🧵.@ama_media GPs will soon be able to access new telehealth Medicare items for smoking cessation consults where they can write scripts for nicotine e-cigarettes.

From October, a doctor’s prescription will be required before a person can legally import nicotine e-cigarettes and
liquid nicotine.

The move is designed to curtail use of e-cigarettes, particularly among the young.

But it will also mean more GPs will be able to prescribe them to patients as a smoking cessation product of last resort, and potentially without having to go through the TGA’s
special access scheme.

To support the change new telehealth MBS items will be rolled out from March — although as yet there are few details on which patients will be eligible, what the consults will involve or the rebates.

The AMA says it fears they could be used by a small
group of doctors happy to prescribe e-cigarettes long-term to individual patients.

It has called on the Federal Government to prevent patients claiming the item without an existing face-to-face relationship to their usual GP or their practice.

“We are very concerned about the
idea of a specific item number that would be purely there to facilitate vaping to people with no intention to quit,” @amapresident president @omarkhorshid82 Dr Omar Khorshid said.

“The normal telehealth item numbers are linked to a patient’s usual GP and we wouldn’t want this
to be a way around that.”

Dr Khorshid said GPs were already offering smoking cessation advice and prescriptions to patients in consultations funded with existing Medicare items.

“If you just ended up with an online service that basically made vaping products freely and easily
available without providing proper care, that would be a policy failure.”

Currently, it is illegal to sell nicotine-containing e-cigarettes in Australia and possession in all states and territories except SA is illegal without a valid medical prescription.
Under reforms introduced last year, nicotine-containing e-cigarettes are being down scheduled from S7 products — a dangerous poison — to S4 products to ensure medical oversight of their use.

The TGA’s scheduling delegate said restrictions on e-cigarettes were necessary
to mitigate the potential uptake of smoking in young adults who would otherwise be at low risk of nicotine addiction.

They also argued the evidence did not support the claim that e-cigarettes were a safer alternative to smoking cessions aids currently available.
According to Dr Khorshid, the TGA is indicating it will reduce the paperwork demands on GPs seeking to become authorised prescribers of e-cigarettes.

“They have said it will be a minimal approach, where doctors will only need to provide a prescriber number and contact details,”
he said.

“Whether that will be tightened to include some basic education on the product is still being discussed but it certainly won’t be an onerous process for doctors.”

Read more: RACGP backs vaping as second-line smoking cessation therapy

The @AMAGenPractice @ama_media
AMA has long opposed the sale of nicotine e-cigarettes without a doctor’s prescription, arguing there are unknown long-term health effects and insufficient evidence on their efficacy as a treatment.
However, the @rcgp RACGP gave qualified support for the products last year as second-line treatment for patients who wanted to quit smoking but only as a last resort.
Its updated guidelines stressed that doctors should only make the recommendation after the patient had raised
the subject themselves, and it said patients must be given enough context to make an informed decision.
So GPs instructed not to recommend vaping but instead the least effective, most expensive pharmaceutical methods & every time they shop, death sticks will be in their face.
Instead of following @PHE_uk @RCPLondon 95% harm reduced sans cancer, @rcgp & @AMAGenPractice @ama_media @amapresident @TGAgovau @healthgovau @CancerCouncilOz @LungFoundation @smokefreetas @tobaccofreeaust @msh_wa et all in @SimonChapmans6 against graphic he smugly parades;
would rather you quit vaping, even though you know you'll just end up smoking again? These bodies wouldn't have to look hard to see past the propaganda and misinformation to find the real experts to #KnowNicotine & #RethinkNicotine

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More from @hbowly

12 Jan
@LivePippas @hollieahughes @mattjcan @SimonChapman6 Simon Chapman should stop being called on and allowed to speak. Isn't he retired?
He has no business giving opinions & cherry-picking fact science to suit his prohibition stance. He simply is not qualified to understand the age of tobacco harm reduction because he refuses to...
@LivePippas @hollieahughes @mattjcan @SimonChapman6 Look past his bias stemming from the era he came from which was fighting deadly combustible tobacco. Anyone who thinks they know best no matter what and can't learn each day, even if that means they were wrong, has no place in public health.
He runs around academically like a...
@LivePippas @hollieahughes @mattjcan @SimonChapman6 5-year-old bully in the playground, threatening, slandering and displaying bigotry towards those who have successfully quit using fast safer nicotine delivery. After which, he cowardly blocks then writes academic reports selecting tweets to display justification for his actions..
Read 11 tweets
11 Jan
Liquid manufacturers; the age 3-6mg clouds bro clouds is over. Liquid in low mg bought Lamborghini's, hosted parties where coke was snorted off hookers & created a lot of riches quick. Now the adults are left, lets remember everyone is different & bring back up to 24mg Covert 🚬
Why do you think 50/60mg salt boomed and made @JUULvapor massive overnight? Because industry forgot who it served and got outta control.
I only for go flavour and use high salt because limited 12/24/36 freebase for mtl users. Time to move on. Exhaling weather systems is PC either
@dashvapes does the unsalted up to 12mg (CA)

@VapourEyesAU NZ store line up to 18mg & @TheVapingBogan brews (@boganbrews) up to 12mg freebase / 35mg salt

paradigmdistro.com - range up to 12mg

@FivePawns - range up to 12mg

All quality vendors with high quality products.
Read 4 tweets

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