Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697642542014.pdf (Australia)
Submission to Senate Select Committee on Tobacco Harm Reduction Submitter Charlie McCracken Versatile Vapes Tobacco Harm ReductionSubmission 211 Submission to Senate Select Committee on Tobacco Harm Reduction About the submitter My name is Charlie McCracken, I have been the proprietor of a vape shop in Lonsdale, South Australia for over 5.5 years.

I am a 67-year-old vaper and ex-smoker of 6.5 years.

I started smoking in my teens and continued smoking heavily until the age of 60 years.
Until I quit smoking, I was smoking around 60 roll-your-own cigarettes per day.

I had tried quitting on occasion, but was far too entrenched in the habit to succeed, I had resigned myself to dying with a smoke in my hand.

6.5 years ago, I came across a pack of 2 cigarette-like vaping sticks, and sceptically tried them.

The batteries were much too small (low battery life) and the vapour produced was inadequate, but it was proof of concept for me.

My vaping journey had begun.


I then started researching the topic of e- cigarettes and vaping, found myself a good vape setup with adequate battery life and vapour production, ordered liquid nicotine from the USA and set it up.

The same day I started vaping with nicotine, I ceased smoking and have not smoked a cigarette since.
My health has improved immensely, I no longer have several bouts of colds and flu every year, no black fingers, ashtrays and butts, I breathe better, I no longer cough, I snore less, I smell better, taste my food better, exercise better, have saved an estimated $90,000 in 6.5 years and I will enjoy a longer life.

I still enjoy my nicotine and the benefits it provides for me.
Summary Preventing the avoidable death and disease from combustible cigarette smoking should be the highest priority of Public Health and government in Australia, not a war on safer nicotine vaping.

 Combustible tobacco products are “consumer” products used by adults as a matter of adult choice, and the far less harmful vaping products (that have killed nobody in over a decade of use) should also be “consumer” products by adult choice (the choice to live or die, for most smokers).
 While the Australian government enables the sale of known deadly combustible tobacco products, access to less harmful vaping products by Australia’s adult smokers and vapers should be far easier than that for the incumbent deadly product.

Federally based regulation of vaping products as a consumer product will remove the unequal state legislation across Australia, and hopefully give greater ease of access for all Australian smokers and vapers to reduce their harm from tobacco smoke.
  Nicotine scheduling in Australia is a mess, with the most harmful nicotine delivery system (combustible tobacco cigarettes) being exempted from poisons scheduling or “out of scope” of the TGA, yet available everywhere.

Less effective pharmaceutical nicotine replacement therapy products (readily available to anyone over 12 years old) available from pharmacies and grocery stores, no questions asked (at toddler height in some outlets).
And yet, the same nicotine in low strength liquid form for less harmful and more effective vaping, not available for supply and sale without a doctor’s prescription, and criminalised.

Youth smoking rates are the lowest ever and falling faster as less harmful vaping grows.

Youth under the age of 18 years are protected by law in all states of Australia where it is prohibited for them to buy or use any smoking or vaping product (a la alcohol).
Appropriate penalties should apply to offenders, and be enforced.

Online third-party verification systems  Tobacco Harm ReductionSubmission 211  could be implemented to curb online sales by minors.

(Licenced vape shops are already compelled to check ID in store).
The cohort of Australians most at risk right now are those adults middle-aged, elderly, rural/remote living, mental health and indigenous that continue to smoke, not the small minority of youth that may possibly vape (most won’t unless they already smoke).

Children and youth are advantaged when their parents vape instead of smoke.

(More finances for family, less exposure to smoke and longer life expectancy to spend with their families).
 Nicotine is a mild stimulant similar to caffeine in coffee that gives pleasure to its users, is not particularly addictive on its own, is not carcinogenic, and confers very little harm to users.

The addictive potential of nicotine is enhanced by other chemicals in tobacco smoke.

In response to particular terms of reference, I submit the following.
(a) The treatment of nicotine vaping products (electronic cigarettes and smokeless tobacco) in developed countries similar to Australia (such as the United Kingdom, New Zealand, the European Union and United States), including but not limited to legislative and regulatory frameworks It is my understanding that the UK has the best outcomes from their regulation of vaping products in terms of lowering death and disease from smoking, and reducing smoking rates by encouraging adult addicted smokers to switch.
Sweden’s record on smokeless tobacco (snus) should be the envy of the world.

