Pharmacist Information Hub
A concise breakdown of the PSA guidelines
Professional Practice Guidelines for Pharmacists
Nicotine Dependence Support
Pharmaceutical Society of Australia (PSA) – September 2024
PSA criteria for referral to a medical practitioner
Refer the patient to a medical practitioner or cessation support service (e.g. Quitline) in the following circumstances:
- Age <12 years;
- Pregnancy;
- Pharmacotherapy is unsuitable;
- Patient continues to require vapes beyond 12 weeks (when initiated by a pharmacist);
- Patient has not ceased or reduced smoking since initiating nicotine vapes; and/or
- Patient requires more than 1 pod or cartridge (~2 mL) of a vape per day.
Supply non-prescription pharmacotherapy, if appropriate, and refer the patient to a medical practitioner and smoking or vaping cessation support service (e.g. Quitline) in the following circumstances:
- Cardiovascular disease;
- Diabetes;
- Mental illness;
- Substance use disorder;
- Multiple comorbidities;
- Breastfeeding; and/or
- Age 12–17 years (vapes cannot be supplied as a Schedule 3 medicine).
PSA guidance on dual-use (smoking and vaping)
Dual-use of tobacco and vapes must be avoided.
Advise people who use both cigarettes and vapes to switch completely from smoking to vaping only, and then implement intervention strategies to cease nicotine use.
There is a lack of evidence to guide nicotine cessation in patients who are dual users of cigarettes and vapes.
- It may be reasonable to recommend smoking cessation pharmacotherapy as a first-line intervention.
- If first-line pharmacotherapy is unsuitable, advise patients to initially switch completely to vaping and cease smoking, with the intention of ceasing vaping after an agreed treatment period.
Preventing tobacco relapse
Although cessation of both tobacco smoking and use of other forms of nicotine including vapes is always the goal, there may be instances where you and the patient agree that longer use of vapes will help prevent relapse to tobacco use.
If you and the patient are considering longer-term use of vapes:
- Inform them of the risks and benefits of vapes;
- Explain that the long-term safety of vapes is unknown; and
- Counsel that dual-use of tobacco and vapes must be avoided.
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Important links
Therapeutic Goods Administration
Pharmaceutical Society of Australia
References
- PSA Professional Practice Standard 1: https://www.psa.org.au/practice-support-industry/pps/
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