Australia’s Anti-Vaping Policies Are Failing GPs, Pharmacists & Smokers

18 April 2025

by Pippa Starr

Australia’s vaping policy has been one of the most restrictive in the world, requiring some adults to obtain a prescription for nicotine vapes, deal with a clueless chemist, while smoking remains freely accessible on nearly every street corner.

A recent nationwide study published in the Harm Reduction Journal reveals critical flaws which clearly highlight:

our frontline health professionals are ill-equipped to carry out Mark Butler's chemist-based vaping policy.

General practitioners (GPs) are often the first and only point of contact for many people who smoke, yet they remain deeply uncertain, under-informed, and hesitant about vaping as a smoking cessation tool. This isn’t surprising. The government introduced sweeping regulatory changes in 2021 and again in 2024, demanding GPs take on the role of gatekeepers to nicotine vapes, but provided little support in the way of education, training, or clinical guidance.

The study tracked GPs' knowledge, attitudes, and prescribing intentions from the time of the law’s introduction to one year later. The results are sobering:

• Just 14% of GPs were recommending e-cigarettes in the first wave; this only rose slightly to 23% a year later.

• Knowledge remained poor, barely improving from 2.7/6 to 3.4/6 on average.

• Confidence talking to patients was modestly better, but still low.

• GPs who did feel knowledgeable and confident were far more likely to prescribe, a strong signal that education could unlock better patient support.

Last year I visited a GP and asked him if he could help with a prescription vape, and he said, "They're at all the tobacconists, just go there! You don't need a prescription!"

Australia's prescription-only model for vaping was justified as a “precautionary” move to curb youth uptake. But it has inadvertently created a thriving black market, as reported by multiple experts, including criminologist Dr James Martin​.

Meanwhile, GPs are left confused and unsupported in conversations with adult smokers who could benefit from switching to a safer alternative.

The evidence is mounting, including a recent Cochrane review, that nicotine e-cigarettes are more effective than traditional nicotine replacement therapies (NRTs), yet Australia persists in limiting access, wrapped in precaution but starved of pragmatism.

One of the most damning findings from the study is that prescribing intentions are directly linked to GP knowledge and confidence. Those who had registered as e-cigarette prescribers and stayed informed were far more likely to recommend them.

But most GPs weren’t confident. Most weren’t prescribing. And most didn’t have the tools or training to start.

The conclusion is clear: you can’t ask GPs to be gatekeepers if you haven’t given them the keys!

We need urgent investment in GP education, evidence-based clinical guidelines, and access to unbiased, evidence-based resources. Regulatory change must be accompanied by professional development, not left as an empty directive that leaves doctors in the dark and patients without support.

Now that vapes no longer require a prescription except in Tasmania and Western Australia, it's important for the handful of pharmacists that sell vapes to be better educated as well.

Pippa Starr from the ALIVE Advocacy Movement, who speaks on behalf of thousands of vaping consumers across Australia, said, "Vapers go into chemists and either learn that they have no vapes or when they do, the person behind the counter has no idea what they're doing or supplying when asked questions!".

Australia’s rigid policy is not only isolating smokers from harm reduction tools, it’s burdening our GPs and Pharmacists with a policy they can’t implement effectively. A tightly regulated over-the-counter consumer model, with clear age restrictions, product standards, and health warnings, may achieve a better balance between youth prevention and adult access.

If supermarkets can retail nicotine replacement patches and sprays to consumers, why must vapes be only limited to chemists?

The chemist model of selling vapes has clearly failed as we see well more than 90% of vapes sold via a dangerous black market!

Tobacco kills more Australians than alcohol, drugs, and car crashes combined. In this context, harm reduction isn’t optional, it’s ethical. E-cigarettes/Vapes are not a silver bullet, and they’re not risk-free. But they are a lifeline for many smokers who’ve failed with traditional methods.

This recent study makes it clear: if we want to reduce smoking through vaping, our doctors must be empowered, not hamstrung.

Our chemists must no longer be expected to have a monopoly on vape sales!

Let’s stop pretending regulation alone will solve the problem. It’s time to train, support, and trust our GPs, respect our pharmacists and reconsider who we’re really protecting with our current approach.

Because right now, the nicotine consumers of Australia aren't being protected!