TGA pokes its nose into nicotine-script mills

4 minute read

Joining the single-product-clinic gang alongside cannabis and Ozempic are vape-only prescribers.

The TGA is investigating telehealth companies offering only nicotine vape prescriptions for illegal advertising, as the sector raises concerns over vertical integration and unsafe models of care.

“Although [vape-only prescription] services are not illegal, advertising them could, depending on the context, amount to encouraging patients to request a particular prescription medicine and may therefore amount to unlawful advertising of that prescription medicine,” a TGA spokesperson said.

The platforms under investigation include,, and

The TGA did not provide any further information as the investigations are ongoing.

At the beginning of this month, the federal government introduced new laws that limit access to nicotine vapes to prescription-only.

In the wake of this change, it seems vape-only prescription platforms may join those dedicated to cannabis and weight-loss-drug telehealth prescribers.

Such providers have proved a divisive topic among GPs, with some criticising the confusing business model while others praise the accessibility.

Some of the companies under investigation have adopted vertically integrated business models, mirroring those adopted by some cannabis-only prescription platforms.

While these models are legal, they, unsurprisingly, put regulators on edge.

One such culprit, MEPH Pharmacy Ltd’s MyDuke, under investigation by the TGA, requires that patients redeem prescriptions issued through their service at MyDuke’s online pharmacy.

A spokesperson for MyDuke said that they were “unaware of any assessment by the regulator” and that smoking cessation was “no different” to the other tens of thousands of telehealth consultations untaken in Australia daily.

MEPH Pharmacy Ltd has previously been fined almost $40,000 for unlawful advertising of nicotine vapes.

Similarly to MyDuke, SmokerHealth, previously MedicalNictoine, provides online scripts that must be used at Quitmed.

In an email to customers in February, the company said that as “1 March looms ever close”, “there are already some excellent online pharmacy options for ordering products, with delivery anywhere in Australia within days”.

Speaking to The Guardian, RACGP president Dr Nicole Higgins said that patients should be allowed to choose where to use their prescription.

“To all people using nicotine products, I encourage you to have a chat to your GP about quitting,” she said.

“We can talk through a full range of options, rather than just pushing you towards one particular product or service. 

“Remember too, GPs provide holistic care and will take full account of your circumstances and medical history.”

Chief executive of the Consumers Health Forum, Dr Elizabeth Deveny, urged patients to remember that there may be “good clinical reason” for doctors to not prescribe nicotine vapes for smoking cessation.

“We are concerned this model, ‘quickly go over here and get a service’ where you might pay upfront, means you get it quickly but without the same questions asked [as your own GP would ask],” she said.

“We’re not sure that model necessarily ticks all the boxes that we want to see in a safe, person-centred, high-quality model of care.”

The Medical Board of Australia raised concerns over prescriptions which may be issued without a consultation by some of these online services.

“Prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board,” said the board.

According to Guardian Australia, who used the SmokerHealth platform in February, a six-month script for nicotine vapes was issued within minutes, following a $40 payment and a short questionnaire.

A Pharmaceutical Society of Australia spokesperson said that vaping is not a first-line treatment for smoking cessation.

“The body of scientific evidence points to registered Nicotine Replacement Therapy, and other prescription-only medicines as being the most effective way to quit, in combination with supports such as Quitline or health professional consultations.

“The PSA’s view remains firm in that it is not the role of health professionals, including pharmacists, to recommend unregulated products purporting to be therapeutic goods to patient.”

Amid the growing demand for smoking cessation support, Sydney’s Ramsay Mental Health has opened a “first of its kind” clinic in St Leonards.

The clinic will be run by Professor Renee Bittoun, an expert in smoking cessation who opened Australia’s first smokers’ clinic in the 80s.

The clinic offers a “comprehensive vaping cessation program” for people of all ages.

According to Professor Bittoun, children as young as 12 are seeking vaping cessation help.

“The use of vapes has increased dramatically in recent years, particularly among young people,” Professor Bittoun said.

“Marketing campaigns often target teenagers and young people, hoping to get them addicted for life.

“The younger you are when you start your exposure to nicotine, the harder it is to quit.”

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