Vaping has been my Gateway out of .

Part 1 The Smoker

I started smoking at 12 and by 14 I was smoking a pack a day. I became seriously addicted to tobacco very rapidly and smoked continuously for 38 years.

I first attempted to quit in 1991 with cold turkey. I never lasted more than two hours, unless you count sleeping. I regularly woke up to smoke in the middle of the night. Smoking was the first thing I did when I woke and the last thing I did before sleeping.

0ver the past 29 years I made increasingly desperate attempts to quit. I used ALL of the recommended approaches including Quitline, the Alan Carr method, three separate hypnotherapists of no less than 3 sessions per practitioner, NRT products such as patches, gums, sprays, lozenges and inhalers. Herbal products and herbal .

I went further, I trialled a drug with potential for , and heart attacks. It failed.

I later tried Zyban. I tried it twice.

I took Champix knowing that some people (with no history of mental illness) suicide within a week of taking it. I told my family so they could watch me closely. I had no side effects, no suicidal thoughts and no success in stopping smoking. It seems for Champix to be a success you have to also be susceptible to very severe side effects.

After reading some research on heavy smokers and the possibility that fast metabolism of was the key issue I tried the recommendation to wear numerous patches. I increased the patches expecting at some point I wouldn’t crave a . The reality: I eventually increased to 5 patches, vomited from and still smoked a cigarette.

I remained a heavy smoker of 45-60 cigarettes a day. My life revolved around access to smoking. I avoided visiting people’s homes, didn’t share car rides so I could smoke in my car, didn’t go to movies or anywhere where my chain smoking would be disrupted.

I have never been addicted to any other substance and rarely drink. I do not gamble. I was spending more than $300 per week. Even with significant further increases in excise I would have continued to smoke because I had the income to do so.

I’m struggling to find the right words to illuminate to the committee the psychological impact of so many attempts to quit that resulted in failure. Reading these submissions, it is clear many people have had a similar experience and have tried everything the experts said would, or should, work.

Eventually I came to a point where I completely believed I would NEVER be able to stop smoking.

Part 2 The Vaper.

In 2016 I heard about vaping. I bought a vape pen online from the US and some juice containing nicotine. The device was far too underpowered for a heavy smoker, the nicotine level was too weak. I vaped for a few days but still smoked. I now realise that successfully stopping smoking using vaping does require expert help. The kind of help no one is going to get from a medical professional or a pharmacist.

In 2017 I returned to NZ for a visit and was shocked that all my friends who used to be heavily addicted smokers had stopped smoking and were vaping. One friend took me to a , and they helped me find the right device and let me try a range of nicotine levels and flavours. Over that fortnight I went to the shop several times to fine tune my set up and this time I was successful.

From that point onwards I haven’t had a single cigarette.

Not one.

I have to vape in the smokers area at work. I had to quit smoking while standing next to people smoking cigarettes and I’m still a non-smoker. The one advantage of this is that I turned all those smokers into vapers. It’s now rare to see a smoker at my work place.

Finally I found something that actually works. I’m so grateful and happy not to smoke anymore.

Now the TGA wants to take this away and make it impossible and difficult to obtain but will continue to let children buy NRT products in the supermarket and adults buy tobacco without restriction.

It’s so illogical it’s incredulous, if the real point it to reduce the harm of combustible tobacco why would anyone want to stamp out something that has been so successful in helping the heavy smokers quit in the US, UK, NZ and Australia. To date, smoking cessation policies have successfully reduced smoking rates in casual and social smokers but has failed in reducing the residual highly addicted cohort.

I would also like to note that I started on 32 mg of nicotine and now I’m down to 8-12mg. My plan is to continue halving the nicotine every 6 mths till I am vaping 0mg of nicotine and when ready, to also stop vaping. For me, smoking was more than nicotine, it was habit, it was self soothing rituals, it’s falsely self medicating for anxiety, it was hand to mouth ritual and it was breathing regulation, just not healthy breathing. Vaping will allow me to slowly titrate down to to Omg nicotine, leaving me to wean from the habit separately. I feel this is a lot of the reason for the success of vaping over NRT.

