Why I quit the AMA over pill-testing hypocrisy

I have cancelled my membership of the Australian Medical Association after 30 years as a loyal member.

I can no longer tolerate its hypocrisy on harm reduction: supporting pill testing for drug takers but opposing vaping to reduce the harm from smoking.

The association recently lent vocal support for pill testing at music festivals. Pill testing is a sensible harm reduction policy that aims to the reduce harm from illicit drugs. The association accepts people will continue to use drugs despite the risk. Pill testing is a pragmatic solution that aims to reduce the harm that will inevitably occur in some cases.

However, with smoking the association takes a zero-tolerance approach and rejects safer alternatives such as vaping for smokers unable to quit. According to Britain's Royal College of Physicians, long-term vaping "is unlikely to exceed 5 per cent of the harm from smoking tobacco".

Smoking is a powerful addiction and quit rates are low. The average 40 year-old smoker has tried and failed more than 20 times. The association's advice is just to keep trying. This advice is especially troubling as the stakes are so much higher for smoking than for illicit drug use.

Each year in Australia, 19,000 smokers die prematurely from smoking. Smoking rates in Australia have not declined since 2013. Are the lives of smokers less important than those of pill-takers at music festivals?

Vaping is a way out for addicted smokers and has helped millions of smokers quit overseas.

The AMA has a long-standing commitment to a "quit-only" approach to smoking. Accepting a behaviour that resembles smoking and involves nicotine may be seen as an admission of failure. It can be hard to change established thinking.

The AMA position is based on fear of potential risks. These fears, such as the "gateway theory", the risk of "'renormalising" smoking and uncertainty about safety, are not supported by the evidence to date. The AMA fails to accept the growing international evidence that vaping is an effective and legitimate quitting aid.

If the AMA reviews the evidence and reverses its position on vaping, I will renew my membership. But I am not holding my breath.

  • Colin Mendelsohn is a professor in the School of Public Health at the University of NSW, and the chairman of the Australian Tobacco Harm Reduction Association.