In the absence of admonition from the Therapeutic Goods Administration (TGA), authors autograph in the Medical Journal of Australia accept provided admonition to GPs about prescribing e-liquids for e-cigarettes to smokers aggravating to abdicate tobacco cigarettes.
Dr. Miranda Ween, a Senior Postdoctoral Researcher at the Royal Adelaide Hospital, Associate Professor Alexander Larcombe, of Curtin University and the Wal-yan Respiratory Analysis Centre, and Dr. David Chapman, from the University of Technology Sydney, wrote that although the TGA had appear a Standard for Nicotine Vaping Products (TGO 110) able from 1 October 2021, the adjustment “does not accredit to e-cigarettes themselves (which abide crooked by the TGA as smoker abeyance devices), but rather the nicotine-containing liquids (e-liquids) acclimated in them.”
Since 1 October, e-cigarette users can alone accurately admission e-liquids absolute nicotine locally with a decree from an accustomed prescriber or via a appropriate admission arrangement through an Australian pharmacist registered to accumulation nicotine.
“TGO 110 provides no admonition to GPs as to how to administer e-cigarette prescriptions, but Royal Australian College of General Practitioners guidelines admonish that doctors should advance accustomed nicotine backup therapies (NRTs) and accurate biologic therapies accompanied by behavioral abutment afore because e-cigarettes,” the authors wrote.
“As always, doctors should use their own acumen of a patient’s absorbed afore prescribing any medication.”
The authors provided admonition on the afterward issues:
Concentration of nicotine: “At present, there is little affirmation as to the ‘ideal’ nicotine assimilation in e-cigarettes to admonition tobacco smokers to alteration to complete nicotine abstinence. However, e-liquids absolute 18 mg/mL accept been apparent to abate cravings to a agnate admeasurement as acceptable tobacco cigarettes, and accept been appear as abacus baby allowances on tobacco smoker abeyance aloft those acquired with NRTs. As such, 18 mg/mL, which is abutting to the EU best assimilation of 20 mg/mL,5 may be a advisable starting concentration.”
Behavioral support: “Ongoing structured behavioral abutment is bare to attain nicotine abnegation … GPs should accordingly accede prescribing nicotine-containing e-liquids for abbreviate periods as allotment of an agreed abnegation plan … acceptance ecology of advance and any abrogating bloom furnishings at accustomed intervals. This is important, as abiding use of e-cigarettes may itself access the accident of adverse bloom effects.”
Flavors: “Given that the abiding bloom furnishings of e-cigarettes abide abundantly unknown, unflavoured e-liquids should be preferentially prescribed. It is analytical that [patients] be accomplished that no additive chemicals are accustomed for assimilation and that there is affirmation that abounding affectation a accident to health. This should be allotment of the altercation as to why complete abnegation should be the ambition rather than continued appellation e-cigarette use.”
Nicotine absorption: “Studies accept apparent that [some] flavored e-liquids can decidedly access claret nicotine levels up to 1.66 fold, acceptable associated with the aftereffect of flavourants on acidity and nicotine absorption. This abolishment could advance to vapers application e-cigarettes added frequently, or application e-liquids with college nicotine concentrations, to arm-twist the aforementioned nicotine reward. Taken together, these allegation accreditation attention in prescribing flavored e-cigarettes, to ensure that they do not advance to added and/or abiding use of e-cigarettes.”
Provided by Medical Journal of Australia
Citation: Should doctors be prescribing nicotine e-liquids to admonition their patients abdicate smoking? (2021, November 29) retrieved 3 December 2021 from https://medicalxpress.com/news/2021-11-doctors-nicotine-e-liquids-patients.html
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