No guidance here

Confusion reigns over advice and information about the sale of e-cigarettes and how to handle customer enquiries

Australian pharmacists are unsure with how to proceed in offering information about e-cigarettes in the face of conflicting information and a lack of guidelines about what to do.

New research has shown a high level of confusion about how to react to customer enquiries about e-cigarettes, and a relatively low level of knowledge about their regulation and what advice to be offering.

There is a need to “provide evidence-based and customised education for pharmacists regarding e-cigarettes to help them guide their clients,” the study authors said.  

Pharmacy and public health academics from the University of Queensland conducted detailed interviews with 64 pharmacists and 76 pharmacy assistants in Queensland and found that many (39%) had already been asked by a customer about e-cigarettes.

Three-quarters felt that their customers would be interested in using them as a smoking cessation aid.

Few of the respondents were confident in the short or long-term safety of e-cigarettes (36% and 15% respectively), and the majority believed that e-cigarettes with nicotine should be regulated as a medicine, although 27% said it should be treated as a tobacco product.

Almost a quarter (24%) of the respondents felt that e-cigarettes were equally as harmful as conventional cigarettes.

The authors said that, given the “growing popularity and use of e-cigarettes as a way to quit
smoking, it is essential that pharmacists have adequate and updated information in order to guide their customers in making evidence-based decisions”.

However, the inability of pharmacies to sell these products in Australia, and a lack of advice from the Pharmacy Board of Australia on the topic has created a knowledge gap, they said.

Similar to Australia, “tobacco products are not sold in UK pharmacies, however, in contrast to
Australia, most sell e-cigarettes and professional bodies have positions and policies in regard to e-cigarettes,” they said.

“The Royal Pharmaceutical Society (RPS) in the UK indicate in their position statement that ‘where
someone is unwilling to use a licensed NRT product, pharmacists should use their professional judgement when giving advice to patients and the public on the use of e-cigarettes'”.

“There are no clear guidelines or policy statements provided by any of the professional organisations for pharmacists on how Australian pharmacy staff should handle customer enquiries about e-cigarettes or on dispensing prescriptions for nicotine solution for use in e-cigarettes as a cessation aid,” the authors said.

“The Australian Department of Health has acknowledged there is public confusion about the legal status of e-cigarettes ‘especially in terms of the regulations that apply to their importation, marketing (including sale) and use’,” they said.

“This confusion was reflected in our findings with pharmacy staff. There was no common understanding of current regulation of e-cigarettes in Australia, and a large proportion of participants reported that they did not know how e-cigarettes or nicotine liquid were regulated.”

The study was published in the journal Addictive Behaviours

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