It is the nature of life that mistakes happen. Smart teachers in life will frame error as inevitable and a valuable learning experience. Others can become so fearful of ‘getting it wrong’ that they get almost paralyzed by indecision.
This principle also applies in medicine, where errors are an unfortunate reality despite the best efforts to avoid them. Doctors take steps to minimize risk, and there are established procedures designed to reduce the likelihood of error. However, mistakes still happen, and all doctors are aware of this. When errors do occur, the response should be to learn from them, avoid repeating them, and, whenever possible, share the lessons learned with others to improve patient care.
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 countries are seeing lower rates of smoking, and declining rates of teen smoking and do not have an “epidemic” of youth vaping. Why? Because they have a legally regulated system, with manufacturing standards, control of advertising, and proportionate taxation. The system works.
So what is Australia doing? Doubling down on failed policy 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 flavors. 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 flavors. It seems flavor 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 “crackdown” 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 from 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!
Dr Joe Kosterich – Doctor, Health Industry Consultant and Author
Doctor, speaker, author, and health industry consultant, Joe is WA State Medical Director for IPN, Clinical editor of Medical Forum Magazine, Medical Advisor to Medicinal Cannabis company Little Green Pharma and Course Chair, and writer for Health Cert. He is often called to give opinions in medico-legal cases, has taught students at UWA and Curtin Medical schools and been involved in post graduate education for over 20 years.
A regular on radio and TV, Joe has a podcast – Dr Joe Unplugged, has self- published two books and maintains a website with health information. He has extensive experience in helping businesses maintain a healthy workforce.
Past Chairman of Australian Tobacco Harm Reduction Association, current Vice President of Arthritis and Osteoporosis WA, Joe previously held senior positions in the Australian Medical Association and has sat on numerous boards.
