Key Points:
·Policy Failure: Pharmacies sell only 170 legal e-cigarettes per day on average, with only 5% of healthcare professionals in Australia participating in supply.
·The black market is rampant: seizures in 2024 were 175 times the annual sales through legal channels, creating a regulatory paradox.
·Current situation for young people: Usage rates among 18-24 year olds are on par with smoking rates, but high prices are dampening some demand.
·Implementation challenges: Fragmented state regulations, lack of trust from doctors, and gaps in tracking systems are hindering policy implementation.
·Reform direction: The government will invest in monitoring systems, with experts emphasizing the need to simultaneously strengthen border enforcement.
【2Firsts news flash】According to NewsGP's report on July 2nd, Australia made international headlines for implementing the world's strictest e-cigarette regulations, aimed at curbing nicotine addiction and protecting public health. However, as questions arise about the actual effectiveness of the regulations, the federal government is facing increasing scrutiny.
Despite regulations that strictly prohibit the sale of nicotine-containing e-cigarettes without a prescription or through pharmacy channels, the use of e-cigarettes remains widespread. There is growing concern that this policy may inadvertently push users towards unregulated black markets. The latest data shows that as of May 30, 2025, the Australian Therapeutic Goods Administration (TGA) has only received 40,000 notifications of non-prescription e-cigarette Special Access Scheme (SAS) submissions from 2,000 pharmacies nationwide, equivalent to less than 170 non-prescription e-cigarette products sold per day. Meanwhile, the Border Force seized over 7 million illegal e-cigarettes in 2024 alone.
In response to the growing issue of increased usage among teenagers, Australia has legislated that starting July 1, 2024, all e-cigarettes (including those without nicotine) can only be sold in pharmacies that are approved for such sales. Starting in October 2024, pharmacists will be allowed to sell e-cigarettes with nicotine concentrations of ≤20mg/mL to individuals over the age of 18 through the SAS C notification pathway, without requiring a prescription.
A spokesperson for the Department of Health and Ageing (DoHDA) noted that the SAS-C data "only reflects the supply of therapeutic e-cigarettes in Australian pharmacies," and the actual number may be higher. However, Professor Nick Zwar, Chair of the Royal Australian College of General Practitioners' smoking cessation expert group, stated that while there is an increase in people seeking e-cigarette prescriptions, patients still struggle to find doctors willing to prescribe them or pharmacies willing to dispense them.
Among Australia's 39,000 general practitioners, only around 3,000 are permitted to prescribe e-cigarettes; out of 38,000 pharmacists, only 2,000 have submitted non-prescription sales notices. A spokesperson for the Department of Health and Drug Administration (DoHDA) stated that the e-cigarette reform aims to "strike an appropriate balance" by protecting adolescents from health risks while ensuring that those with a genuine need can access smoking cessation aids.
Health and Aging Minister Mark Butler admits the need to crack down on illegal sales, but insists that current laws are "taking e-cigarettes out of the hands of children." The Cancer Council's "E-cigarette Generation" study shows that during the period of October to December 2024, e-cigarette usage among 18-24 year olds is at 18%, equivalent to smoking rates. Models predict that without current legislation, 1185 adolescents aged 12-19 will start using e-cigarettes every week.
Professor Zivar pointed out that the significant increase in prices of illegal e-cigarettes may be the main reason for the decrease in usage among adolescents, but the majority of e-cigarettes in Australia are still consumed through illicit channels. Inconsistencies in regulations among states and issues such as inadequate preparation in pharmacies are hindering legal supply. While the government has provided some assurance to doctors through TGA quality standard reviews, many doctors remain concerned that e-cigarettes have not undergone a complete drug approval process.
Currently, the Therapeutic Goods Administration (TGA) has not established a prescription data collection system for therapeutic e-cigarette products. A spokesperson for the Department of Health and Drug Administration (DoHDA) revealed that the federal government will fund the TGA to establish a monitoring system to track the supply of legal e-cigarettes. Professor Zwar emphasized that enforcement efforts must be strengthened in order for therapeutic avenues to be effective, as the current regulatory effectiveness is still far from meeting standards.
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