The USA is far less restrictive than Australia but has farcical bans and restrictions in some states, burdensome FDA regulations and other hindrances to tobacco harm reduction.

Canada has less restrictive vaping regulation than Australia, unfortunately under threat in some provinces.
New Zealand has by far the best regulation of any country in our area, encouraging smokers to switch to vaping and aiding New Zealand’s aim to be smoke free by 2025 (Smoke free=5%).

Australia has by far the worst understanding of Tobacco Harm Reduction, where access is restricted to vaping products for both youth and adults, and nicotine for vaping is banned and criminalised.
(b) The impact nicotine vaping products have had on smoking rates in these countries, and the aggregate population health impacts of these changes in nicotine consumption All countries that have legalised and/or encourage vaping have faster decreasing smoking prevalence rates than Australia.

Australia, historically, has had a good record in reducing smoking rates but in the last 6 years that good record has declined.
The National Tobacco Strategy from 2012 -2018 had the goal of reducing smoking rates to 10% by 2018, which goal had failed by mid-term and recently reset to the same figure, and still failing.

Over 21,000 Australians continue to die every year from smoking related diseases while legislation based on perceived fears and misinformation persist.
(c) The established evidence on the effectiveness of e-cigarettes as a smoking cessation treatment A new Systematic Review by Dr Hartmann-Boyce of Cochrane has upgraded certainty that e- cigarettes with nicotine are helping smokers to quit their deadly habit, more so than cold turkey and NRT.

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub4/full.

Previous studies in NEJM and others have found similar.
Tobacco Harm ReductionSubmission 211 (d) The established evidence on the uptake of e-cigarettes amongst non-smokers and the potential gateway effect onto traditional tobacco products As a vape shop owner, I have had less than four handfuls of non-smokers attempting to purchase e- cigarettes in more than 5.5 years.

Non-smoking youth under the age of 18 years are forbidden to purchase or use e-cigarettes.

For non-smoking adults over the age of 18 years it becomes a matter of adult choice.
My research and personal experience indicate that most non-smoker e-cigarette use is experimental and short-lived.

I know of no non-smokers who started vaping and progressed to smoking, although common liability, or common jeopardy, would suggest there are going to be some small amount.

Most negative studies pointing to a “gateway” to smoking have never proven a causal relationship, instead, evidence would suggest that vaping, if practiced at all by non-smokers, is diverting them from smoking.
Education campaigns would deter uptake by non-smokers.

Decreasing smoking rates with simultaneously increasing vaping rates are a reasonable indicator that the “gateway” does not exist.

(e) Evidence of the impact of legalising nicotine vaping products on youth smoking and vaping rates and measures that Australia could adopt to minimise youth smoking and vaping It would make sense that as the number of e-cigarette users rose, smoking prevalence would decrease, if they were effective.
The US, for instance, has high (but decreasing) vaping rates among youth but the lowest youth smoking rates in history.

Critical analysis of NYTS data in the US revealed that there was no teen “epidemic” of regular vaping, as had been suggested.

Regular vaping by youth in the UK is low.

Smoking rates in youth in Australia are also low, and there is no substantial evidence that there is a huge uptick in regular youth vaping.
Youth in Australia can be protected by a Federal age restriction with appropriate penalties, and third-party age verification for online sales.

Most regular vaping by youth is by “risky kids” who have previously smoked or would have otherwise smoked.

Advertising of vaping products should be targeted to adults only as per alcohol advertising.
Rhetoric regarding nicotine poisonings is not warranted when compared with the comparatively huge amount of calls to poisons centres and hospitalisations caused by many other household chemicals in Australia.

(f) Access to e-cigarette products under Australia’s current regulatory frameworks Australia has probably the most restrictive and punitive anti-tobacco harm reduction regime of any western democracy in the world.
Vaping products are a safer “consumer product”, an alternative to a known deadly “consumer product”, the TGA should be encouraged to remove its barriers to easy access to liquid nicotine for Australia’s adult vapers.

