Therapeutic vapes for smoking cessation and nicotine dependence

The Australian Government has enacted laws restricting the supply of electronic cigarettes (vapes) to people requiring them for smoking cessation or the treatment of nicotine dependence, under the care of a medical practitioner, nurse practitioner or pharmacist. Currently no vapes are included on the Australian Register of Therapeutic Goods, meaning that the prescription and supply of therapeutic vapes must be through the Special Access Scheme or Authorised Prescriber pathways. Clinical guidelines state that therapeutic vapes may be considered for supporting people who have been unable to quit smoking using first-line therapies (a combination of behavioural support and registered nicotine replacement therapies or oral smoking cessation medicines). Clinical review should occur 1 week after vape initiation, with additional follow-up according to an individualised management plan, to monitor progress, review adverse effects (e.g. cough, irritated throat, headache or nausea), encourage the use of behavioural smoking cessation supports, and discourage dual use of vapes and conventional cigarettes. An attempt to wean or stop vaping after 12 weeks is recommended, with a possible transition to registered smoking cessation medicines if required (in addition to ongoing behavioural support). The maximum recommended duration of vape use is 12 months.