Vaping and young people
Use of e-cigarettes, or vapes, has been increasing in Australia - especially among young people.
In response to the growing concern, the Government has changed how vapes are regulated.1
While we don’t know the long-term health impacts yet, evidence suggests that vaping isn’t risk-free.
Here, we look at the potential risks of vaping, and what you can do if you know a young person who vapes.
What is 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.
Vaping devices come in a variety of shapes, sizes, and styles. And they’ve changed a lot over time.
- First generation devices looked like cigarettes and were mostly disposable.
- Second generation vapes were rechargeable and used cartridges or tanks for the liquid.
- Third generation (‘mods’) were larger devices with bigger batteries and refillable tanks.
- Fourth generation devices (‘pods’) are significantly smaller, and can look similar to a USB stick. Others have varying shapes, are often brightly coloured, disposable and have higher concentrations of nicotine.2, 3
What is a ‘therapeutic’ vape?
You may have heard Australia is banning ‘non-therapeutic’ vapes but allowing ‘therapeutic’ vapes. So, what does this mean?
- Therapeutic vape (legal): an e-cigarette used by someone quitting smoking, or managing a nnicotine dependence (addiction) and that meets certain requirements set by the Therapeutic Goods Administration (TGA), including limits on flavours and ingredients.4 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.5
- Non-therapeutic vape (illegal): an e-cigarette that doesn’t meet TGA specific requirements. This includes vapes with or without nicotine, and disposable vapes.
To find out more about these changes visit the Therapeutic Goods Administration’s vaping hub or the Government’s vaping webpage
How many young people vape?
In a recent Australian schools survey it was found:
- 30% of secondary students had tried vaping at least once
- 12.9% of 12-15-year-olds had vaped in the last month
- 22.1% of 16-17-year-olds had vaped in the last month.3
The latest National Drug Strategy Household Survey (NDSHS) also found increasing use among young people aged 14-17:
- vaping in the past year increased from 1.8% in 2019, to 9.7% in 2022-23
- 3.5% reported vaping daily – use in this age bracket was higher for females:
- 13.5% of girls vaped in the past year compared to 7.1% for boys
- 5.7% of girls vaped daily, compared to 1.8% for boys.6
And for young people aged 18-24:
- vaping in the past year increased significantly from 5.3% in 2019, to 21% in 2022-23.
- almost 1 in 10 (9.3%) reported vaping daily.6
In comparison, only 1.6% of people aged 60–69 reported using a vape in the past year in 2022-23.6
We know that vaping can increase the risk of certain health harms.
Injuries and burns
Vapes have caused injuries and burns, often due to a faulty battery or the device exploding. Most burns and injuries have been to the leg, from a vape in someone’s pocket.6 And some injuries have been reported on the hands or mouth.2
Lung disease
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.2,8,9
Dependence
Nicotine is addictive. Repeated use causes changes in how our brains release dopamine, which can impact our capacity to learn, increase feelings of stress and reduce self-control.10
Nicotine withdrawal symptoms include:
- irritability
- anxiety
- cravings
- having trouble concentrating
- sleep problems
- feeling sad or depressed.10
Other Impacts
- There’s evidence that vaping can lead to seizures, but we’re not sure yet exactly how and why this occurs.2
- Vaping can cause nicotine toxicity - leading to symptoms such as nausea, vomiting and shortness of breath.2
- Exposure to vape e-liquids containing nicotine, mostly through accidental ingestion (swallowing e-liquids), has led to toxicity, and in more extreme cases poisonings - which can result in seizures and death.2
- Young people who vape are more likely to start smoking tobacco, but more research is needed to understand this relationship.2,11,12
- Research based on animal studies shows nicotine may negatively affect brain development, impacting things like learning and attention.13 But there isn’t evidence yet on how vaping might affect teenage development.14
- Using e-cigarettes is associated with greater mental ill health among young people.15 But we don’t fully understand yet why this is, and there isn’t conclusive evidence on whether vapes cause mental health issues.2,15
‘Combustible tobacco’ refers to any tobacco product that is smoked, such as ready-made cigarettes, roll-your own cigarettes (tailor-made or rollies), cigars or cigarillos.
Tobacco is responsible for most of the harmful chemicals and carcinogens (cancer causing components) in cigarettes.16
In the short to medium term, it’s likely that using therapeutic vapes poses a much smaller risk to health than smoking tobacco. But it’s too soon to know what the long-term health impacts of e-cigarettes might be.8
It’s important to remember that many of the vapes sold illegally in Australia haven’t been tested, so we don’t know exactly what’s in them. And they often don’t state that they contain nicotine – even when they do.
This means young people may be inhaling unknown chemicals, additives, flavourings or nicotine, without realising.16,17
Vapes and e-liquids often contain solvents (water, propylene glycol and vegetable glycerine), flavourings, and other chemicals. The vapour (aerosol) from e-cigarettes can also contain metals and other chemicals, which may cause serious health effects.2
Using therapeutic (legal) nicotine vapes has been found to help some people quit smoking, compared to traditional nicotine replacement therapy (NRT).19
But given the potential health risks and unknown long term impacts of vapes, they aren’t recommended as the first treatment option in Australia for someone wanting to quit smoking.4
If you, or someone you know, want to find out more about using therapeutic vapes to quit smoking, talk to a GP or visit the TGA’s website.
Help and support
- Quit (13 78 48) has a range of resources – including making a quit plan, quitting tips and tactics and resources and factsheets for parents. While some of these are designed for people quitting smoking, they can also be used to help quit vaping.
- Options for quitting smoking or vaping.
- Read our article Helping young people quit vaping.
- Visit Raising Children’s list of helplines for parenting advice or support.
- Find out more via Positive Choices’ vaping resources page or Dovetail’s vaping resources.
- Gartner C. Will the latest vaping reforms find the right balance and what will they mean for recreational vapers? The University of Queensland [Internet]. 2023 [24.01.2024].
- 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.].
- Scully M, Bain E, Koh I, Wakefield M, Durkin S. Cancer Council Victoria. ASSAD 2022/2023: Australian secondary school students’ use of tobacco and e-cigarettes 2023 [20.02.2024].
- Therapeutic Goods Administration (TGA).New regulation of vapes starting January 2024. 2023 [24.01.2024].
- Therapeutic Goods Administration (TGA). Changes to the regulation of vapes 2024 [[08.07.2024].
- Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2022–2023 2024 [29.02.2024].
- Christopher MS, Zubair K. Burn injuries caused by e-cigarette explosions: A systematic review of published cases 2018 [23.02.2024]; 4.
- McNeill A, Simonavičius E, Brose L, Taylor E, East K, Zuikova E, et al. Nicotine vaping in England: 2022 evidence update summary 2022 [20.02.2024].
- 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.].
- National Institute of Drug Abuse (NIDA). Is nicotine addictive? 2022 [24.01.2024].
- 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.].
- 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.].
- 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.].
- Baenziger ON, Ford L, Yazidjoglou A, Joshy G, Banks E. E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis. BMJ Open [Internet]. 2021 [19.02.2024]; 11(3).
- 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.].
- Centers for Disease Control and Prevention (CDC). Tobacco and Cancer 2023 [23.02.2024].
- 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).
- Therapeutic Goods Administration. Potential reforms to the regulation of nicotine vaping products: Consultation paper 2022 [24.01.2024].
- 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 [23.02.2024]; (1).