About Vaping

In this article we tackle some of the key questions: What is vaping? What are the risks? What are governments and schools doing about this issue for students?

What is vaping?

Vaping is a term used to describe the act of inhaling and exhaling an aerosol produced by an electronic device. These devices are also known as e-cigarettes, e-cigs, or vape pens, and are becoming increasingly popular among teenagers and young adults. Vaping devices are typically battery-powered and work by heating a liquid, called e-juice or vape juice, that typically contains nicotine, flavourings, and other chemicals. The liquid is transformed into an aerosol that is inhaled, providing a sensation similar to smoking regular tobacco cigarettes.

Vaping is often marketed as a safer alternative to smoking cigarettes because it doesn’t involve burning tobacco. However, there are still many health risks associated with vaping, including respiratory problems and addiction to nicotine [1]. Despite the health risks, there are a variety of reasons some people still choose to vape. The primary reasons cited by young people are social pressures and fitting in, curiosity, and stress relief. This is also due to lack of education and misrepresentation of the health risks involved, so it is important to be aware of the potential dangers associated with vaping in order to make informed decisions.

Vaping is an increasingly concerning issue in high schools around the world. Many students are attracted to the flavours and social aspect of vaping, leading to a rise in its popularity. Recent research found that 10% of young Australians aged 14-17 years old and 26% aged 18-24 have used e-cigarettes [1, 2]. As a result of the rapid increase in vape usage amongst young people, schools and parents are working tirelessly to educate students about the potential dangers of vaping and to discourage use.

Since 2017, the US saw a record increase in adolescents’ vaping of nicotine – the largest for any substance over the past 44 years [3]. In Australia, vape usage in people aged 14 years or older has more than doubled from 2016 to 2019 [4], and jumped by 18% between 2017 and 2021 in secondary school students [5], Now the research has shown that more than 3.5 million Australians aged 14 years and over vape or smoke [6, 7].

Health Minister Mark Butler has called vaping ‘the number one behavioural issue in high schools,’[8] and commented on the tobacco industry’s ‘deliberate strategy […] to create a pathway into smoking, to create a new generation of nicotine addicts.’[9]. This is in response to the dramatic increase in the smoking rates of teenagers since 2020, which hasn’t been seen since the 1990s [7]. Vaping is therefore reversing the progress made against tobacco use, potentially behaving as a gateway into smoking and other substance use [8].

Vapes are often seen to be the lesser of two evils when compared with tobacco cigarettes. This has partly driven their popularity and uptake as most people are unaware of the dangers associated with vaping, and while the long-term effects remain largely unknown.

What are the risks?

  • Nicotine is considered one of the most addictive substances. Unregulated vapes contain unknown amounts of nicotine and over half of adolescents who use e-cigarettes develop symptoms of dependence [11, 12, 13].
  • Mouth inflammation, gum disease and oral health problems [13]
  • Throat irritation, cough, dizziness, headache, nausea, [13]
  • Nicotine overdose, including seizures and poisoning [13]
  • Burns and injuries [13]
  • Respiratory illness, including risk of lung disease [13]
  • Single use waste and impact on the environment [13]
  • Exposure to potentially harmful chemicals. Some of the more concerning substances include metals such as nickel, chromium, and lead, as well as formaldehyde, acetaldehyde, acrolein, arsenic, VOCs, and an onslaught of flavouring chemicals and particulates – some of which are known carcinogens and found in products such as paint stripper, petrol, weed killer, and rat poison [8, 11, 13] While some of the components of e-cigarettes have been deemed safe to eat or drink, they have not proven safe for inhalation.
  • Risk of developing chronic disease such as lung cancer or cardiovascular disease [13]
  • Potential negative effect on brain function and development [13]
  • Potential negative effect on mental health and links with depression and anxiety [13]

Read more about these risks on our blog article here.

Tighter regulations and legislation governing the promotion and sale of e-cigarette products, as well as the establishment of effective clinical, educational, and public health programs, are necessary to assist in managing the growing nicotine epidemic that is affecting our youth [8].

