Relaxing Australia’s regulations on vaping could save the lives of 70,000 to 104,000 people by 2080, according to a modelling study published in Nicotine and Tobacco Research.
Assessing the findings, Dr Colin Mendolsohn, writes that the study uses Australian data where available, but also bases some calculations on US data where it is not:
The study includes the health benefits for daily smokers switching to vaping as well as any increase in harm from vaping in those who would never have smoked.
The population impact of switching to vaping is based on a range of estimates of the risk of vaping compared with smoking. If vaping is 5% of the long-term risk of smoking (estimated by the UK Royal College of Physicians), 104,000 Australian lives will be saved by 2080 and more than 2m years of lost life will be prevented.
And if it is (a very unlikely) 40% of the risk of smoking, 70,000 smoking-related deaths will be prevented and 1.2m million years of lost life prevented.
Australia’s smoking targets
The Australia government has set a modest goal of <10% daily adult daily smoking by 2025 and <5% by 2030 but the study shows that this will be missed by a wide margin. The New Zealand target is 5% by 2025.
Under the current vaping regulations, the national smoking rate will only reach 7.5% for males in 2080 and 5% for females in 2064. With relaxed vaping laws, a 5% target for men will be reached in 2042 and for females in 2036.
As well as vaping, further additional tobacco control policies are needed to reach the target. These could include mass media campaigns, reducing the nicotine in cigarettes to non-addictive levels, reducing the number of retail outlets selling cigarettes and providing further smoking cessation services.
Time to act
The impact could be even greater if Australian governments, health and medical organisations supported and encouraged vaping, as they do in the UK and New Zealand. Improvements in vaping technology are also likely to make vaping more effective. The benefits would also be greater if non-daily smokers were included.
Australia’s outdated regulations on vaping need to change urgently. The evidence for vaping is now convincing and modelling indicates that easy access to nicotine for vaping could save the lives of substantial numbers of smokers, writes Mendelsohn.
Study details
The Australia Smoking and Vaping Model: The Potential Impact of Increasing Access to Nicotine Vaping Products
David Levy, Coral Gartner, Alex Liber, Luz María Sánchez-Romero, Zhe Yuan, Yameng Li, K Michael Cummings, Ron Borland.
Published in Nicotine and Tobacco Research on 8 September 2022
Abstract
Background
We model the potential impact of relaxing current nicotine vaping product (NVP) restrictions on public health in Australia.
Methods
A Restricted NVP Scenario was first developed to project current smoking and vaping rates, where a US smoking model was calibrated to recent Australian trends. To model less restrictive NVP policies, a Permissive NVP Scenario applied rates of switching from smoking to vaping, initiation into NVP and cigarette use, and cessation from smoking and vaping based on US trends. The model measures vaping risk relative to the excess mortality rate of smoking. The public health impacts are measured as the difference between smoking- and vaping-attributable deaths (SVADs) and life years lost (LYLs) in the Restricted and Permissive NVP Scenarios with sensitivity analysis regarding the NVP excess risk and other factors.
Results
Assuming an NVP excess risk of 5% that of smoking, 104.2 thousand SVADs (7.7% reduction) and 2.05 million LYLs (17.3% reduction) are averted during 2017-2080 in the Permissive NVP Scenario compared to the Restricted NVP Scenario. Assuming 40% NVP excess risk, 70 thousand SVADs and 1.2 million LYLs are averted. The impact is sensitive to the rate at which smokers switch to NVPs and quit smoking, and relatively insensitive to the smoking initiation and NVP initiation and cessation rates.
Conclusions
The model suggests the potential for public health gains to be achieved by relaxing NVP access regulations. However, the model would benefit from better information regarding the impact of NVPs on smoking under a relaxation of current restrictions.
Implications
Australia has implemented a strong array of cigarette-oriented policies, but has restricted access to nicotine vaping products (NVPs). The Smoking and Vaping Model offers a framework for modelling hypothetical policy scenarios. The Australian model shows the potential for public health gains by maintaining cigarette-oriented policies while relaxing the current restrictive NVP policy. Modelling results under a permissive NVP policy are particularly sensitive to the estimated rates of smoking cessation and switching to vaping, which are not well established and will likely depend on past and future cigarette-oriented policies and the specific NVP policies implemented in Australia.
See more from MedicalBrief archives:
Anti-vaping research drowns out harm reduction advocates in Australia
Vaping raises chances of regular smoking threefold — Australian research review
Australia: New laws won’t drive vapers back to smoking, say experts
Vaping – Time for doctors to get on board