Vaping

Vaping refers to the use of an electronic device (e-cigarette) to heat liquids that produce a vapour, which is then inhaled.

Various substances can be vaped, including:

• nicotine (which is the main psychoactive drug in tobacco)
• nicotine-free ‘e-liquids’ made from a mixture of solvents, sweeteners, other chemicals and flavourings
• other drugs, e.g. THC (cannabis) e-liquids

Regulation of therapeutic (legal) vapes is changing in Australia. Therapeutic vapes require a prescription until October 1, 2024. After that, they can be bought from pharmacies by anyone 18 and over, without a prescription.¹ To find out more about these changes visit the Therapeutic Goods Administration’s vaping hub or the Government’s vaping webpage.

Some vapes contain nicotine and concentrations can vary. Many vapes sold illegally in Australia do contain nicotine – even though it might not say so on the packaging.^2,3

Therapeutic vapes sold legally can have a certain amount of nicotine in them, or have zero nicotine.¹

We know that vaping can increase the risk of certain health harms - including injuries, burns (from faulty devices), lung disease and nicotine dependence.^{4 5-8} Research based on animal studies shows nicotine may negatively affect brain development, impacting things like learning and attention.⁹ But a 2022 review didn’t find any available evidence as to how vaping affects teenage brain development. More research is needed on this and other

potential harms, and we don’t know what the long-term health impacts of e-cigarettes might be yet.⁶

Nicotine is addictive. Repeated use of nicotine vapes can lead to dependence, where the brain relies on the regular release of dopamine from nicotine, and without it can go into withdrawal.⁸ Nicotine withdrawal symptoms include:

• irritability
• anxiety
• cravings
• having trouble concentrating
• sleep problems
• feeling sad or depressed.⁸

Many vapes don’t state they contain nicotine, even though they do, and often at high strengths.

Vaping has lead to lung injury and disease  – known as EVALI (‘e-cigarette, or vaping, product use-associated lung injury’). But nearly all cases of EVALI have been linked to THC vapes which contain vitamin E acetate (an oily chemical), and only a few cases have  been reported from nicotine vapes.^5-7

There’s a lot we don’t understand yet about vaping. But we do know that young people who vape are more likely to start smoking tobacco.^{5, 10, 11}

And using e-cigarettes is linked to greater mental ill health among young people.¹² We don’t fully understand yet why this is, or if vapes cause mental health issues.^{5, 12}

Using vapes has been found to help some people quit smoking, compared to traditional nicotine replacement therapy (NRT), such as patches and gum.¹³

But given the potential health risks, they aren’t recommended as the first treatment option in Australia for someone wanting to quit.¹⁴

• Quit - call 13 78 48
• Options for quitting smoking or vaping
• Helping young people quit vaping.
• Raising Children’s list of helplines (for parenting advice or support)
• Positive Choices vaping resources page
• Dovetail’s vaping resources

1. Therapeutic Goods Administration (TGA). Changes to the regulation of vapes 2024 [08.07.2024].
2. Jongenelis MI. Challenges and opportunities associated with e-cigarettes in Australia: A qualitative study. Australian and New Zealand Journal of Public Health, [Internet]. 2023 [24.01.2024]; 47(1).
3. Therapeutic Goods Administration. Potential reforms to the regulation of nicotine vaping products: Consultation paper 2022 [24.01.2024].
4. Christopher MS, Zubair K. Burn injuries caused by e-cigarette explosions: A systematic review of published cases2018 [23.02.2024]; 4.
5. Banks E, Yazidjoglou A, Brown S, Nguyen M, Martin M, Beckwith K, et al. Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence. The Medical journal of Australia [Internet]. 2023 [23.02.2024]; 218(6):[267-75 pp.].
6. McNeill A, Simonavičius E, Brose L, Taylor E, East K, Zuikova E, et al. Nicotine vaping in England: 2022 evidence update summary2022 [20.02.2024].
7. Cao DJ, Aldy K, Hsu S, McGetrick M, Verbeck G, De Silva I, et al. Review of Health Consequences of Electronic Cigarettes and the Outbreak of Electronic Cigarette, or Vaping, Product Use-Associated Lung Injury. Journal of Medical Toxicology [Internet]. 2020 [23.02.2024]; 16(3):[295-310 pp.].
8. National Institute of Drug Abuse (NIDA). Is nicotine addictive? 2022 [24.01.2024].
9. Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain. The Journal of physiology [Internet]. 2015 [27.05.2024]; 593(16):[3397-412 pp.].
10. Notley C, Gentry S, Cox S, Dockrell M, Havill M, Attwood AS, et al. Youth use of e-liquid flavours—a systematic review exploring patterns of use of e-liquid flavours and associations with continued vaping, tobacco smoking uptake or cessation. Addiction [Internet]. 2022 [23.02.2024]; 117(5):[1258-72 pp.].
11. Chan GCK, Stjepanović D, Lim C, Sun T, Shanmuga Anandan A, Connor JP, et al. Gateway or common liability? A systematic review and meta-analysis of studies of adolescent e-cigarette use and future smoking initiation. Addiction [Internet]. 2021 [23.02.2024]; 116(4):[743-56 pp.].
12. Becker TD, Arnold MK, Ro V, Martin L, Rice TR. Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults. Nicotine and Tobacco Research [Internet]. 2020 [23.02.2024]; 23(3):[415-25 pp.].
13. Lindson N, Butler AR, McRobbie H, Bullen C, Hajek P, Begh R, et al. Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews [Internet]. 2024 [20.02.2024]; (1).
14. Therapeutic Goods Administration (TGA). New regulation of vapes starting January 2024 2023 [24.01.2024].