With more Australian kids picking up vapes and some as young as 13 reportedly becoming addicted to nicotine, the federal government has taken action.
Starting on October 1, Federal Health Minister Greg Hunt closed a loophole that allowed Australians to import nicotine vaping products (NVPs) from overseas without a doctor’s prescription.
But some experts are concerned the new laws will put users at a higher risk of harm, by forcing them into the black market to buy a product that could save their lives.
What’s the problem?
It’s currently illegal to purchase or possess a nicotine vaping product (NVP) in every Australian state and territory except South Australia.
Yet many users have been buying NVPs from overseas vendors or under the counter from Australian tobacconists.
As of October 1, Border Force has the power to seize NVPs with no doctor’s prescription attached, along with those that contain dangerous contaminants, like some cinnamon or creamy flavourings.
Public health officials hope the import ban will limit black market sales of NVPs and help Australia avoid a youth vaping epidemic, like that seen in the United States.
As many as one in five high school students in the US now vape, according to the National Center for Chronic Disease Prevention and Health Promotion.
“Youth vaping is definitely on the rise,” Quit Victoria director Dr Sarah White told The New Daily.
“We’ve seen about a doubling of kids who are using e-cigarettes in the latest National Drug Strategy Household Survey.”
Dr White said she received a call on Quitline from a teacher in distress because one of her students, a 13-year-old boy, was heavily addicted to nicotine.
Quitline provides counselling to people who want to quit smoking tobacco. But for the first time in decades, people are calling up about children who are addicted to nicotine vapes, Dr White said.
“When you start getting calls like that it’s really scary,” Dr White told The New Daily.
Is there a youth vaping epidemic?
University of Queensland Professor Wayne Hall said prohibition advocates often use a double standard when it comes to statistics around youth vaping and smoking.
“There has been much more experimentation with vaping amongst young people in recent years, but I think there’s a tendency to focus on ever-use,” Professor Hall told The New Daily.
“I mean, these are young people who might have tried a vape once, and they’re all counted as vapers.”
Some surveys found about 5 per cent of teenagers said they had used a vape in the past month.
But the 2019 National Drug Strategy Household Survey—cited in the government’s own reasoning for the new law — found just 1.8 per cent of kids aged 14-17 said they currently vaped, up from 0.9 per cent in 2016.
This figure included those who said they vaped less than once a month, and made no mention of whether the vapes contained nicotine.
Nevertheless, experts and public health officials agree we should be concerned about youth vaping.
Dr White is particularly concerned that some vape companies seem to be marketing NVPs to young people.
“We know that the flavours and packaging seem to be highly attractive to kids,” Dr White said.
“Some of them are like juice boxes, some of them have cartoon characters — the flavours are like hubba-bubba and cherry pop.”
“And we’re certainly seeing them being marketed to kids and adolescents on social media platforms like TikTok.”
Despite vowing to remove posts promoting the use or sale of NVPs, TikTok, Snapchat and Instagram are awash with pages selling nicotine vapes, The New Daily can reveal.
And many are concerned that if kids start vaping, they may then go on to smoke cigarettes.
Is vaping a gateway to smoking?
“There have been countless numbers of studies now showing that if somebody starts using e-cigarettes, or vaping, they’re three times more likely to go on to smoke cigarettes,” Dr White said.
But Professor Hall said the evidence that vaping is a gateway to smoking is “fairly weak”, because the researchers were unable to contact large numbers of participants.
What’s more, studies were unable to properly determine whether young people who vape were already predisposed to smoke cigarettes, Professor Hall said.
Victorian state MP and Reason Party leader Fiona Patten said the new laws were “extremely short-sighted” and not rooted in evidence.
“There is absolutely no evidence that vaping leads to smoking,” Ms Patton said.
“There is a tonne of evidence that vaping can stop you smoking.”
Can vaping help people quit?
Professor Hall found NVPs were about twice as effective at getting people to quit as other nicotine-replacement products (NRPs), like patches or gum.
“We have a really hard time getting people to quit, and if there’s a product that’s twice as good as other NRPs then we’d be mad not to use it,” Professor Hall said.
As little as 3 per cent of Australians who try to give up smoking actually succeed. And in the UK, where vaping has been embraced as a tool to help people quit smoking, more than half of those who successfully quit do so using a vape.
But many health organisations disagree.
The World Health Organisation, the Australian Medical Association, the Australian Cancer Council, and the Australian Department of Health all say there is insufficient evidence that NVPs are an effective quitting-smoking tool.
And until recently the peak body for GPs, the Royal College of General Practitioners, discouraged doctors from prescribing nicotine vapes.
A change to RACGP guidelines last year saw NVPs recommended as a “second-line” quitting aid, to be used only after patients had exhausted all other options.
Dr White concedes that with proper guidance, smokers can have success quitting by using a vape.
“If somebody is tempted to try to use a nicotine vaping product for smoking cessation, the best thing they can do is talk to their doctor, and make sure they’re using it under that medical supervision and with Quitline counselling,” she said.
But Reason Party leader Ms Patton said forcing people to go to their doctor to get a prescription for NVPs is unnecessary and inappropriate.
“Doctors don’t feel comfortable writing a prescription for a product that is not listed on the PBS, is not approved by the TGA,” Ms Patten said.
“We don’t ask doctors to write a prescription for tobacco, we don’t ask them even to write a prescription for Nicorettes, so why are we asking them to do this?”
Professor Hall said quit services, rather than doctors, could provide guidance to those seeking to quit smoking by using NVPs.
“But in this country the quit services are hostile to e-cigarettes and they discourage smokers from using them,” Professor Hall said.
Is vaping safe?
Those who oppose vapes often do so because they believe they are unsafe.
Vaping advocates, however, say policy makers and health officials should embrace NVPs as a quit-smoking tool because they are significantly safer than cigarettes.
“It’s not just marginally safer,” Professor Hall said. “I mean, it’s enormously safer in terms of levels of carcinogens and toxicants.”
But Dr White said comparing vaping to the most deadly consumer product ever sold was not a glowing endorsement.
“Cigarettes are the leading cause of preventable death in Australia, a full 8.6 per cent of our disease burden is due to tobacco smoking alone,” Dr White said.
“So that is an incredibly low bar to get over.”
Although it is not advisable for non-smokers to start vaping, Professor Hall said, playing down the differences in safety could see more people transition from vaping to smoking.
“Safer is not safe,” Professor Hall said.
“But I think it’s an astonishing outcome of misinformation that most smokers believe there’s no difference in the risk between vaping and smoking, which just encourages the transition to smoking if people begin to vape.”
What’s more, by further restricting access to vapes, the federal government could actually be exposing users to more risk.
In the US, for example, thousands were hospitalised and 68 people died after using illegal cannabis vape products that were contaminated with a toxic substance.
“That’s the trade-off with prohibition, is you reduce overall prevalence but you make the use much riskier,” Professor Hall said.
“We might confine e-cigarette use to the more adventurous, risk-taking, rebellious young people in the community, but we’ll increase the risk that they run, because they’ll be using products that are unregulated and could contain contaminants.”
Black marketeers everywhere
With an estimated half a million users and reports of a proliferation of illegal nicotine vapes already being sold under-the-counter at Australian stores, some are concerned the horse has already bolted.
But Quit Victoria is firm in the view that the new laws will prevent young people from starting to vape.
“I don’t think the horse has bolted for nicotine vaping products at all,” Dr White said. “But the stable door is definitely open and we really need to act fast to slam it shut.”
Meanwhile, illegal vape vendors are telling their customers it will be business as usual after October 1.