Vaping: Safer alternative or a big concern?

Vapes, or e-cigarettes, have become such a big issue in Australia that some schools are installing vape detectors in bathrooms to deter students from using them.

That’s because more and more people are using these devices — vaping use almost tripled among Australian adults between 2013 and 2019, with young adults taking up vaping in droves. 

Although evidence is limited, males appear to be using e-cigarettes more than females in Australia. The 2020-21 National Health Survey — which collected data from approximately 11,000 households around Australia — showed:

• Men 18 years and over were more likely than women to have used an e-cigarette or vaping device at least once (11.3% compared to 7.5%)
• Men were also more likely than women to currently use an e-cigarette or vaping device (2.9% compared to 1.6%)

Nicotine-containing vapes are only legally available to adults in Australia with a doctor’s prescription to help people stop smoking. Despite these restrictions, both nicotine and no-nicotine vapes are being sold to under-18s, and to people without prescriptions.

So what exactly are vapes, are they dangerous to your health, and what should you do if you (or others) have an issue with them?

What are vapes? 

Vapes are electronic devices designed to deliver vaporised liquids into your lungs when you breathe them in. The main ingredient in vapes is propylene glycol, vegetable glycerine or glycerol.

These battery-powered devices have a cartridge that is filled with e-liquid or e-juice which may contain nicotine, flavours, and other compounds. When the e-juice in the cartridge is heated, vapour is produced, which the user inhales.

Vapes come in different sizes, shapes, designs and colours. The flavours (such as bubble gum, mint, caramel and watermelon) and colourful packaging make these devices appealing to potential buyers (especially younger people).

While they were initially produced and marketed as a device to help cigarette smokers quit, vapes are now extensively used by people who had never previously smoked, including teenagers and young adults.  

In Australia, data from 2019 indicated 11% of people aged 14 and over had used e-cigarettes and 2% reported current at least monthly use. Use was more common among youth, males and smokers, and the majority did not use vapes for the purpose of quitting smoking.

Health effects of vaping

Vapes began to appear in Australia around the mid-2000s. They were marketed as a ‘safer’ alternative to smoking, due to lower concentrations of many harmful chemicals in their emissions, compared to traditional cigarettes. 

However, it’s now been shown they contain hundreds of chemicals, many of which are toxic. 

Because of the relative newness of e-cigarettes, there is still a lot of mystery about their effects but any claims that they are safe is not supported by evidence. 

According to NSW Health:

• Many vapes contain nicotine, making them very addictive
• The nicotine in one vape can is the equivalent of 50 cigarettes
• If you vape, you are three times as likely to take up smoking cigarettes
• Vaping has been linked to serious lung disease
• Vapes can contain the same harmful chemicals found in cleaning products, nail polish remover, weed killer and bug spray

Professor Bruce Thompson — Head of the School of Health Sciences at the University of Melbourne and a leading expert in respiratory medicine — says lung damage is a major concern for people who use e-cigarettes. 

“Vaping is a product that you inhale into an organ that is not designed to inhale anything except clean air,” he says. 

“When these pollutants are inhaled, the lungs don’t like it and the body doesn’t like it either. There is a harmful effect on the cardiovascular system and the toxicity of these little particles (from the vapes) also have a negative effect on other organs as well.

“The other thing about lungs is, they are really shit at repairing themselves — they tend to lay scar over scar over scar, and lungs are like tissue paper and can exchange gases really well, but if you have big, thick scars, it’s not going to work as well. 

“(And sometimes) you don’t even know what you’re inhaling (with vaping).

“It is really scary.”

Can vaping actually help people quit smoking?

Some people use these devices to try and cut down or completely stop smoking.

Ex-smokers who use nicotine e-cigarettes are more likely to not smoke than those who use other nicotine replacement options such as patches, gum, lozenges, mouth spray, inhalators and intranasal sprays. However, most studies showing this effect have a moderate or high level of bias and key Australian health organisations such as the Australian Medical Association, Cancer Council Australia and the Australian Council on Smoking and Health, state there isn’t enough evidence to promote the use of e-cigarettes for smoking cessation. 

