safety data is highlighted as a major issue, WHO does offer support for nicotine vaping in current smokers who are unable to stop smoking:

• “If the great majority of tobacco smokers who are unable or unwilling to quit would switch without delay to using an alternative source of nicotine with lower health risks, and eventually stop using it, this would represent a significant contemporary public health achievement.”
• “It is very likely that electronic nicotine devices are less toxic than cigarette smoke”
• “Electronic nicotine devices are unlikely to be harmless, (but) the magnitude of these risks is likely to be smaller than from tobacco smoke.”
  — World Health Organization 2016, WHO Framework Convention on Tobacco Control

RACGP provides a comprehensive guideline for doctors regarding smoking cessation. The relevant section can be accessed here. In essence, although nicotine vaping is not a first-line smoking cessation method, the RACGP say it ‘may be a reasonable intervention’ in certain groups:
“For people who have tried to achieve smoking cessation with approved pharmacotherapies but failed, but who are still motivated to quit smoking and have brought up e-cigarette usage with their healthcare practitioner, nicotine containing e-cigarettes may be a reasonable intervention to recommend.”

Anyone under 18 is not eligible for a nicotine script from me, regardless of circumstances. The Australian legislative position is absolutely clear on this – Vaping (with or without nicotine) is UNSAFE for young people to experiment with. There are valid concerns that vaping when young may lead to smoking. However, I am happy to discuss other smoking cessation strategies with anyone under 18. And please, make sure to explore what QUIT.org.au can offer you. 

• See https://www.tga.gov.au/blogs/tga-topics/nicotine-e-cigarettes-laws-are-changing for latest updates
• In Australia, vaping (with or without nicotine) is not recommended as first-line therapy for smoking cessation.
• From Oct 2021, a doctor’s prescription is required in order to buy, possess and use liquid nicotine for vaping (Over 18s only)
• With a script, you have 2 options for accessing the product: 
  1. import every 3 months from overseas
  2. purchase from a participating Australian pharmacy