E-cigarettes and vaping: The reforms we need are happening

Unsurprisingly, the statistics show what you’ve likely noticed – “vaping” through the use of e-cigarettes has become a thing.

The increase is particularly apparent in young people, with the 2022-23 Australian Secondary Students’ Alcohol and Drug survey finding about 30% of students have vaped, compared with 13% in 2017, and that 16% of students had vaped in the previous month, compared with 4% in 2017. The use of e-cigarettes increases to about 20% for Australians aged 18-24 years, then falls in older groups.

And we were doing so well with smoking.

Australia’s smoking rates have fallen to among the lowest in OECD countries. In 2021, it was about 11% of adults, down from 24% in 1991, 35% in 1980, and over 45% in the 1950s.

The multi-pronged strategies worked well – advertising bans, plain packaging, explicit warnings, anti-smoking campaigns, pricing, restrictions on where people can smoke, QUIT supports.

They’ve worked synergistically to decrease uptake and usage, increase quitting rates, and cause a cultural shift – with a consequent decrease in the enormous and devastating burden of cancer, lung and vascular disease.

Yet over the past decade, smoking’s sibling, vaping, has emerged as an increasing personal and public health problem.

The targeting of e-cigarettes to young people is undeniable.

Unethical industry tactics use social media and “vaping influencers” to promote and sell dangerous e-cigarettes and to normalise vaping – watermelon, bubble-gum and musk flavours, disguised as highlighters, sold as one-offs, and the establishment of a plethora of “vape stores” near schools are just some of these tactics.

It’s little wonder such tactics have fed both a cultural acceptability of vaping that largely no longer exists for smoking, and a mistaken belief that vaping has insignificant health risks.

But make no mistake, the use of e-cigarettes is harmful, with the knowledge of harms increasing as more research emerges.

And, contrary to labelling as “nicotine-free”, the vast majority contain nicotine, with the nicotine in one e-cigarette being up to the equivalent of 50 cigarettes.

Nicotine can harm the brains of children and adolescents, increase heart rate and blood pressure, disrupt sleep, cause irritability, contribute to mood disorder, and is addictive. And even the few without nicotine have serious health concerns.

All e-cigarettes, both the majority with nicotine and the few without, contain dangerous substances in the liquids and the aerosol that are carcinogenic and cause lung damage – formaldehyde, heavy metals such as nickel, tin and lead, chemicals found in weedkiller and antifreeze, flavourings such as diacetyl, which is linked to serious lung disease, and ultra-fine particles that are inhaled deep into the lungs and cause damage.

Unsurprisingly, there’s also a strong association between vaping and future smoking, with young people who vape three times more likely to start smoking cigarettes.

In 2021, the federal government legislated so that all nicotine vaping products, including nicotine e-cigarettes, nicotine pods and liquid nicotine, could only be purchased with a doctor’s prescription.

However, it just hasn’t worked. The loophole was that nicotine-free vaping devices and e-liquids could still be legally imported, sold and bought.

The government is therefore rolling out a series of much-needed regulatory changes regarding the importation, access, advertising and sale of both nicotine and non-nicotine e-cigarette products and liquids.

From the beginning of this year, the importation of single-use e-cigarettes has been banned. Also, e-cigarettes can now only legally be obtained with a prescription and through a pharmacy, with all doctors and nurse practitioners now able to prescribe e-cigarettes for therapeutic purposes and if clinically appropriate.

From 1 March, 2024, the importation of any vaping product must meet Therapeutic Goods Association (TGA) standards, with these standards being tightened over the coming year to limit flavours, reduce maximum nicotine concentrations,  and require pharmaceutical-style packaging.

This means that moving forward, e-cigarettes and vaping products will only be obtainable under a prescription, will have quality testing and labelling, and much stronger measures to decrease uptake and usage.

If you’ve been using e-cigarettes, you may be able to stop on your own; however, many people do need help.

Along with those who smoke cigarettes, I’d encourage you see your GP, call QUIT on 13 7848, or make a booking with the UHS. There are highly effective interventions that can help you stop – support, behavioural and nicotine replacement, and, in some cases, there’s a place for a prescribed vaping product for a limited time. 

If you have a young person in your life, I’d also encourage you to open the conversation about vaping with them, with the understanding that it’s prevalent, and you can support them to quit or not to start.