Part of the problem in anti-vaping rhetoric, is “anti-nicotine” zealots, including the World Health Organisation.
Despite statements in Article 1(d) and other articles of the Framework Convention on Tobacco Control that state the need for member nations to use “all” means, including harm reduction, to reduce the death and disease from smoking, the WHO FCTC actually enables protections for tobacco companies by denying the harm minimisation aspects of its own articles.
The “precautionary principle” used by Public Health bodies in Australia to justify anti-tobacco harm reduction legislation has been a harmful failure since introduction, the principle should not be used if it creates more harm than good whilst 21,000 Australians continue to die from smoking related disease every year.

Old approaches are no longer working to decrease smoking rates fast enough.
As a vape shop owner in South Australia, I suffer the indignity of walking into my shop every morning to find products covered from display (like deadly tobacco products), and trying to reconcile that with, for instance, the alcohol or other adult- Tobacco Harm ReductionSubmission 211 only product industries.

In South Australia, almost uniquely, I am banned from selling my products online (a violation of Mutual Recognition Agreements).
This law has created a dog’s breakfast where some vendors can advertise online, others can’t.

Myself, or my customers (adult smokers and vapers only) are forbidden vape inside my own licenced adult only premises (a must for instruction on safety and use of the products).

It is hard for Australia’s more than 2 million adult smokers to switch to far less harmful vaping under the unwarranted and unjust circumstances that currently exist, and that is reflected in Australia’s stagnant smoking prevalence rates.
The committee should be aware that a proposed prescription/pharmacy model for access to nicotine would be unworkable, unwarranted and unjustified because:  Doctors will not write prescriptions for nicotine liquid, and they have better things to do       with their time, there are only about ten doctors currently in Australia that will write them.
Pharmacies have shown a disinclination to dispense liquid nicotine (see Pharmacy Guild), a complete reskilling needed, and little knowledge of vaping devices and characteristics.

Vapers will mostly not go to a pharmacy for nicotine, they do not consider themselves ill or diseased, nicotine is not a medicine (just as caffeine isn’t).

Black market sales will surely grow if more restricted and more expensive pharmacy attained nicotine becomes law.
The pharmacy model will devastate existing vape shops which rely on the sale of flavoured liquids to mix with liquid nicotine.

There is no prescription required to purchase deadly tobacco cigarettes which are available on every street corner and kill over 21,000 Australians every year.
There is no prescription required to purchase pharmaceutical nicotine replacement therapy products if one is over the age of 12 years (no questions asked) available from pharmacies, Coles, Woolworths and grocery stores (at toddler height in some).

The nicotine in all products is the same, not “highly addictive” as some may suggest, and when removed from tobacco smoke, about as addictive and harmful as caffeine is.
I would urge the committee to not overlook the anecdotal evidence and real-life experiences of Australia’s more than half a million vapers when evaluating efficacy.

Many anti-vaping studies with negative outcomes for smoking cessation efficacy have proven to be flawed in methodology, biased, cherry-picked or contain unwarranted nicotine-abstinence rhetoric.

Vapers know best how they feel.


(g) Tobacco industry involvement in the selling and marketing of e-cigarettes To my knowledge there are no tobacco company owned vaping products being sold or marketed in Australia.

Tobacco companies were late comers to the vaping market, with their own harm reduction products.
However, if tobacco companies wanted to be involved in a solution to the death and disease caused by their products, and those products were far less harmful, as vaping is, they should be encouraged to do so.
The historical mistrust of Tobacco companies will remain for some time, but WHO FCTC Article 5.3 is an impediment to those companies in having the confidence to make business decisions that could see them shift the balance of their trade towards harm reduction products, and away from deadly cigarettes.
The pretending “dragon slayers” involved in Big Tobacco conspiracy rhetoric are notably also the ones continuously holding out their hand to government and private funders for research and study grants, the outcomes of which are often methodologically flawed to produce adverse outcomes for vaping regulation, and result in regulatory protection for the very “dragons” they are pretending to “slay”.
For some anti-vaping activists, their very livelihoods depend on vaping not displacing smoking and disease remaining.

Tobacco Harm ReductionSubmission 211 (h) Any other related matter: Health risks associated with e-cigarette use As a vendor of vaping products for over 5.5 years, I started my business because I witnessed the surprising and gratifying reality that vaping worked for me to quit tobacco cigarettes when I believed nothing would.
The primary purpose of vape shops is to help Australia’s addicted adult smokers to transition to far safer products, most vape shop owners are well versed in nicotine mixing and titration, product suitability, maintenance and cleaning of products, customer education, help and support (my shop is open 7 days per week).