Thompson says while the evidence is still not 100% concrete, there could be some benefits to using vapes to help cut down or quit cigarette smoking.

“Arguably, it is, (better to use a vape than smoking cigarettes) — as nicotine replacement therapy, it’s potentially of use, but the jury’s still out (in terms of any evidence),” he says. 

“There’s enough data to suggest that if you want to truly use this as a nicotine replacement therapy, if it’s prescribed under medical care, it can assist with people getting off cigarettes. 

“But there is no data to suggest vaping is safe.”

If you’re considering using vapes to help with your cigarette smoking, speak to your GP or medical specialist first to discuss your best course of action.

Are vapes a gateway to cigarettes?

One of the many concerns Thompson has with vaping is the danger of non-smokers becoming cigarette smokers as a consequence of their use of vapes.

In Australia, rates of tobacco smoking have almost halved over the past three decades. However, increased use of vapes has seen that long-term trend start to reverse.

“Smoking has been decreasing over time but due to the recent uptake in vaping, smoking is now increasing again — that scares me,” he says.

“We don’t want to replace smoking with something else that is then an on-ramp to smoking.”

How parents, teachers and others can help a young person who vapes

Quit advises people to learn the facts about e-cigarettes if they are concerned about a young person vaping, and then follow up with a conversation.

The Royal Children’s Hospital Melbourne has several recommendations for parents if they’re concerned about their children vaping, including: 

• Parents should learn about e-cigarettes. It’s important to talk to your teen about the health risks of e-cigarettes. Many teenagers are under the misconception that e-cigarettes are safe. It is helpful to know what the different devices look like and the different words young people may use to describe using e-cigarettes.
• Talking with teens about risky behaviours is an important way for parents to help keep them safe. Parents are already good at talking to their teens about alcohol, smoking and drugs. E-cigarettes should be included in the conversation.
• The earlier and more often you speak with young people about e-cigarettes, the more likely they are to listen. It’s important for parents to educate themselves, so they know the facts and what to say when the topic comes up.
• Finally, young people are more likely to use smoking products if others around them do. Parents can lead by example by not using e-cigarettes at all, especially when children are around.

“My main piece of advice would be to learn about them (vapes) — there’s a lot of noise out there, and there’s even people who are pro-vapes, but they are in the minority. Get solid advice, through a GP as a starting point,” Thompson says.

“We also need to get to the 15-year-olds and their (peer) leaders and say ‘hey this is not OK’ — you will screw your lungs up when you’re 25 or 30. It’s really harmful, it will potentially affect your sports and all these things you value highly.

“For anyone in a supervisory role, it’s hugely concerning because we don’t know what’s in them but also the on-ramp to starting smoking tobacco (is concerning).”

Signs you may be addicted to vaping

If you consume nicotine while vaping, you could become addicted.

Smokefree states: “nicotine is in most vapes and is very addictive. The more you vape, the more your brain and body get used to having nicotine, and the harder it is to go without it. When you go without vaping, the nicotine level in your bloodstream drops, which may cause unpleasant feelings, physical symptoms, and strong urges to vape. This is nicotine addiction.

“If you answer yes to one or more of these questions, you may be addicted to vaping.

• Do you continue to vape even though you want to stop or think it’s hurting you in some way?
• Do you feel anxious or irritable when you want to use your vape but can’t?
• Do thoughts about vaping interrupt you when you are focused on other activities?
• Do you still vape after getting in trouble with your parents or school for vaping?
• Have you ever tried to stop vaping but couldn’t?
• Do you feel like you have lost control over your vaping?”

If you want to quit but don’t know how, ask your GP, or reach out to expert resources such as the Australian Department of Health and Aged Care, or organisations like Quit.