A growing number of GPs are prescribing nicotine vaping products to people who want to quit smoking after restrictions around the importation of e-cigarettes were tightened and large fines introduced for illegally selling or importing the products.
On October 1 last year – after a delay amid fierce backlash from within the Coalition – the federal government increased restrictions and introduced tough sanctions against people or businesses importing nicotine-based vaping products without a prescription.
But there are claims that gaps in the system have allowed some telehealth doctors to provide 12 months’ worth of prescriptions to patients.
Data from the Department of Health shows the number of GPs approved as authorised prescribers of nicotine vaping products rose from 27 in July 2021 to 354 in October that year and 618 in January.
Those Medicare Benefits Schedule items do not require doctors to have an established clinical relationship with patients when using telehealth.
A department spokesperson said the government “will continue to monitor usage of the nicotine and smoking cessation counselling items and consult with stakeholders”.
Richard Lee is the chief executive of Liber, which manufactures prescription-only nicotine vaping products in Australia and is pursuing registration with the medical regulator. He says he has collected evidence of GPs essentially prescribing e-cigarettes as a consumer product.
“We have seen, anecdotally, cases of doctors that are issuing without ever speaking to a client or a patient,” he said. “We have seen social media offering ‘refer a friend’ discounts on TikTok and things like that. Now, that doesn’t feel like a medicine.”
In September, the Royal Australian College of General Practitioners updated its advice to doctors on prescribing quit-smoking aids, telling GPs e-cigarettes should be prescribed only after other treatments have been tried, and that only three months’ worth of products should be prescribed at a time.
A spokesperson said the college does not have data on doctors who are not adhering to the guidelines, but president Dr Karen Price said there were risks around telehealth or online services that offer prescriptions.
“A key concern is that these services are fundamentally responding to a business opportunity rather than delivering healthcare,” she said.
The federal government has committed to a review of the system a year after the prescription-only model was introduced. A government source with an understanding of the regulations said while they were aware of the potential downsides of telehealth-only prescribers, the benefit to regional patients and vulnerable groups during the pandemic must be weighed against it.
Since the October 1 change, 25 fines totalling nearly $260,000 have been issued for unlawful advertising of nicotine vaping products and more are likely in coming weeks, medical regulator the Therapeutic Goods Administration said.
The watchdog is also working closely with the Australian Border Force and states and territories to uncover illegal importations of nicotine vaping products, and a spokesperson said several investigations were under way.
Rachel Clun – Sydney Morning Herald – 2022-02-06.
Want More Investigative Content?
