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Common patient enquiries

LIBER Common Patient Enquiries

Common Patient Enquiries

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Is vaping safe?

There isn’t enough data to declare any vaping product as ‘safe’. However, for smokers seeking to quit, Nicovape® Q is safer than continuing to smoke.

In Australia, therapeutic vapes are supplied, prescribed and dispensed as unapproved therapeutic goods, meaning the TGA has not assessed them for their quality, safety, or efficacy. While these are unapproved medicines, the TGA has created a framework to allow them to be supplied under prescription.

Nicovape® Q uses pharmaceutical-grade ingredients and processes, and the liquids have been subject to comprehensive toxicological risk and hazard assessments for inhalation.

Yes. All nicotine vapes, including Nicovape® Q, use liquids that contain nicotine – an addictive substance.

The purpose of Nicovape® Q is to help patients stop smoking or to manage nicotine dependence in patients transitioning away from recreational vaping products.

Once a patient has stabilised off smoking or has effectively transitioned from recreational vapes, their doctor will work with them to reduce and eliminate nicotine using Nicovape® Q, traditional NRT protocols or both.

Nicovape® Q cartridges are available in:

  • 2-packs with an RRP of $29.99 (20 mg/mL only);
  • 7-packs with an RRP of $79.95; and
  • 28-pack maxi-boxes with an RRP of $299.95.

If your patient buys a 7-pack box, each Nicovape® Q cartridge will cost them $11.42 – most patients will consume significantly less than one cartridge per day.

For reference, if we assume that 20 cigarettes cost $40, a pack-a-day smoker switching to using one Nicovape® Q cartridge per day would save up to $10,000 annually.

Advise the patient that their doctor will discuss with them how long each Nicovape® Q cartridge should last. Unless they are a very heavy smoker, it is unlikely that their doctor will prescribe more than one Nicovape® Q cartridge per day.

However, if a single Nicovape® Q cartridge per day is not sufficient to prevent your patient from relapsing to smoking, encourage them to speak to their doctor urgently to consider reassessing their prescribed amount.

Liber has formulated its liquids with molecularly characterised ingredients and uses only pharmacopoeia (where available) or high-purity food-quality ingredients. All ingredients are toxicologically screened, and the formulations are tested for harmful emissions under realistic conditions of use.

The Nicovape® Q is available in three (3) nicotine concentrations and three (3) flavours:

Nicotine concentrations:

  • 20 mg/mL – Nicovape® Q20
  • 35 mg/mL – Nicovape® Q35 (prescription only)
  • 50 mg/mL – Nicovape® Q50 (prescription only)

Flavours:

  • Classic tobacco
  • Coolmint
  • Freshmint

While the Nicovape® Q20 is available without a prescription and, due to this, may initially be the preferred choice of many patients in pharmacy, it is unlikely to be the optimal intervention for most patients, as outlined in the following question.

Historically, c.90% of all Nicovape® Q products prescribed have been at more than 20 mg/mL concentrations.

Many patients will require continued access to higher concentration vapes for them to remain smoke-free or to ensure they do not seek illicit vapes.

However, Nicovape® Q20 will act as an important tool for pharmacists when they first discuss therapeutic vaping with their patients, and may aid as an immediate replacement for cigarette and/or illicit vape use for a short duration while patients undertake a consultation for a script.

Ask your patient if they know whether their doctor is experienced in dealing with smoking cessation or prescribing vapes – the patient’s own doctor is always the best place to start.

If that fails to address the patient’s query, can you recommend a local prescriber of therapeutic vapes to them? If not, our team can help connect you to your local prescribers of therapeutic vapes, or assist them in registering as authorised prescribers.

Register for our Liber:Activate Program to establish your local GPs as activated authorised prescribers.

That is a question for your patient to ask their doctor.

For any doctor, prescribing a therapeutic vape is a matter of clinical judgement and the patient having met certain criteria for eligibility in accordance with the RACGP’s Smoking Cessation Guidelines.

Suggest to the patient that they explain to their doctor their smoking and/or vaping history, and they may decide that using a vaping product is appropriate for them.

