Nicotine Prescriptions Australia and Nicotine Vaping Products
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Vaping is another term for an e-cigarette. The vape is a battery powered device that contains a liquid. Vaping liquids can contain nicotine for use as nicotine replacement as part of a smoking cessation program. Vaping is the world’s most popular quitting aid and is significantly more effective than nicotine replacement therapy.
The difference between smoking and vaping is that smoking delivers nicotine by burning tobacco. Smoking is dangerous as the toxins produced by burning tobacco damage your body and cause lethal smoking related illnesses. Vaping delivers nicotine by heating a liquid in a much less harmful way. Although this is a much safer alternative than smoking cigarettes, vaping is not harmless, but it is much less harmful than smoking.
Is Nicotine Vaping Safer Than Smoking?
Vaping is at least 95% safer than smoking according to the Royal College of Physicians. This estimate is based on independent reviews of the scientific evidence by both Public Health England and the UK Royal College of Physicians.
“Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products and may well be substantially lower than this figure – Royal College of Physicians”.
Most of the dangerous toxins in cigarette smoke are not present in vapor. When smokers switch to vaping, levels of toxins and carcinogens measured in the blood, saliva and urine (‘biomarkers’) are substantially lower and for many toxins are the same as for a non-smoker. The risk of cancer from vaping has been independently estimated to be <0.5% of the risk from smoking.
Switching from cigarettes to vaping is a way to immediately minimize harm.
Is Nicotine Vaping The Most Effective Quit Smoking Strategy?
A review of worldwide quit smoking trials by British policy institute Cochrane, found rates of quitting were considerably higher in people who used vapes and e-cigarettes than when they used nicotine replacement therapies such as patches. Multiple randomised control trials were reviewed globally including studies from the USA and UK.
Quit smoking rates with vaping were over double the rates of nicotine replacement therapy alone.
Vape To Quit Smoking
The strategy is to completely replace your use of cigarettes with a nicotine vape. Move 100% to using the vape and stop smoking cigarettes. You should be able to do this within a matter of days. Use the nicotine vape as much as you need to stop any cravings for cigarettes.
The advantage of the nicotine vape is the ability to not significantly change your behaviour as a Step 1. So, if you smoke first thing in the morning or with a coffee, or whatever your smoking ritual is, keep doing that. However, replace the cigarette with the nicotine vape. All the harm from cigarettes comes from the burning tobacco that causes heart attack, cancer and stroke. By moving to a non-combustible nicotine vape device, you significantly reduce those risks. Vapes are not without risk, but there is strong evidence that they at least 95% safer than burning tobacco inhalation.
Step 2 should be implemented when you feel psychologically that you are an ex-smoker. This could be within the first 3-6 months of making the switch from smoking to vaping. You then work with your doctor to tackle your nicotine dependence.
- gradually reduce your nicotine vape concentration over time
- reduce you use of you vape on a daily basis
- identify and plan for high risk periods during the day when you are needing to use nicotine
The aim is to gradually move to being free of nicotine over a period of 3-12 months. So Step 1 is to minimise harm quickly by coming off combustible tobacco and Step 2 is toe tackle the nicotine dependence and cease the vape. Your doctor will be able to work with you to support this process.
What Happens When You Quit Smoking And Start Vaping?
Most smokers make the switch from smoking to vaping with relative ease. Usually within a matter of days. The most reported initial side effects are throat or mouth irritation, mild headache, cough or nausea. These are relatively uncommon and reduce over time (1-2 weeks) as people continue using the vape.
Within a few weeks most patients self report feeling like their lung capacity and exercise tolerance has improved – they can breathe more deeply. They feel more energetic and conditions like asthma and COPD improve. These reports are anectdotal and need further investigation.
It’s important to commit to the switch. Don’t smoke and vape.
How To Get A Nicotine Vaping Prescription In Australia
In Australia, it is illegal to buy or sell nicotine for use in e-cigarettes without a prescription from an Australian doctor that is an authorized prescriber of nicotine vaping products.
Quitmate doctors are Australian registered doctors that are authorized to write nicotine prescriptions.
If you have been unable to quit with conventional (first line) treatment, a doctor may consider vaping nicotine as a safer alternative to cigarette smoking and provide nicotine prescriptions when appropriate. Electronic prescriptions can be written and delivery organized with pharmacies nationally.
Best Vape To Quit Smoking Australia
Quitmate doctors will be supportive of any safe strategy that moves towards cessation of cigarettes.
If nicotine vaping is decided upon in a consultation as a strategy, the preferred device is a nicotine pod based device dispensed from an Australian pharmacy. The pod based devices are simple to use with a controlled amount of nicotine. As a quit smoking aid, most patients find pod based devices very simple to start, with minimal knowledge required about nicotine devices or liquids.
If patients have a particular vaping device that they have used in the past and prefer to continue with that device, doctors will be generally supportive if you are aware of the constituents of the product and you are purchasing e-liquids from pharmacies or reputable suppliers and the product is TGO110 compliant.
Talk to your doctor about device options. It’s also important to consider attributes such as child safety with device choice.
First Line Quit Smoking Treatments
Nicotine Replacement Therapy
An important part of a smoking cessation plan is to understand your nicotine dependence. Using products to help control nicotine cravings will improve quit smoking rates.
Nicotinell and Nicorette nicotine patches and chewing gum – can assist by giving the body nicotine in another form and enable withdrawal by gradually reducing doses.
Combination therapy seems to be the best. This involves combining a long-term form of nicotine replacement therapy (such as a nicotine patch) with a short form for cravings (such as gum, lozenge, inhaler).
Nicotine patches can work synergistically with nicotine vaping products.
Medications for smoking cessation
Medications that aid in smoking cessation demonstrate effectiveness. Varenicline, for instance, improves quit smoking rates by diminishing cravings for smoking.
For optimal results, treatment typically spans at least 3 months. Certain patients may encounter side effects like nausea, sleep difficulties, insomnia, vivid dreams, and constipation. However, many of these side effects tend to ameliorate or diminish after a few weeks.
It’s advisable for all patients to discuss the potential utilization of medications as a component of their smoking cessation plan.
There are two pharmacological interventions for stopping smoking available on the Pharmaceutical Benefits Scheme (PBS). These include:
- Bupropion (Zyban) – sustained-release tablets which affect some of the areas of the brain that are affected by nicotine and play a role in brain reward for nicotine withdrawal.
- Varenicline (Varenapix) – can reduce cravings and block the rewarding effects of smoking. Patients on Varenicline plus behavioural support are:
- Nearly three times more likely to quit smoking compared to those on placebo plus behavioural support*
- More likely to quit than patients on buproprion plus behavioural support*
All medications have risks. Your doctor will talk to you about the risks versus benefits of utilizing medications as part of a smoking cessation management plan.
We recommend counselling for all patients that are on a smoking cessation plan. Quit smoking counsellors are here to discuss practical ways to deal with triggers and high-risk times for smoking. Thinking through these high-risk triggers and having a plan in place in how to change your behaviour to avoid smoking cigarettes is vital.
Quitmate recommends contact with Quitline counsellors as part of a quit smoking program and will provide a referral as part of your smoking cessation program.
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