Vapes Should Be Pharmacy Prescribed, Says New Zealand Health Groups

As a response to the rapid surge in teen vaping, public health researchers and doctors in New Zealand are advocating for vapes to be made pharmacy or prescription-only.

While the number of people smoking cigarettes in New Zealand has dropped to record lows, those taking up vaping – particularly teenagers – has soared, with youth vaping more than tripling between 2019 and 2021. Now some doctors’ groups are pushing for New Zealand to follow in Australia’s footsteps, where vapes have been made a prescription-only drug.

Dr. Bryan Betty, medical director of the Royal New Zealand College of General Practitioners, said the college was advocating for vapes to be made available only through pharmacies and doctor’s offices.

Vaping was “very, very valuable as a smoking cessation tool, and we are incredibly supportive of it being used in that way”, Betty said, but doctors were highly concerned about young people who had never smoked taking up vaping.

He said a study of early high school students in New Zealand found about 30% of daily vapers had never smoked cigarettes. The level of nicotine in most vapes made them highly addictive. “We don’t know the harms of vaping long term … a lot of those harms will not be obvious for us for the next 10 to 20 years,” Betty said. Early research has indicated vaping could increase the risk of blood clots, worsen respiratory conditions, and be associated with acute lung injuries in young people.

“The Australian model, where it’s prescription only, seems like a really good approach,” said Dr. Kelly Burrowes, a vaping researcher at the University of Auckland’s bioengineering school, and should be adopted alongside other measures such as eliminating vape flavours, and raising age restrictions.

“It’s clear that there will be negative health effects from vaping, it’s just unclear exactly what those long-term effects will be,” she said. “We should be preventing those people who don’t already smoke from starting vaping.”

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Dr. ​​ Collin Tukuitonga, who has worked extensively across Pacific health services, said he hoped to see the rise in youth vaping plateau. However, if it continued to rise, further restrictions were needed, including the possibility of making vapes an over-the-counter drug. “Restricting availability through pharmacies might be less punitive than prescription only,” he said.

According to data released last year, New Zealand’s smoking prevalence had dropped to 8% – one of the lowest in the world – but the rise in daily vape users was larger than the drop in daily smokers. It found 8.3% of adults were vaping daily, up from 6.2% in the previous year. The rise was particularly marked in young people: the number of year 10 students – about 14 years old – who vaped daily had risen from 3.1% in 2019 to 9.6% in 2021.

The government is now reviewing its vaping regulations. In January, associate health minister Ayesha Verrall said the government was opening a consultation on revamping vaping laws, saying “youth vaping rates are too high” and the government “need[s] to strike a better balance”.

The government’s proposed changes, however, have focused on restricting the sales of vapes to some premises, reducing the level of nicotine, and changing packaging, rather than shifting to a pharmacy- or prescription-only model.

Verrall has not responded to a request for comment on the latest calls.

In Australia, the government introduced laws in 2021, meaning that nicotine-containing vaping products could be obtained only via a doctor’s prescription. Dr. Becky Freeman, an associate professor in public health at the University of Sydney, said Australia’s prescription-only model offered a way forward, though the current rules had too many loopholes – including the exclusion of vapes sold as “nicotine-free” that often still contained the drug.

“Making things prescription-only will shut down that easy access, will make enforcement a lot easier, and should ensure that the products get into the right people’s hands for the right reasons”.