Most potential side effects of using any nicotine-containing vape are related to nicotine consumption.

If your patient consumes too much nicotine (or too quickly), they may experience a headache, nausea, trembling or dizziness. Your patient may also experience a ‘dry mouth’ from frequent use of any vaping product. They may also experience ‘initiation cough’ (short duration coughing) when they first start using vapes, although this usually resolves with continued use.

For further information regarding possible side effects, please consult the Nicovape® Q CMI leaflet, which can be accessed at nicovapeq.com/cmi.

Under the TGA’s new regulatory framework, Nicovape® Q only contains four ingredients:

Propylene glycol: a clear, tasteless liquid used because it mixes well with flavouring ingredients and produces an aerosol when heated. PG is used in food products, drugs and food flavourings.

Glycerol: Typically derived from plants and often called ‘vegetable glycerin’ (VG). VG is used in pharmaceutical products such as cough syrups, creams, toothpaste, and foods. It imparts a sweet flavour and produces a denser aerosol.

Flavours: Designed to mask the bitter taste of nicotine and make therapeutic vapes palatable.

Nicotine salts: Found naturally in tobacco leaves, these enable lower-powered vapes to more closely mimic the experience of smoking a cigarette by allowing faster nicotine absorption and less irritation to the throat than freebase nicotine.

No, patients must never attempt to refill/reuse Nicovape® Q cartridges.

Refilling any closed-cartridge system risks exposing users to toxicants due to degradation of the coil through repeat usage.

Nicovape® Q is a closed-system vape, and Nicovape® Q cartridges have been designed and studied for one use only.

No. Epidemiological research shows that while lessening the number of cigarettes smoked can lower the risk of some diseases, smoking just one cigarette daily still poses a severe cardiovascular health risk.

The sooner your patient can stop smoking altogether, the sooner their body can begin repairing itself. Nicovape® Q is designed to deliver sufficient nicotine to ensure that your patient will not need to smoke to satisfy their nicotine cravings.

The global scientific consensus is that vaping products have a role to play in smoking cessation, particularly for patients who have tried to stop smoking and failed.

The regulatory framework in Australia only allows patients to be supplied or dispensed vapes by pharmacies to help them stop smoking or to manage nicotine dependence. Importantly, this framework is now focused on stopping the sale of illicit vapes across Australia.

Pharmacies stock therapeutic vapes to ensure that nicotine- dependent patients who may benefit therapeutically from using them are able to do so immediately, either via pharmacist supply (under 20 mg/mL) or upon presenting a script for higher-concentration vapes.

There is no safe level of inhaling cigarette smoke and regularly smoking just one cigarette daily confers a severe health risk. Vaping allows patients to inhale nicotine without the smoke, tar and chemicals of cigarette smoking.

While nicotine is addictive, it is not the cause of smoking-related diseases.

More than 250 chemicals in tobacco smoke are known to cause harm and have been linked to 16 types of cancer, chronic respiratory conditions, heart disease and strokes, an increased risk of developing diabetes and dental problems, and a negative impact on mental health.

As with most prescription products, there may be some risk from therapeutic vaping. However, using a locally-insured therapeutic product such as Nicovape® Q with contents and output that are studied and assessed is a much better option than smoking.

The term EVALI (e-cigarette or vaping product use-associated lung injury) is usually used to refer to an outbreak that caused serious lung injuries in over 2,800 people in the USA in 2019.

94% of those EVALI cases involved the presence of vitamin E acetate, which is not found in therapeutic vapes but is commonly used in black-market cannabis products.

Vitamin E acetate is a prohibited ingredient under TGO 110, and Nicovape® Q e-liquids are tested to ensure that they do not contain any prohibited ingredients, including vitamin E acetate.

Supplying and Dispensing Therapeutic Vapes

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Liber:Onboard

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Liber:Activate

Establish your local GPs as activated authorised prescribers

Important links

Therapeutic Goods Administration

Pharmaceutical Society of Australia

References

  1. PSA Professional Practice Standard 1: https://www.psa.org.au/practice-support-industry/pps/