Australia currently leads the world in this endeavor, through the implementation of a nationwide vaping crackdown. A loophole in the previous Australian regulations allowed the sale of unlabelled vapes containing nicotine that were indistinguishable from non-nicotine vapes. This meant that people were consuming nicotine without even being aware of it. In May this year, the Federal government took action by pledging to invest $737 million on tobacco and vaping control, including $63 million in evidence-based public health campaigns and $30 million in support programs to educate health professionals and help people quit. An additional $141 million is being invested towards the Tackling Indigenous Smoking Program for reducing vaping and smoking among First Nations people [14].

What's changing?

 

  1. Total ban on single use, disposable vapes: Australia has banned the sale of e-cigarettes and vaping products, both with and without nicotine, within the country. [15]
  2. E-cigarettes will be prescription only intended to aid in the cessation of smoking. There will be quality standards restricting flavours, colours and other ingredients as well as a restriction on the amount of nicotine prescription vapes can contain.
  3. Public health campaigns – $63 million of the budget will be spent on a public health campaign to discourage smoking and vaping. [16]
  4. Pharmaceutical-like health warnings on vaping product packaging and restricted marketing and advertising to minimise their appeal to young audiences. [16]
  5. Support programs and education and training for health professionals and encouraging traditional nicotine replacement cessation methods for vapers and smokers. [16]
  6. Border controls: Strengthened border controls with the aim to prevent the illegal importation of vaping products, with severe penalties for unauthorised imports. [17]
  7. State-enforced raids
    • In Perth, 300,000 vapes were confiscated in Australia’s largest raid, estimated to be worth $10 million
    • In Brisbane, 40,000 vapes were confiscated, valued at $1.2 million in a recent raid [18]
    • In NSW, a series of raids across tobacco stores and convenience stores has removed an estimated $3 million worth of vapes from the streets [19]
    • Similarly in Victoria, raids aim to send a message to stores with the confiscation of up to $800,000 worth of vapes from the streets, and a pledge to continue to discourage the sale of illegal vapes [20]
  8. Research and education Initiatives: Australia invests in research to understand the long-term health effects of vaping and educate the public about associated risks [14]

Australia’s vaping crackdown could have a significant positive impact on public health by preventing the emergence of a new generation of nicotine addicts. Australia has paved the way with a determined effort to protect public health and curb the rise of vaping among the younger population, and we will see over the next few months how these bans are enforced in each of the states and territories.

Some have criticised the hard stance claiming it will drive the supply of vapes underground, as we have previously seen with other types of illicit drug use through an unregulated black market. [10] While the effectiveness of these policy measures is yet to be known, it is critical that also we arm young people with the knowledge and skills to make positive decisions for their health and wellbeing by providing evidence-based education.

Read more about Australia’s vaping crackdown here, and the worldwide policy trends to ban vaping here.

 

What do principals and teachers think about vaping use?

A recent study by the University of Melbourne among 218 school staff found [21]:

●      46% of school staff had found a vape on campus at least monthly

●      36% of principals had suspended or expelled students at least monthly

●      93% said it was becoming a problem in secondary schools and were concerned about use by students

●      51% had a vape policy in place

●      biggest barriers to enforcement were the discreet nature of e-cigarettes and difficulty in locating where the vapour came from [21]

The results highlight the extreme disruption vaping is presenting for schools on a day to day basis. Moreover, it highlights a need for schools and parents to educate their students about the dangers and risks of vaping.

What are schools doing to stop vaping use?

 

●      Implementing vape-smoke detectors, at the reported cost of $15,000 – $25,000 [22]

●      Locking or removing bathroom doors, or requesting an access card to use the bathroom – seen to be a drastic measure by many parents [23]

●      Suspending or expelling students [21]

●      Banning aerosol deodorants which break the vape-smoke detectors! (as reported by one of our school clients)

While the lengths being taken show how big the issue is, these are drastic and unsustainable measures which only drive backlash. Educating students on the effects of vaping is essential to help prevent the detrimental physical and mental health outcomes. A harm-minimisation approach, such as diverting students to evidence-based prevention programs and interventions may be more effective, rather than punishment. Some schools are already doing this to benefit their students.

Below are some practical strategies on how to manage vaping in schools, following a harm-minimisation approach.

