MEDICUS May 2022

THE EVIDENCE ON E-CIGARETTES IS CLEAR A recently published systematic review ( bit.ly/3yxAeen ) of the evidence related to e-cigarettes undertaken by the Australian National University is the most comprehensive study on the health effects of e-cigarettes published to date. The landmark study found strong evidence that e-cigarette use can increase the risk of significant harms to health. These include poisonings, seizures (due to inhalational toxicity), burns and lung disease. There is also evidence that e-cigarette use may negatively impact cardiovascular health markers (such as blood pressure and heart rate), lung function, as well as adolescent brain development. An essential finding of the systematic review is the paucity of evidence regarding e-cigarettes and clinical health outcomes, with the impact on many clinical health outcomes, such as cancer, not yet known. E-cigarettes and e-liquids can contain hundreds of chemicals, with many known to be toxic. E-cigarettes are a gateway for addiction, with nicotine a main ingredient in many e-liquids. Products containing up to 100 mg/mL of nicotine for dilution can be prescribed, and accidental ingestions of small volumes can cause life-threatening toxicity in children and adults. Research has found that products labelled as ‘non-nicotine’ may still contain high levels of nicotine. The use of e-cigarettes (commonly referred to as ‘vaping’) in Australia is rapidly increasing, with young people being the highest users. The latest data from the Australian Institute of Health and Welfare demonstrates that most e-cigarette use is not for the purpose of quitting smoking, particularly among younger Australians. There is strong evidence that non- smokers who use e-cigarettes are significantly more likely to take up tobacco smoking compared to non-smokers who do not use e-cigarettes. The evidence shows that population harms from e-cigarettes outweigh any individual benefits, and that non-smokers and young people are most at risk. Further action is needed from all levels of government to protect the community, especially young people, from the harms of e-cigarettes. ■ References available upon request. Lorena Chapman Make Smoking History Policy and Research Coordinator, Cancer Council WA Associate Professor Alexander Larcombe Head, Respiratory Environmental Health Telethon Kids Institute School of Population Health, Curtin University Elizabeth Lim Specialist In Poisons Information, WA Australian Poisons Information Centre Continued from page 12. The myth of urgent care centres. Dr Simon Torvaldsen Labor has agreed to fund a $1 billion package, which includes expansion of the Workforce Incentive Program (WIP); bringing after-hours back to 6pm (about time!); and payments for voluntary patient enrolment. These are all key items the AMA has been arguing for. In addition, Labor has committed to a program of infrastructure grants for General Practice. We see this as the first step to revitalising Australian General Practice. The devil will be in the detail, and Labor has agreed to an implementation group, including the AMA and RACGP. We will then follow up to push for further reform and funding for Australian GPs. We will also need to ensure that any urgent care funding is directed in a way that will empower, not damage GPs. The results will be functional primary care that will save costs in the long term. From an initial proposal that had all the problems listed, we have managed to get a commitment at least from Labor that has the potential to benefit GPs. Your AMA will continue to work to ensure this commitment is honoured, and that General Practice is better supported and viable into the future. ■ Please feel free to contact me: Simon.Torvaldsen@amawa.com.au M AY 2 0 2 2 M E D I C U S 13 P U B L I C H E A L T H