It is the nature of life mistakes happen. Smart teachers on life will frame error as inevitable and a learning experience. Others can become so fearful of “getting it wrong” that they get almost paralysed by indecision.
This applies in medicine too where errors will occur despite best efforts to avoid them. Doctors take steps to minimise risk and there are procedures designed to reduce the likelihood of error. However, they still happen and all doctors know this. When they occur, the response is to learn, hopefully not repeat, and if possible, make the lessons available to others.
There is though, one field of medicine where error is either never made or, if it is, never admitted. That field is public health. Have you ever heard anyone in public health come out and admit they got it wrong?
The approach to vaping in Australia typifies this. The regulations introduced by the previous government whereby those wanting to quit smoking by vaping (the world’s most popular and successful quit smoking method) had to go to a doctor to get a prescription have abjectly failed – both to help smokers and to stop access by teens.
There has been a significant increase in black market activity and access to vapes by teens has never been easier. Meanwhile those less tech savvy have barriers put in front of them when seeking to stop smoking.
New Zealand, the UK and other counties are seeing lower rates of smoking, declining rates of teen smoking and do not have an “epidemic” of youth vaping. Why? Because they have a legal regulated system, with manufacturing standards, control of advertising and proportionate taxation. The system works.
So what is Australia doing? Doubling down on failed policy which has created the very problem that public health now wrings its hand about. It is already illegal for teens to vape. You cannot make that which is already illegal, more illegal.
Rather than admit error and accept that other countries have got it right – Australia’s public health is doubling down on failed policy. And patting themselves on the back for doing so.
It is already illegal to be in possession of nicotine liquid without a prescription. Thus, some 90-95% of the estimated over 500,000 vapers in Australia are currently in breach of the law. The new regulations do not change this. The plan is to ban flavours. Apparently, they are a problem.
However, if you go to the supermarket (not even the chemist) you can buy, without a prescription, nicotine sprays and chewing gums in a range of flavours. It seems flavour is only a problem when nicotine is in liquid form. You can also buy nicotine patches at the supermarket and of course, cigarettes. Maybe as soon as nicotine liquid enters Australia it changes compared to the rest of the world.
In the UK there are plans to provide free vape kits to those wanting to give up smoking. A cursory check of health department websites of the UK and NZ government will reveal research that vaping is at least 95% less harmful than smoking.
Smoking remains the biggest contributor to premature deaths in Australia with some 20,000 per year. Tobacco excise raises over $17 billion, and growing, each year for the federal government. Whilst price increases have had some effect, there is a point where people either go to the black market or buy cigarettes before feeding their children. These people do not move in the circles frequented by the academics and latte set so are invisible to them.
Ultimately the “crack down” on vaping will not have the desired effects. In fact it will strengthen the black market and make it harder for smokers to quit. Keep in mind that some 40% of Indigenous citizens smoke and over 70% of those with mental health problems smoke. The national average is around 13-14%.
Teens should not smoke, or drink, or use illicit substances or vape. In the real world some do. These changes won’t stop teens accessing the black market. When it comes to smokers, far from helping those most in need in society these changes will make the situation worse.
This is a lose – lose. And it is so unnecessary. New Zealand and the UK have shown what works. It is not difficult. It does, however, require admission of error by public health.
It seems that they would rather the situation get worse rather than do that. Very sad!
Medical Doctor, author, speaker, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
Joe writes for numerous medical and mainstream publications, is clinical editor at Medical Forum Magazine, and is also a regular on radio and television.
Joe is Medical Advisor to Medicinal Cannabis Company Little Green Pharma, Chairman of Australian Tobacco Harm Reduction Association and sits on the board of Arthritis and Osteoporosis WA. He is often called to give opinions in medico legal cases.
He has self-published two books: Dr Joe’s DIY Health and 60 Minutes To Better Health.
Through all this he continues to see patients as a GP each week.