How to Tackle Vaping in Schools

Some tips from Matilda Centre’s Vaping expert, Dr. Emily Stockings:

  1. Arm yourself with the facts (eg. here and here) so you can have frank, non-judgmental conversations.
  2. Start a conversation. See tips on how to talk to kids here, and specifically about vaping here.
  3. Listen with patience
  4. Convey expectations: Why you don’t want them to vape, why you are concerned about the risks to their brain, lungs, and their future wellbeing
  5. Identify alternate strategies: Ask what might work for them. Ask them to self-reflect on vaping patterns to identify vaping triggers and develop a coping strategy or replacement behaviour. Eg., having a breath mint or glass of water, change routines, exercise, chat to a friend. Or, if you suspect nicotine dependence it may be appropriate to try nicotine replacement therapy (eg. patches, spray, gum) to assist with symptoms of nicotine withdrawal.
  6. Start a peer-led conversation in class. For example, “What worries you about vaping?” “What do you think about vaping?” “What would you say if someone offered you a vape?” (Practising refusal skills in class).
  7. Other exercises such as recognising tobacco industry manipulation
  8. Developing a quit plan: Tips on how to get started
  9. Seeking help from a GP, Quitline or Psychologist
 

Find Dr Emily Stockings’ webinar on e-cigarettes and vaping in young people here, and check out our blog here.

 

Vaping use has increased significantly among adolescents and young adults, causing a new worldwide epidemic. The appealing flavours, discreet packaging and misinformation have made them highly popular with teenagers, whose undeveloped brains are most susceptible to the harmful effects of nicotine and harmful chemicals contained in vapes. Vaping only compounds the significant mental health challenges facing today’s youth and the development of their adolescent brains. Schools desperately need better tools and resources to help prevent students from vaping before the nicotine dependence sets in, while also supporting them to quit through non-judgmental conversations and strategies. Evidence-based prevention education such as what OurFutures offers is essential.

Vaping Clinical Trial: Prevention Program

We are currently running Australia’s most rigorous evaluation of a vaping prevention program. Background information on the OurFutures vaping trial can be found here.

And check out our website for more: https://ourfuturesinstitute.org.au/vaping/

It’s important to provide support rather than punishment for nicotine dependence!

Vaping Facts

References

 

