Colin Mendelsohn | National Health and Medical Research Council releases flawed advice on e-cigarettes

The NHMRC position statement on vaping was reviewed last week by 11 leading, independent Australian and international addiction scientists. We found it was riddled with serious scientific errors and misinformation and failed to meet the high standards expected of a leading health and medical organisation. The review was published in the leading scientific journal Addiction.

This matters because NHMRC advice is used to guide Australian health policy. It is clear now that this policy has failed. The Therapeutic Goods Administration has admitted Australia's policy on vaping is not working and is reviewing the evidence once again to reform the regulations. It is essential we get it right this time.

Firstly, the NHMRC exaggerates the risks of vaping nicotine. It highlights the presence of chemicals in vapour without making it clear that most of these chemicals are below levels that cause harm to health. The science suggests vaping carries just 5 per cent the health risk of cigarette smoking. The NHMRC incorrectly claims vaping causes seizures and the serious lung conditions "EVALI" and "popcorn lung". However, there is no evidence that vaping nicotine causes any of these conditions.

Secondly, the NHMRC wrongly claims "e-cigarettes are not proven effective cessation aids". On the contrary, the highly respected Cochrane Review concluded there is high certainty evidence that vaping is significantly more effective than nicotine replacement therapies such as patches and gum. E-cigarettes were also found by the UK National Institute for Health and Research to be the most effective single therapy for quitting smoking.

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Thirdly, the NHMRC claims vaping causes young people to take up smoking, when the opposite is more likely to be true. Increased vaping is accompanied by accelerated declines in youth smoking in many western countries, suggesting that vaping is diverting more young people AWAY from smoking than encouraging them to smoke. Most youth vaping by non-smokers is experimental and transient and does little harm.

Fourthly, the NHMRC Statement dismisses the evidence that vaping is already having a net positive public health effect. Research shows the decline in smoking has accelerated since vaping became available in many countries. In New Zealand, after vaping was regulated in 2020, the daily adult smoking rate fell by an unprecedented 33 per cent in two years. In comparison, the smoking rate in Australia declines by about 2 per cent per year.

Vaping is the most popular aid for quitting or reducing smoking in Australia and other western countries. Because of its proven effectiveness and wide reach, vaping is likely to have a far greater population effect than any other strategy.

Finally, the NHMRC argues we should not allow vaping because of uncertainty about long-term risks. While the precise long-term risk will not be fully known for many decades, it is highly likely to be far less harmful than deadly smoking. The relatively small risks of harm from vaping will be far outweighed by the more substantial known harms from delaying access to current smokers, for whom the known risks are substantial.

Australia's restrictive, prescription-only policy on vaping is out of step with other western countries where vapes are sold as consumer products. Governments in New Zealand and the United Kingdom recommend vaping products as smoking cessation aids. Australia's harsh restrictions have led to a thriving black market selling dodgy unregulated products freely to adults and children. Legal access to vapes by adult smokers is almost impossible.

This is not the first time that a NHMRC report has been criticised as seriously flawed. Formal charges on scientific and ethical conduct and bias by the NHMRC in the preparation of the 2015 report on homeopathy have been filed with the Commonwealth Ombudsman and a review is under way. This places serious question marks over the NHMRC's ability to objectively assess information.

Conflicts of interest and bias by the NHMRC are also a serious concern. Three members of the NHMRC Electronic Cigarette Working Committee have published papers opposing vaping. Other members of the committee represent organisations which have made strong public anti-vaping statements. No pro-vaping experts, vapers or smokers were included on the Committee.

An independent and impartial Australian review of the evidence by a balanced committee is urgently needed before further changes to vaping policy are implemented. If we continue to follow the current NHMRC guidelines, we will miss a huge opportunity to reduce smoking rates and more Australian smokers will die unnecessarily.