Mapping Access to Nicotine Vaping Products for Smoking Cessation: Pharmacist Needs and Practice Implications in...

In October 2024, nicotine vaping products (NVPs) containing ≤ 20 mg/mL nicotine were reclassified to the Schedule 3 ('pharmacist-only') category, permitting pharmacy-based supply of unregistered therapeutic vapes for smoking cessation in Australia. This regulatory shift expanded pharmacists' roles in tobacco harm reduction, yet their preparedness and capacity to deliver counselling and product supply, specifically related to unregistered therapeutic vapes under the 2024 reforms, remain unclear. In South-East Melbourne, where smoking and vaping rates are high, equitable access to cessation services via community pharmacy is a public health priority. This study examined the availability of therapeutic vapes in pharmacies and explored pharmacists' smoking cessation practices and support needs.

A sequential mixed methods study was conducted across the South East Public Health Unit (SEPHU) catchment in Victoria. It included: (1) an audit of therapeutic vape availability in community pharmacies; (2) a survey of pharmacists' cessation practices, confidence and service provision and (3) qualitative interviews to contextualise findings. Survey and audit data were mapped using Geographic Information System (GIS) tools to examine spatial patterns in NVP availability, socioeconomic status (SES) and smoking and vaping prevalence. Interview transcripts were analysed using Braun and Clarke's 6-step framework for thematic analysis. Data were collected between May and July 2025.

Of 418 community pharmacies audited in the catchment region, 174 (41.6%) reported supplying therapeutic vapes. Seventy (16.7%) pharmacists completed the survey; most (n = 30/32, 93%) dispensed therapeutic vapes fewer than five times weekly. Availability was higher in areas of greater socioeconomic advantage. Interviews revealed barriers to supply including perceptions of limited evidence, low demand and shelf space constraints. Ethical tensions around therapeutic vape provision, commercial pressures influencing supply decisions and systemic barriers to counselling including time constraints and lack of remuneration were also identified.

By mid-2025, therapeutic vapes were available in fewer than half of community pharmacies in South-East Melbourne, with access skewed towards higher socioeconomic status (SES) areas. Pharmacists faced multiple barriers to the provision of nicotine vaping products and cessation counselling, shaped by commercial determinants and systemic constraints. Further research and regional public health action are needed to support equitable, evidence-based cessation care in community pharmacy.

Uneven availability of therapeutic vapes across socioeconomic areas risks reinforcing existing inequities in smoking cessation support. Targeted public health strategies are needed to improve equitable access, strengthen pharmacist capacity and ensure implementation of vaping reforms aligns with broader smoking cessation goals.