Volume 210 - Issue 3
Regulating known unknowns: ensuring the safety of e‐liquids in Australia
Authors: Sarah L White, Claire Grace and Michelle M Scollo
Med J Aust 2019; 210 (3): 119-120. || doi: 10.5694/mja2.50008
Published online: 18 February 2019
Published online: 18 February 2019
Governments must ensure that purportedly nicotine-free e-liquids do not contain any nicotine
Governments must ensure that purportedly nicotine‐free e‐liquids do not contain any nicotine
The Australian Poisons Standard1 lists nicotine as a schedule 7 ”dangerous poison”, except when included in tobacco products prepared and packaged for smoking or in preparations for therapeutic use. No e‐cigarette has been approved by the Australian Therapeutic Goods Administration (TGA) for therapeutic use.2 Selling e‐cigarettes or e‐liquids containing nicotine is consequently illegal in every Australian state and territory.2
There are a few exceptions. The TGA Personal Importation Scheme allows the import of a small amount of liquid nicotine for personal use if the importer satisfies a number of requirements, including obtaining a prescription from an Australian‐registered medical practitioner.
E‐cigarettes that do not contain nicotine may be sold in Australia, provided they are not marketed as therapeutic products.4 Most Australian states and territories regulate the sale of non‐nicotine‐containing e‐cigarettes to some extent. For example, their sale to minors is prohibited in most jurisdictions, as are their advertising and promotion; in Western Australia, e‐cigarettes that resemble standard cigarettes are banned.4
As Wylie and colleagues point out in this issue of the MJA,5 some imported products do not have child‐resistant closures or appropriate and accurate labelling. No Australian state or territory specifically regulates the packaging or labelling of non‐nicotine‐containing e‐cigarettes and e‐liquids. There is no general legal requirement that manufacturers of e‐cigarettes list the ingredients on their packaging, nor that the packaging be child‐ or spill‐proof. This is problematic, given that some liquids are sold in packaging resembling that of drinks or confectionery and may appeal to children.
The finding of Chivers and colleagues, also reported in this issue of the Journal,6 that six of ten purportedly nicotine‐free e‐liquids tested contained nicotine and other potentially harmful (and some unknown) compounds is therefore deeply disturbing. How does a consumer know what they are inhaling? And what dangers are posed to children (and adults) when consumers are unaware that their e‐liquid contains nicotine and do not take appropriate action (such as calling a Poisons Information Centre) when an unintended exposure occurs?
Following several reviews in Australia7,8 and overseas9,10 and two parliamentary inquiries,11,12 the Australian government has recently commissioned the National Centre for Epidemiology and Population Health at the Australian National University to examine the scientific evidence regarding the potential role of e‐cigarettes in reducing the population harm caused by tobacco. This research should help inform the development of the most appropriate regulatory framework for e‐cigarettes for effectively achieving this public health aim. Whatever framework is ultimately adopted, regulation of e‐cigarettes in Australia should cover packaging and labelling in order to avert accidental poisonings, as noted by Kennedy and Jones in this issue of the Journal.13
Banning the sale of non‐nicotine‐containing products to people under 18 in all Australian states and territories is a good start, but does not protect children from products purchased by adults. Governments should go further, prohibiting e‐cigarette products in packaging attractive to children. In the meantime, state and territory governments have a responsibility to ensure that purportedly nicotine‐free e‐liquids available to consumers do not contain nicotine: monitoring these products should commence immediately.
Competing interests
No relevant disclosures.
References
- Australian Department of Health, Therapeutic Goods Administration. The Poisons Standard (the SUSMP). 28 Sept 2018. https://www.tga.gov.au/publication/poisons-standard-susmp (viewed Dec 2018).
- Australian Department of Health, Therapeutic Goods Administration. Electronic cigarettes. 30 Mar 2015. https://www.tga.gov.au/community-qa/electronic-cigarettes (viewed Dec 2018).
- Australian Department of Health, Therapeutic Goods Administration. Liquid nicotine and personal importation for use in electronic cigarettes. 4 June 2014. https://www.tga.gov.au/behind-news/liquid-nicotine-and-personal-importation-use-electronic-cigarettes (viewed Dec 2018).
- Greenhalgh E, Grace C, Scollo M. Electronic cigarettes (e‐cigarettes): legal status in Australia. In Scollo MM, Winstanley MH, editors. Tobacco in Australia: facts and issues. Melbourne: Cancer Council Victoria, 2017. http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18b-e-cigarettes/18b-9-legal-status (viewed Dec 2018).
- Wylie C, Heffernan A, Brown JA, et al. Exposures to e‐cigarettes and their refills: calls to Australian Poisons Information Centres, 2009–2016. Med J Aust 2019; 210: 000–000.
- Chivers E, Janka M, Franklin P, et al. Nicotine and other potentially harmful compounds in ”nicotine‐free” e‐cigarette liquids in Australia. Med J Aust 2019; 210: 000–000.
- Kelso A. Insufficient evidence for the safety of e‐cigarettes [media release]. 3 Apr 2017. https://nhmrc.gov.au/about-us/news-centre/insufficient-evidence-safety-e-cigarettes-0 (viewed Dec 2018).
- Byrne S, Brindal E, Williams G, et al. E‐cigarettes, smoking and health: a literature review update. 22 June 2018. https://www.csiro.au/en/Research/BF/Areas/Nutrition-and-health/E-cigarettes-report (viewed Dec 2018).
- McNeill A, Brose LS, Calder R, et al. Evidence review of e‐cigarettes and heated tobacco products 2018. A report commissioned by Public Health England. London: Public Health England, 2018. https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review/evidence-review-of-e-cigarettes-and-heated-tobacco-products-2018-executive-summary (viewed Dec 2018).
- National Academies of Sciences, Engineering, and Medicine. Public health consequences of e‐cigarettes. Washington (DC): National Academies Press, 2018. http://nationalacademies.org/hmd/Reports/2018/public-health-consequences-of-e-cigarettes.aspx (viewed Dec 2018).
- Parliament of Australia (Senate). Vaporised nicotine products bill. June 2017. https://www.aph.gov.au/Parliamentary_Business/Bills_LEGislation/Bills_Search_Results/Result?bId=s1071 (viewed Dec 2018).
- House of Representatives Standing Committee on Health, Aged Care and Sport. Report on the inquiry into the use and marketing of electronic cigarettes and personal vaporisers in Australia. Mar 2018. https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/ElectronicCigarettes/Report (viewed Dec 2018).
- Kennedy RD, Jones VC. E‐cigarettes and child poisonings: opportunities for product regulation and consumer education. Med J Aust 2019; 210: 000–000.
Provenance: Not commissioned; not externally peer reviewed.