When I started vaping I used tobacco flavours because I thought I needed tobacco flavour not to smoke. It took a year before I mentally became a non-smoker and saw myself as such. At that point I was able to switch to non- tobacco flavours. I feel that switch was another monumental step away from combustible tobacco and very important to me. Flavours need to remain available otherwise people will add flavours at home that are dangerous. At the moment we are protected by buying safe liquids through vape shops.

I do agree that the best thing to put into your lungs is air and nothing else. However I have had significant health benefits already from using a far less damaging alternative. I was under investigation for COPD immediately prior to taking up vaping. I had annual bouts of bronchitis, used an asthma inhaler and was prescribed prednisone (steroids) three years in a row for chest infections.

Since taking up vaping, I no longer have any COPD symptoms, no longer use an inhaler and have not had bronchitis or chest infections and have not been prescribed prednisone. I have started exercising and I’m no longer short of breath.

Much community conversation on the proposed policies to restrict access to vaping have created a community belief that this is a deliberate act to get the hundreds of thousands of vapers back to cigarettes to increase or to protect the tax revenue. I do not subscribe to that view.

I believe the people in those agencies sincerely wish to reduce smoking in the community. However, I wish point out to the committee that no attempt has been made to use a user centred design approach to smoking cessation policy. To put it plainly, every effort has been made to studiously avoid asking heavy smokers (who quit by vaping) why it has been so successful. This is extraordinary. Why would you not want to understand from our point of view if it is “us” you are trying to save? Is smoking cessation policy being designed by people who have never ever smoked? I want smoking cessation policy to be successful, I want them to engage with heavy smokers who have quit to understand why this is working, so they can design better policy and help the remaining smokers quit.

Response to senate committee questions A: the treatment of nicotine vaping products (electronic cigarettes and smokeless tobacco) in developed countries similar to Australia (such as the United Kingdom, New Zealand, the European Union and United States), including but not limited to legislative and regulatory frameworks; I have experienced the NZ approach. I encourage the committee to look at the regulatory framework adopted by NZ. It’s pragmatic, it’s sensible and it’s smashing smoking rates.

In particular I would recommend that specialised vape shops remain. My experience has been that vape shops in Australasia are small businesses owned by ex-smokers who are passionate about assisting smokers quit combustible tobacco. I would like to see tobacco companies restricted from selling vaping liquid direct to consumers or establishing vape shops. I understand an industry is required to manufacture safe commercial nicotine for use in vape liquid, it would be great to see tobacco companies restricted to this space.

Pharmacies will not be able to help smokers find the right device or help them get the device/juice combination right. They are not the right industry to administer vaping. I don’t need to go to a pharmacy to buy NRT products, cigarettes or alcohol and unless these products are also to be restricted to pharmacies, I oppose this proposal.

I object to needing a regular script from my Doctor. I am not required to get a script to buy cigarettes, NRT or alcohol. The cost to the health system of this proposal is offensive. My Doctor has a three week wait for appointments, they do not have the capacity to medicalise vaping.

Nicotine is not a product to be encouraged to non-smokers. I would support a one-off certification by my Doctor to provide evidence that I was a smoker using vaping for smoking cessation. If nicotine juice was then restricted for sale only to adults certified as smokers or ex-smokers I could support this and I would assert that General Practitioners could manage one-off demand and that certifying my smoking status would not be counter to their medical ethics.

B: the impact nicotine vaping products have had on smoking rates in these countries, and the aggregate population health impacts of these changes in nicotine consumption; A key New Zealand study (Petrovic-van der Deen, et al., 2019) used a computer simulation model to estimate the likely net health impact of liberalising access to e-cigarettes and concluded that the NZ population alive in 2011 was estimated to gain 236,000 extra years of healthy life over the remainder of the population’s lifespan through making e-cigarettes available in specialist stores and pharmacies.

