The frequency with which young Australians are utilizing vape has reached a level that justifies federal government action. However, what is the underlying cause of this significant public health concern, and what are the regulatory issues?
Vapes, often known as e-cigarettes, are a regular sight on our streets with their distinctive clouds of white smoke. However, there is growing worry regarding its use, particularly among youth. Numerous reports of high school pupils vaping on school property prompted the Australian Medical Association’s NSW branch to investigate students’ vaping habits.
The Federal Budget includes funds to address illicit vaping, as part of the move to “stamp out vaping – particularly among young Australians” that was announced earlier this year by Mark Butler, the Federal Health Minister.
What can be done to stop young Australians from becoming so dependent on these flavored nicotine hits?
A true emergency in public health
A unique long-term study, Generation Vape is run in collaboration with the Daffodil Centre, the University of Sydney, and Cancer Council NSW. Before going nationwide in 2022, it started in NSW in 2021.
“The study is still in progress, and our focus is on the attitudes, beliefs, and behaviors of youth, parents, educators, and young adults regarding vaping, as there is a dearth of data available,” says Dr. Becky Freeman, the lead investigator of the Generation Vape research and an associate professor at the University of Sydney’s School of Public Health.
Focus groups, questionnaires, interviews, and other quantitative and qualitative methods are used in the study. Thus far, research indicates that obtaining e-cigarettes is simple for teenagers, whether from friends, “dealers,” or locations other than schools. Indeed, eighty percent of youth reported that obtaining vapes in New South Wales was simple.
As of right now, research data indicate that 53% of teenage vapers who participated had used a vape that they were aware included nicotine.
Freeman claims that the study has given important new information about the vaping habits of young Australians, adding, “We now have a lot of data to back up that vaping is truly a public health crisis in Australia.”
Business concerns versus public health
It has been suggested that vaping could be a useful technique for weaning smokers off of dangerous cigarettes. They now appear to be causing issues akin to those caused by their counterparts that cause cancer.
“It’s crucial, in my opinion, to find out who said it would be a smoking cessation aid and why it was positioned that way,” Freeman adds.
The tobacco business, which is a part of the vaping industry as well, has consistently claimed that e-cigarettes, or vaping devices, are products for quitting smoking. However, if you look at who is selling them, how they are advertised, packed, produced, and sold, the majority of the users are young people who have never smoked.
This opinion is supported by data from the Australian Institute of Health and Welfare (AIHW), which shows that 34% of those aged 14 to 17 who tried vaping had previously smoked, compared to 65% who had never tried. When they tried vaping for the first time, 39% of people in the 18–24 age range had never smoked, and 58% were current smokers.
Additionally, some of the reasons why young people vape are shown by the Institute’s data:
- Of those between the ages of 18 and 24, 22% believed that they were less dangerous than regular cigarettes.
- Twenty-one percent thought the flavor was superior to cigarettes.
- Six per cent reported trying e-cigarettes to aid in their smoking cessation.
Because some vapes contain “hazardous substances” and nicotine is addictive, the AIHW expresses concern about this trend. “E-cigarette liquid flavors have played a marketing role in promoting the perceived attractiveness of e-cigarettes and in encouraging people to start smoking them,” the AIHW said, citing a US study.
The research conducted by Generation Vape sheds light on the reasons behind young people’s vaping decisions. According to the summary of their February to May 2023 NSW findings, young people cited “flavors and taste” as their top motivation.
An ineffective differentiation
According to Freeman, there are many variables at play when it comes to the prevalence of vaping, particularly among young people.
It’s kind of a result of the prevalence of low-cost, flavor-infused, disposable vaping devices on the market that have a high nicotine salt content. We have a lot of false information on the safety of our products, along with aggressive web marketing. The distinction that we have between nicotine and non-nicotine is incredibly ineffective since it has allowed shops to legitimately sell products they say are non-nicotine even though we know they are actually nicotine.
“And you put all of those together with the commercial interests at play—selling a highly addictive product to young people is very profitable, and there’s a loophole that prevents these laws from being enforced because it doesn’t involve nicotine,” the speaker continues.
“There’s a lot of money to be made in selling young people a highly addictive product, and this non-nicotine loophole makes it impossible to enforce these laws.”
All of this indicates that among young people, the “dramatic increase in vaping” has become “normalized.”
Because of the business need to sell vapes, prohibition, or outright bans, are difficult to implement. However, the Federal Government outlawed vaping without a prescription in May.
The federal government wants to regulate and enforce vapes with greater rigor, which includes:
- Halting the import of e-cigarettes without a prescription;
- Raising the minimum vaporizer quality requirements;
- Mandating that vapes be packaged like pharmaceuticals;
- Limiting the nicotine content that can be found in vapes, and;
- Outlawing disposable, single-use vaporizers.
Additionally, the federal government promised to restrict the sale of vapes to pharmacies and stop selling them in establishments like convenience stores. Prescriptions are required for both vaping devices that contain nicotine and those that do not.
A “fiddle with the edges” strategy
These goods will remain accessible and are regulated. They’re not being prohibited from access by anybody. Devices for vaping that contain nicotine will be available, and pharmacies will prescribe liquids for purchase, according to Freeman.
The Federal Government’s proposal was examined and compared to other vaping laws across the globe in a report titled “Recreational vaping ban in Australia – policy failure or masterstroke?” that was published in The Lancet in November. Vaping is 8.6% common among 11–18 year olds in the UK, where it is utilized as a “first-line treatment for smoking cessation,” according to the report.
