Vape reservations: Why the silence on e-cigarettes?
AS thousands of smokers across the country grapple with the decision to quit smoking - or have already seen their decision to quit in 2018 fall by the wayside - an Australian government ban on nicotine e-cigarettes remains in place.
But supporters of nicotine vaping say 2018 may be the year die-hard smokers - the very ones targeted by a decade of Quit campaigns - will try to force the government hand an overturn the ban.
Just don't put much faith in a government inquiry: Health Minister Greg Hunt has already said it won't be lifted on his watch.
And therein, says expert Associate Professor Colin Mendelsohn from the University of NSW's School of Public Health and Medicine, lies the problem.
"They don't want to hear what the benefits may be," Prof Mendelsohn says.
"An inquiry is due to deliver a report in February, but the Health Minister is already undermining (it). You have to wonder why."
It's investing heavily in "healthier products", including heated tobacco products and e-cigarettes.
Currently in Australia, it's legal to use electronic cigarettes that don't have nicotine, but illegal to use the ones that do.
It's illegal to possess the liquid nicotine used in vapes. The same nicotine contained in the perfectly legal cigarettes which the government would like you to quit, and which can be legally bought in any convenience store.
The only exception for liquid nicotine is if you have a prescription from the doctor.
Which is how some of the 250,000 vapers (1.2 per cent of the population) in Australia, according to the 2016 National Drug Strategy household survey, are getting their fix.
"We know a lot of people are doing it, despite the fact it's so hard to get hold of," Prof Mendelsohn says.
He has helped many smokers quit the habit via vaping and thinks he knows why the government doesn't want to have the nicotine e-cigarette conversation.
He believes they're struggling to reframe and rethink the "stop smoking" message after years of promoting total abstinence as the only way to quit.
It's why, he says, politicians and public health organisation seem determined to ignore the lead of the USA and the UK, where vaping with nicotine is approved as a stop smoking aid, and the results are in as more people are kicking the smoking habit than ever.
'STOP SMOKING OR YOU WILL DIE'
"In Australia most of the public health foundations like the Heart Foundation, the Cancer Council, Public Health Australia, the AMA, have this group think where they are locked together and are actively opposing any changes," Prof Mendelsohn says.
"Australia has been very successful in reducing smoking rates, and the way we have always done it is to focus on abstinence only.
"We have public health campaigns, plain packaging, smoke-free bans and the message has always been: 'Stop smoking or you will die'.
"They can't see past that abstinence only approach."
"I think the fear is if we tell people they can switch to something that still includes nicotine and still looks like smoking, it could be seen as them kind of diluting the campaigns. It's not what we do here."
NUMBERS STACK UP
But if the experience overseas is anything to go by, Prof Mendelsohn says it's well past time to rethink.
Because the numbers stack up.
"In the past three years smoking rates have not fallen in Australia," he said.
"From 2013 to 2016 there was no significant drop."
But in countries where there's no ban on nicotine e-cigarettes, smoking rates are falling faster than ever.
The UK, US, European Union and New Zealand have all moved to legalise e-cigarettes in recognition of their capacity to help people quit, and save lives.
"What we do know is in countries where e-cigarettes are available, quitting rates have gone up," Prof Mendelsohn says.
"In the UK, quit rates are higher than they have ever been, and e-cigarettes are the most popular quitting aid.
"In the US studies are showing more people are trying to quit than ever, and successful quit rates have gone up for the first time ever.
"What we can say is that where e-cigarettes are available, quit rates have improved."
He says the US now has lower smoking rates than Australia for the first time ever - 14.8 per cent compared to Australia's 15.6 per cent in 2016.
"In the UK they are also right down to our level. A large part of the difference is vaping, and that's what is acknowledged in those countries."
THE ARGUMENTS AGAINST
The official arguments against hurrying to lift the ban on e-cigarettes include that there's not enough information on what might happen to vapers years down the track.
"Even if we find the risks of vaping are greater than we think they are later on, they are still not going to be any greater than smoking," he says.
"When you look about what we know about what is in smoke versus vapour, the level of toxins is so much less in vapour.
"One study in the US looked at the toxic ingredients in smoke as opposed to vapour and calculated that the risk of cancer from vaping was less than one per cent of that of smoking.
"There are far fewer chemicals in vapour."
Another argument is that allowing and endorsing vaping may "re-normalise" smoking in a country which now shoves smokers outside and out of sight to indulge in their filthy habit.
"If you see people around vaping it looks like smoking and there's a fear it will make smoking more acceptable again," said Prof Mendelsohn.
"But what is normalising, on countries where it's allowed, is vaping. It's showing these are people who don't want to smoke.
"What we do know is if you do keep smoking your risk of dying from smoking is two in three".
And Australia has 2.6 million smokers.