So many Australian children are now addicted to nicotine from vaping that the federal health minister, Mark Butler, will propose reforms aimed at curtailing the e-cigarette industry.
Many children do not know they are consuming the highly addictive chemical until it is too late, experts say.
“The former government dropped the ball on vaping,” Butler told Guardian Australia. “Our children are paying the price for that division and delay.”
It is illegal to sell, supply or possess an e-cigarette or any liquid that contains nicotine in Australia without a doctor’s prescription. But suppliers have been getting around this by removing “nicotine” from the ingredients list, even though their products contain it.
It means many children are unknowingly consuming nicotine and becoming addicted, prompting calls from health experts for tougher laws and penalties.
As well as nicotine, the products can contain hundreds of other harmful ingredients such as acetone (found in nail polish remover) and pulegone (found in insecticide).
At an event at at Parliament House in Canberra on Wednesday to mark 10 years since plain packaging was introduced for tobacco products, Butler will announce the government will begin a public consultation process through drugs regulator the Therapeutic Goods Administration on nicotine vaping products.
“We need to understand where the current regulatory framework falls short and what action governments can take to move the dial,” he said.
Guardian Australia understands the proposed vaping reforms will include a blanket ban on the import of nicotine vaping products and tougher measures to curb advertising of tobacco and vaping to children on social media.
Butler is also expected to propose additional tobacco control measures at the event.
Youth vaping rates skyrocket
Butler said vaping rates had doubled in Australia between 2016 and 2019. In New South Wales, almost a third of 16- to 24-year-olds had tried vaping by last year, up from 15% three years earlier, according to a state government population survey.
NSW Health has set up a team to get manage the growing problem by testing products and acting on tips from the public. More than 157,000 vapes containing nicotine were seized during raids in the 18 months to September.
The department also prosecuted a dozen retailers for selling the products over the same period, but this was just “the tip of the iceberg”, according to chief health officer Kerry Chant.
“We are ramping up our regulatory action but I can’t express my concern [enough] at the growing access to vapes in the community,” she told a P&C Federation webinar this month.
“It feels like sometimes we are fighting against a torrent of supply.”
The deputy secretary of the federal health department, Adjunct Prof John Skerritt, told Senate estimates earlier this month: “The urgency to make sure our children and adolescents don’t access nicotine for vaping is extreme.”
“There’s a view by government that, as a matter of urgency, the dramatic increase in youth vaping needs to be addressed.”
A teacher at a Melbourne public high school with about 1,500 students said for the first time in her nine years of teaching she is seeing many children and teenagers addicted to nicotine, unable to concentrate in class. Toilet blocks at her school are now locked between classes.
“It is an issue across all of the year groups,” she said.
“The students want to leave class more frequently, and they are getting agitated and start shaking if they can’t go to the bathroom.
“We’ve even had instances where kids have done it inside classrooms, hiding their vape up their sleeve. We have installed cameras outside of the toilet blocks to identify the frequent flyers.”
The NSW health department’s director of public health programs, Carolyn Murray, said retailers should “assume that their products have nicotine in them” even if they were not labelled as such, based on results from the department’s testing on seized products.
Murray wants to see greater collaboration between state departments including police and education, as well as changes to commonwealth rules regarding advertising.
Harder to quit than smoking
Sydney psychotherapist Eugenie Pepper helps people quit tobacco smoking, but told Guardian Australia that in the past 18 months, 50% of her clients have wanted help to quit vaping.
“Most of those are in their teens and early 20s,” she said. “From 15 years old they are already feeling they have lost control. I think vaping can be harder to quit than smoking. With smoking there are handbrakes such as the cost, the fact that it is not socially acceptable and it smells.
“Children vaping are doing it nonstop from the moment they wake to when they go to bed at night. They are like little babies with a dummy unable to function without their vape in hand.”
Pepper said it was hard to believe how quickly vaping rates had taken off. “These kids have no idea how much they are vaping and there is no way of understanding what their intake is of nicotine and other potentially harmful substances.”
Dr Krista Monkhouse is a paediatrician with the Hunter New England Health District’s youth drug and alcohol clinical services program, which began in 2018. Monkhouse said last year, the service began to be inundated with inquiries from schools, GPs, psychiatrists, health clinics and parents asking for help to understand vaping, its effects, and how to help children and teens to quit.