C: The established evidence on the effectiveness of e-cigarettes as a smoking cessation treatment; New evidence from a large New Zealand vaping study suggests that hundreds of thousands more smokers worldwide could successfully quit the killer habit if they used nicotine-containing e-cigarettes (vapes) together with nicotine patches. The study, published in a top medical journal, The Lancet Respiratory Medicine, was a randomised clinical trial, the gold standard in scientific research. The Lancet Respiratory Medicine: Nicotine patches used in combination with e-cigarettes (with and without nicotine) for smoking cessation: a pragmatic, randomised trial https://www.auckland.ac.nz/en/news/2019/09/10/vaping-helps-smokers-quit.html

D: the established evidence on the uptake of e-cigarettes amongst non- smokers and the potential gateway effect onto traditional tobacco products; Vaping was my gateway out of smoking.

See NZ studies on youth vaping at question E

E: evidence of the impact of legalising nicotine vaping products on and vaping rates and measures that Australia could adopt to minimise youth smoking and vaping; I propose: 1. Age restriction for purchase of ejuice containing nicotine.

2. A complete ban on marketing and advertising.

Public Health England (2018) reported that e-cigarettes were attracting very few young people who had never smoked into regular use, and that they did not appear to be undermining the long-term decline in cigarette smoking among young people (McNeill et al., 2018).

US data shows a different pattern but the marketing of products to youth was fairly liberal until recently. Marketing is restricted in the UK and I suggest accounts for the difference.

The media articles surrounding vaping currently in Australia has likely marketed vaping to young people who wouldn’t otherwise know vaping existed. It’s not an attractive product for non smokers or young people. You don’t get high or inebriated and confectionary tastes better than vaping juices. Unless it takes on a “cool status” because it’s become anti-establishment, it’s hard to understand the attraction.

NZ School vaping 'epidemic' doesn't actually exist – study https://www.newshub.co.nz/home/new-zealand/2020/01/school-vaping-epidemic-doesn-t-actually- exist-study.html

2020 NZ Study Finds No Teen Vaping Epidemic in New Zealand Looking at data from an annual ASH (Action for Smokefree 2025) survey, Kiwi researchers found that not only are smoking rates on the decline amongst local teenagers, but additionally, vaping is not being taken up by non-smoking teens. https://www.vapingpost.com/2020/01/31/nz-study-finds-no-teen-vaping-epidemic-in-new-zealand/ And in Australia

Teen vaping is way less common than the news claims https://www.abc.net.au/triplej/programs/hack/vaping-among-young-people-less-common-than-news- claims/12474902

Clarifying Australia’s youth vaping figures https://stories.uq.edu.au/medicine/2020/clarifying-australia-s-youth-vaping-figures/index.html

F: access to e-cigarette products under Australia’s current regulatory frameworks; It’s a lot of work to vape in Australia. I have to buy nicotine overseas and I have had to learn pharmacy skills to mix it safely. I buy non-nicotine flavoured juice locally. If I miscalculate my supply I run the continual risk of having to buy cigarettes. To avoid this I buy more than I need or I am comfortable storing in my home. I am careful but I am not skilful at measurement. I would prefer not to be handling liquid nicotine.

I didn’t know there was a regulatory framework other than I have to buy it overseas and we are allowed to import it as individuals.

When I’m in NZ, I buy pre-mixed nicotine juice from regulated vape shops. I don’t buy in bulk.

Vape liquids should be regulated, I want to be confident of the quality, strength, ingredients and labelling. I do not want to mix nicotine into liquid myself or be an importer, I want to buy pre- mixed nicotine juice from regulated vape shops in Australia.

I want nicotine juice sale restricted to adults. An age requirement should apply similar to cigarettes and alcohol.

In NZ, only vape shops can sell flavoured nicotine liquids. Sales are restricted to 18+. Supermarkets, 7/11’s and service stations may only sell pre-filled pod cartridges in 3 dubious and unpopular flavours.

Lock bags should be compulsory for storage of nicotine liquids stored in homes with children.

G: involvement in the selling and marketing of e-cigarettes; and

I am opposed to tobacco companies selling direct to consumers. They have done quite enough harm with their combustible tobacco.

H: any other related matter.

I would like to thank the committee for the opportunity to share my experience as a former heavy smoker.

I am relying on your commitment to evidence based policy to remain a non-smoker.