  1. E. Banks et al., “Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence,” Medical Journal of Australia, vol. 218, no. 6, Mar. 2023, doi: https://doi.org/10.5694/mja2.51890.
  2. Gardner, L.A., O’Dean, S., Champion, K.E., Stockings, E., Rowe, A.-L., Teesson, M. and Newton, N.C. (2023), Prevalence, patterns of use, and socio-demographic features of e-cigarette use by Australian adolescents: a survey. Med J Aust, 219: 332-334. https://doi.org/10.5694/mja2.52075
  3. Miech R, Johnston L, O’Malley PM, Bachman JG, Patrick ME. Trends in Adolescent Vaping, 2017–2019. New England Journal of Medicine. 2019;381(15):1490-1491. doi:https://doi.org/10.1056/nejmc1910739
  4. Lung Foundation Australia. Vaping and Young People for Educators Vaping and Young People for Educators.; 2021. https://lungfoundation.com.au/wp-content/uploads/2021/07/Factsheet-Vaping-and-Young-People_For-Educators-Jul2021.pdf
  5. Tobacco in Australia. 18.3 Prevalence of e-cigarette use – Tobacco in Australia. Tobaccoinaustralia.org.au. Published 2013. https://www.tobaccoinaustralia.org.au/chapter-18-e-cigarettes/18-3-extent
  6. Current vaping and smoking in the Australian population aged 14 years or older – February 2018 to March 2023. Australian Government Department of Health and Aged Care. Published June 27, 2023. https://www.health.gov.au/resources/publications/current-vaping-and-smoking-in-the-australian-population-aged-14-years-or-older-february-2018-to-march-2023?language=en
  7. Stephanie Borys. Report shows first increase in Australian teen smoking since the 90s. ABC News. https://www.abc.net.au/news/2023-06-02/smoking-vaping-on-the-rise-in-young-australians/102425832. Published June 2, 2023.
  8. Chadi N, Hadland SE, Harris SK. Understanding the implications of the “vaping epidemic” among adolescents and young adults: A call for action. Substance Abuse. 2019;40(1):7-10. doi:https://doi.org/10.1080/08897077.2019.1580241
  9. Freeman B. Vaping and behaviour in schools what does the research tell us. The University of Sydney. Published May 2, 2023. https://www.sydney.edu.au/news-opinion/news/2023/05/02/vaping-and-behaviour-in-schools-what-does-the-research-tell-us.html
  10. “Minister for Health and Aged Care – press conference in Canberra – 31 May 2023,” Australian Government Department of Health and Aged Care, May 31, 2023. https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/minister-for-health-and-aged-care-press-conference-in-canberra-31-may-2023
  11. Everything we know so far about vaping. www.vichealth.vic.gov.au. https://www.vichealth.vic.gov.au/our-health/everything-we-know-so-far-about-vaping
  12. L. A. Gardner et al., “Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents,” BMC Public Health, vol. 23, no. 1, Apr. 2023, doi: https://doi.org/10.1186/s12889-023-15609-8.
  13. Banks E, Yazidjoglou A, Brown S, Nguyen M, Martin M, Beckwith K, Daluwatta A, Campbell S, Joshy G. Electronic cigarettes and health outcomes: systematic review of global evidence. Report for the Australian Department of Health. National Centre for Epidemiology and Population Health, Canberra: April 2022.
  14. Department of Health and Aged Care, “Taking action on smoking and vaping,” Australian Government Department of Health and Aged Care, May 02, 2023. https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/taking-action-on-smoking-and-vaping
  15. J. Evans and T. Lowrey, “Recreational vaping to be banned, all e-cigarettes to be strictly controlled,” ABC News, May 01, 2023. Available: https://www.abc.net.au/news/2023-05-02/vapes-recreational-use-banned-government-crackdown/102290248
  16. M. Grattan, “Albanese government launches war on vaping, declaring it the ‘number-one behavioural issue in high schools,’” The Conversation, May 01, 2023. https://theconversation.com/albanese-government-launches-war-on-vaping-declaring-it-the-number-one-behavioural-issue-in-high-schools-204760
  17. B. Freeman and P. Grogan, “TGA review strengthens case for much tighter vape restrictions at the border,” The Conversation. https://theconversation.com/tga-review-strengthens-case-for-much-tighter-vape-restrictions-at-the-border-202506
  18. R. Wood, “More than 40,000 vapes seized after raids across Brisbane,” www.9news.com.au, Sep. 01, 2023. https://www.9news.com.au/national/forty-thousand-vapes-seized-during-brisbane-raid/8b2fa2a5-f532-4442-9aa3-a0c4b188e6a4
  19. M. Saunokonoko, “NSW raids take $1m of illegal vapes off street,” www.9news.com.au, Jun. 22, 2022. https://www.9news.com.au/national/nsw-authorities-seize-1-million-of-illegal-nicotine-vapes/c9391f39-90d9-4266-b5f2-d64c206442fc
  20. C. Kelly, “Thousands of vapes seized in Melbourne raid as police send ‘clear message’ to stores,” The Guardian, Jul. 27, 2023. Available: https://www.theguardian.com/society/2023/jul/28/thousands-of-vapes-seized-in-melbourne-raid-as-police-send-clear-message-to-stores
  21. Jongenelis MI, Robinson A. Educators’ perceptions of e-cigarettes in Australian secondary schools. Tob Induc Dis. 2023;21:41. Published 2023 Mar 16. doi:10.18332/tid/161025
  22. Pangilinan M. SA government supports installation of vape detectors in schools. www.theeducatoronline.com. Published January 13, 2023. Accessed October 12, 2023. https://www.theeducatoronline.com/k12/news/sa-government-supports-installation-of-vape-detectors-in-schools/281750
  23. Bass C. Aussie school’s plan to stop students vaping slammed by parents. Yahoo News. Published October 21, 2022. Accessed October 12, 2023. https://au.news.yahoo.com/aussie-schools-plan-stop-students-vaping-slammed-parents-041402540.html?guccounter=1

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