The UK government should act to “reduce the accessibility, affordability and appeal of vapes to children” by enforcing regulations on marketing, packaging, and taxation, according to a charity called UK Action on Smoking and Health. According to the survey, vape regulations are also a hot topic in other nations, particularly in Asia and Africa.
The study came to the conclusion that there is a global discussion on the best ways to handle vaping, particularly among youth, and as a tool for quitting smoking. It then posed the question, “Who is right? Will we argue incessantly? Or will we band together to fight the tobacco business as a global community, spanning nations, societies, and health systems, with the aim of achieving long-term tobacco cessation as our shared objective?
Who is correct? Will we argue incessantly? Or will we band together to oppose the tobacco industry across all countries, societies, and healthcare systems?
Freeman compares the current state of vaping prevalence to tobacco control several decades ago and says it is at a critical point.
“I believe that when we realized these things were so hazardous fifty years ago, we made a grave error in tobacco control policy. We made the decision to sort of “fiddle about the edges” [method] fifty years ago,” the woman said.
This strategy included “demand reduction strategies” such as taxing cigarettes more, adding graphic health warnings on cigarette packs, prohibiting smoking in public areas, and raising the price of cigarettes through advertising.
She acknowledges that they did work, although it took some time.
“It has taken decades for smoking rates to decline, but all those little incremental changes over a long period of time have worked really well to do that,” she claims.
Rather, Freeman thinks that the moment has come to confront vaping head-on by addressing the factors that have led to its rise in popularity.
“We’re aware that it’s the accessibility—young people in our Generation Vape research told us as much. It’s because they may be found for sale on every corner of the city. They smell nice, they’re widely available, and they’re really inexpensive. The purpose of these new laws is to address the issue of access.
According to Freeman, Australia’s present regulatory structure is based on nicotine, which is categorized as toxic at both the federal and state levels. Tobacco items that are prepared for smoking are exempt. According to Freeman, this is the legal way that cigarettes and other tobacco products that burn can be sold. Additionally exempt are nicotine-containing smoking cessation products that have received Therapeutic Goods Association approval.
“As of right now, e-cigarettes are an unapproved medication. They fit the definition of poison. However, Freeman claims that instead of being an approved medication that requires a prescription to obtain, they are an unapproved medication that has not gone through the approval processes for being a safe and effective cessation aid.
Although NSW has regulated non-nicotine vapes through its state-level tobacco control regulations, she claims that they are not subject to any regulatory framework at this time. It is against the Public Health (Tobacco) Act 2008 (NSW) to offer vapes to anyone under the legal age of 18. Adults are allowed to purchase non-nicotine vapes; however, vapes with nicotine are only available with a prescription and can only be found at pharmacies. Furthermore, it is against the law to show off, market, or promote the devices.
According to Freeman, the new federal restrictions will eventually make it illegal to import vaping products and eliminate the distinction between products that contain nicotine and those that do not. The prescription model will continue to be available, while disposable vapes will be removed off the market.
“The vaping items available through prescription will differ significantly from those found at convenience stores and gas stations. According to her, the only flavors that are suggested for them are mint and tobacco, and their packaging will resemble that of pharmaceuticals.
She thinks that the importation ban will be especially crucial in addressing the issue of vaping.
These products are oversaturated in the market. They are dispersed throughout. The removal of the non-nicotine/nicotine distinction will make enforcement considerably simpler because it will allow us to simply confiscate things at the border that aren’t meant for a pharmacy.
“With this non-nicotine/nicotine distinction removed, enforcement will be so much easier because we can just seize products that aren’t destined for a pharmacy at the border.”
According to Freeman, “this is going to completely transform the market and eliminate this open season market.” It is unjust, in my opinion, to claim that this will solve every problem; it won’t, of course, but it will be far superior to what we currently have.
Not a miracle cure
The percentage of youth who are addicted to vape pens is still a public health concern, despite impending adjustments. Freeman, though, is hopeful that this can also be resolved.
“A very addictive drug is nicotine. However, she adds, “we have a genuine window of opportunity to act here.”
In addition to offering assistance to individuals wishing to give up vaping, the Federal Government’s vaping action package includes a $63 million public health education campaign aimed at discouraging both smoking and vaping. Thirty million more dollars will go toward programs to help people quit.
Freeman clarified, “We can add vaping to the really good infrastructure for quit smoking support that we already have.”
Schools must get engaged as well, she said, providing support and assistance to children found in possession of vapes rather than punishing them.
Any legislative and regulatory changes aimed at combating vaping must include education, but Freeman argues that given the power of the commercial sector pushing the use of tobacco products, education cannot be counted on to be a panacea.
“Regulating processes are supported by education. The foundation of tobacco control efforts is regulation, which is strengthened by highly encouraging programs for cessation and education, according to the expert.
However, to assume that [education] will be sufficient to counteract the business interests at play here would be to underestimate the strength of the commercial forces at play. Lawmaking is absolutely essential.
According to Freeman, schools shouldn’t adopt a “punitive approach.”
“We don’t want children who use vapes at school to get suspended or to lose out on extracurricular activities. Once more, it is unreasonable to expect the typical 14-year-old to be able to resist the alluring advertising of large tobacco companies or the retailing of vape devices. Thus, [we] ought to be very encouraging and provide those resources to help people stop vaping, all the while making it abundantly evident that vaping is not permitted in schools. It’s adopting a helpful, nonjudgmental attitude rather than approving vaping.”