There is growing evidence that vaping is bad for your health, with the government so concerned that it recently banned the purchase of nicotine vaping without a prescription.
But many people think vaping is safer than smoking, and it’s not uncommon to walk down the street and see someone vaping – and get a puff of flavored smoke as you pass.
Fewer Australians than ever smoke tobacco daily, down to just 11% in 2019, according to the National Household Drug Strategy triennial survey.
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But vaping is on the rise, with 2.5% of survey respondents saying they are current e-smokers and 11.3% who have tried e-cigarettes, up from 1.2% and 8.8% respectively in 2016.
At the same time, a growing body of evidence shows that vapes can contain a host of toxic chemicals and nicotine – which is highly addictive.
Australian Medical Association President Dr Omar Khorshid warned last year: “Vaping is not the risk-free version of smoking that some would have us believe.
So if e-cigarettes containing nicotine are so harmful and even illegal in some states, why are more Australians vaping now?
What is the difference between vaping and smoking?
Regular smoking involves inhaling smoke and small particles from burning tobacco leaves. These small particles contain a highly addictive chemical called nicotine.
When absorbed into the bloodstream in small doses, nicotine travels to the brain and activates receptors that release dopamine – this is what makes smoking so addictive.
Vaping involves inhaling an aerosol of chemicals, heavy metals and particles from a flavored liquid – called e-liquid – that has been heated by a battery-powered device.
Vapes don’t always contain nicotine, but some marketed as nicotine-free actually contain the chemical.
A 2019 study published in the Medical Journal of Australia showed that 60% of e-liquids labeled “nicotine-free” contained nicotine.
“E-cigarettes and e-liquids can be labeled incorrectly, and sometimes they are deliberately mislabeled so the retailer doesn’t get in trouble for selling an illegal product,” said Quit Victoria’s director, the Dr Sarah White, at 7NEWS.com.au.
Another study from 2021 found that six of 65 e-liquids analyzed contained traces of nicotine – but all 65 contained one or more potentially harmful chemicals.
One such chemical was benzaldehyde – found in all but four of the e-liquids tested – which can reduce a person’s ability to fight off lung infections.
Is vaping really bad for your health?
The 2019 National Anti-Drug Strategy household survey found that almost one in four people who used e-cigarettes did so believing they were less harmful than regular cigarettes.
But Australia’s National Health and Medical Research Council has found that over 200 potentially harmful chemicals have been linked to e-liquids – in addition to nicotine.
White said there was “no doubt” that vaping is harmful – adding that an alarming number of young people who had never smoked were taking up vaping.
“The more pertinent question is whether vaping is better than breathing air, and the answer is absolutely no,” she said.
“People who eventually become addicted to vaping find their time and money controlled by this addiction.”
Vaping-related deaths have been reported overseas. The UK medicine and healthcare regulator has reported three vaping-related deaths since May 2016.
The US Centers for Disease Control and Prevention has confirmed 68 deaths from e-cigarettes or vaping-associated lung injury (EVALI), caused by the addition of a toxic agent to e-cigarette liquid, in February 2020.
The Australian Institute of Health and Welfare had no record of deaths from vaping-associated lung injury in 2020.
But there were problems. Last year, a Sydney teenager was treated in intensive care for EVALI.
E-cigarettes — whether or not they contain nicotine — can reduce lung function and make users susceptible to disease, increasing the risk of cardiovascular disease, White said.
NSW Poisons Information Center medical director Dr Darren Roberts said vaping and e-cigarettes of all kinds put young people at risk of serious health issues, including the lasting effects of exposing developing brains to nicotine.
What else can go wrong with vaping?
In 2019, a 24-year-old Texan died when a vape exploded as he was about to use it, sending shrapnel in his face, the Washington Post and BBC reported.
White also said that several toddlers, including one in Australia, have died of poisoning after accidentally drinking e-liquid containing nicotine.
E-cigarette-related calls to Australia’s four poisons information centers more than doubled between 2020 and 2021 – from 218 calls to 501 – the NHMRC has revealed.
Roberts said the NSW Poisons Information Center has received an increasing number of calls about children aged one to four who have been poisoned by accidentally inhaling vapes.
“Common symptoms for this age group are coughing, severe coughing spells and vomiting and in severe cases it can also lead to loss of consciousness and seizures,” he said.
“Children can easily activate vapes and we have seen adverse effects when young children have inhaled vapes.”
What are the rules around vaping?
Since October last year, Australians have needed a prescription to legally buy e-cigarettes containing nicotine.
The supply or sale of electronic cigarettes containing nicotine is illegal under state and territory laws.
Doctors can prescribe e-cigarettes to help people quit smoking, although the National Council of Health and Medical Research says they have not been shown to be a safe and effective method.
White said most doctors would be hesitant to prescribe e-cigarettes.
“Most … are quite skeptical of the evidence for efficacy,” she said, adding that vaping often ends up continuing the cycle of nicotine addiction.
“Vaping can help a small percentage of people quit when combined with advice, like Quitline, to address smoking habits and triggers,” she said.
“Then people need to be helped to stop vaping to reduce the risk of relapse, given that they are still addicted to nicotine and probably still have all of these triggers and habits. “
Do the vaping rules work?
Despite the rules, it is not difficult to buy e-cigarettes – even those containing nicotine.
“A lot of people buy e-cigarettes from tobacconists and convenience stores with no problem,” White said.
White said the problem is that the laws aren’t being enforced enough.
“Enforcement is really patchy and there are no serious consequences for retailers who knowingly do the wrong thing,” she said.
Victoria Police told 7NEWS.com.au they are aware vaping is an emerging issue and e-cigarettes are increasingly being used by young people.
Although Victoria Police can fine people for possessing vapes containing nicotine, their main focus is on education.
“To this end, Victoria Police have engaged with schools in some areas to help inform parents and staff,” a spokesperson said.
NSW is trying to crack down on e-cigarette use, with NSW Health saying in May that it has seized more than $1 million worth of illegal e-cigarettes and nicotine-containing liquids since the start of this year.
NSW was taking a ‘zero tolerance approach’ to retailers caught selling them, health director Dr Kerry Chant said.
“NSW Health routinely raids retailers across the state to protect young people from these harmful devices,” she said.
“You will be caught, illegal items will be seized and you could be subject to prosecution which could lead to a fine or even imprisonment.”
But White said Quit and other health organizations want the federal government to do more to stop illegal e-cigarette imports.
There are also calls for a “retail licensing system” to register who sells what, making it easier to penalize retailers who continue to break the law.
“Anyone can sell these products and the government has no way of knowing or communicating with retailers if, for example, an e-cigarette should be recalled,” White said.
Ultimately, White is adamant that something has to be done to stop a whole “new generation of Australians” getting addicted to vaping products.
“Let’s prepare our young people for a healthier future,” she said.
“We can’t sit idly by and let companies break the law to make money off children’s lungs.”
If you or someone you know needs help quitting smoking or vaping, call Quitline on 137848.
For more information on vaping, including NSW Health’s vaping toolkit, visit https://www.health.nsw.gov.au/vaping.