“And then in 2022 we began to experience young people saying to us, ‘I can’t quit. I’m so dependent on this and it’s really, really hard to stop’.
“They can’t get through the day without needing the vape. Some can’t get through a night’s sleep without having to wake up and vape.
Monkhouse said the brain keeps developing until around age 25, and that nicotine use in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.
“The withdrawal effects are even worse,” she said. “They include depressed mood, irritability, frustration, anger, anxiety, restlessness, difficulty concentrating, and insomnia. Young people who are vaping are also coming to see practitioners about respiratory symptoms like cough, shortness of breath and throat irritation”
It is not just those who use vapes who are being harmed. The Queensland Poisons Information Centre has seen a 486% increase in calls since 2020 involving children under five years of age being exposed to e-cigarette and vaping devices. There have been 88 poisonings so far this year, compared with 15 in 2020. Of those 88 children, 20 went to hospital.
One teaspoon of commercially available liquid nicotine can cause irreversible damage or death to a child. A single e-cigarette containing 0.7ml of nicotine is about the equivalent of inhaling one pack of cigarettes, or 200 puffs.
One in four kids buy vapes from the local shop
“[A vape] is the perfect product to be really appealing to young people,” said Dr Becky Freeman, an associate professor of public health with the University of Sydney.
“It is discreet and cheap, it smells good, it’s being marketed to children on social media.”
Freeman helps lead Generation Vape, the first national research project asking more than 700 young people aged 13 and over, and their carers, including parents and teachers, about their experience of vaping, including their knowledge, attitudes, beliefs and behaviours about using vapes.
While all vaping products, irrespective of nicotine content, are illegal to sell to those under 18 in Australia, Freeman said, “At least a quarter of the young people who responded to our survey said they are just rocking right up to their local shop and buying them directly from convenience stories or tobacconists.”
“So there’s no mysterious way to get your hands on these products.”
Children also got vapes from other students, friends, or from family members who vape, she said, and buy the products online. They range in cost from $5-$30, and can contain hundreds to thousands of puffs.
Even those vaping products claiming to be “nicotine-free” often contain nicotine, Freeman said. She said 53% of the teens surveyed who said they had ever vaped said they had used a vape containing nicotine. But 27% were unsure whether they had used a vape containing nicotine, and the rest believed their vape did not contain nicotine.
“Many brands intentionally make their ingredients unclear, so the only way to know if a product contains nicotine is to take the product and test it in a lab.
“So you have these enforcement officers say from New South Wales Health going out to 7/11 or tobacco stores, and they take a sample of the products for sale, send it to a lab, get it tested, see if it has nicotine, and if it does, they then go back and seize those products. But they could all be sold by then, or replaced with new products.”
The TGA has tested more than 400 vaping products suspected of being counterfeit, including not declaring the presence of nicotine. Of 214 products recently tested, 190 contained nicotine. A spokesperson for the federal health department told Guardian Australia that between 1 October 2021 and 5 November 22, 1,043 investigations began into the alleged unlawful import, supply and advertising of nicotine vaping products, with 955 of those investigations finalised.
Over the same period, 96 infringement notices were issued totalling $735,264, including 86 for advertising-related non-compliance, and 10 for import-and-supply-related non-compliance. More than 4,700 nicotine vaping products have been seized under warrant, and close to 400,000 products have been determined to be non-compliant imports.
E-cigarette flavours ‘deceptive’
Prof Emily Banks, an epidemiologist with the Australian National University and a leading tobacco control expert, said nicotine is one of the world’s most addictive substances.
“We shouldn’t underestimate what vaping addiction means to the child or person affected. And the flavours of e-cigarettes are so deceptive. People think: how could something strawberry flavoured cause me harm?”
She said the pro-vaping lobby had creative a narrative that e-cigarettes are banned in Australia, but this is not true. Those trying to quit cigarettes by turning to vaping can access nicotine vaping products with a prescription from their doctor.
To stop importers exploiting the laws by removing “nicotine” from labels, organisations like the Cancer Council want a blanket ban on non-nicotine vaping products. State and territory governments are also calling for more resources to clamp down on those selling to children.
Do you have a story or experience with youth vaping to share? Contact melissa.davey@theguardian.com