Vape shops are the customer-facing front line in tobacco harm reduction, they are the smoking cessation clinics that the government doesn’t provide.
The vape industry and its clients are a “community” of like-minded citizens that enjoy nicotine but have rid themselves of the curse of combustible tobacco.

Vaping has grown from the efforts of one Chinese pharmacist, spreading from individual to individual organically, without help from government or pharmaceutical companies, to become the worlds most effective and popular quit smoking aid or smoking alternative.
Vaping has not cost the government or taxpayers a cent, vapers pay for their own devices and liquid.

Vaping, if properly and proportionately regulated could relieve the taxpayers and government from the huge burden that smoking related disease currently places on the public health system, and possibly obsolete combustible tobacco in due course.
Although not risk-free, vaping is at least 95% safer, and probably much better than that (see RCP/PHE), and has been proven to cause little harm, if any, to users and bystanders.

Nicotine is a mild stimulant that gives pleasure to its users and has some benefits (when removed from tobacco smoke), including increased cognitive awareness (focus, memory and attention) and relief from symptoms in some mental health and Parkinsons patients.
Nicotine is a part of most people’s daily diet in the form of consumption of tomatoes, potatoes, egg-plant, cauliflower and some peppers (Nightshade family of plants).

Nicotine doesn’t, and never has, caused cancer.

The addictive potential of nicotine is enhanced by other chemicals in combusted smoke.
As a vape shop owner, I have helped many hundreds of smokers to transition to less harmful vaping, most have expressed their huge relief to be smoke-free and report substantial health and financial benefits.

Most have reported relief from COPD symptoms and some asthmatics have reduced or eliminated the use of puffers, it is gratifying to be a part of an industry that has achieved in this way.
Proper and proportionate regulation of vaping products would include:  Regulation by ACCC as a consumer product (one that replaces a deadly consumer product).

 Licenced adult-only vape shops (make vaping at least as accessible as tobacco products).

 Vape shops able to display/demonstrate their products.

(encouraging smokers to switch).


 Online sales of vaping products with third-party age verification (particularly for rural and remote adult smokers and vapers where vape shops may not be readily accessible (smoking rates higher in remote/rural areas).

Sale of nicotine liquids in licenced and accredited vape shops (as in other countries).

Freebase nicotine cap up to 36mg/mL and nicotine salts up to 60mg/mL strength.
Vape products should not be sold where tobacco products are sold (conflicts of interest).

A decrease in the number of tobacco outlets, increase vape outlets.

(the supply strategy).

Proper regulatory impact assessment/statement and consultation with stakeholders as per best practice government regulation guidelines.

Full range of flavours including tobacco (flavours other than tobacco enhance quitting success).

No cartoon imagery on labels, child-resistant caps on liquid bottles.
Federal age restriction and appropriate penalties for underage users and straw purchasers.

       Tobacco Harm ReductionSubmission 211  Business/Building owners can decide whether vaping is appropriate in part/all of their establishments.

(No significant harm from exhaled vapour for users or bystanders).

 Non-smoking vapers should not be forced into smoking-only areas to vape.

(a violation of governmental duty of care to reduce exposure to tobacco smoke for all Australians).
If the government is unable to persuade the TGA to remove nicotine liquid for vaping from its current scheduling, then the TGA should be forced to include nicotine in “tobacco when prepared and packed for smoking” in its scheduling of nicotine.

 The committee should be aware that assertions of “lung injuries and deaths” associated with vaping by top level public health officials and others in Australia are false and misleading.
Previous misleading statements to that effect by public health officials in Australia have never been retracted.

The CDC has stated that EVALI deaths in the US were not associated with nicotine vaping.

I would implore the committee to consider the “human right to the best attainable health”.

Smokers and vapers are human beings with this inalienable human right to tobacco harm reduction.
Finally, a motto that I have lived by and advocated for over the last several years: “There is no justification, no excuse, ever, to restrict or ban less harmful vaping products for Australia’s adult smokers and vapers”.

Thank you for accepting this submission.

Tobacco Harm ReductionSubmission 211