Why Australia decided to quit its vaping habit

By Tom Housden, BBC News, Sydney

"The horse has bolted now, they are addicted," says Chris, a high school teacher in New South Wales.

He is talking about students in his class, teenagers, who can not stop vaping.

He sees the effect of the candy-flavoured, nicotine-packed e-cigarettes on young minds every day, with children even vaping in class.

"The ones who are deepest into it will just get up out of their seat, or they'll be fidgeting or nervous. The worst offenders will just walk out because they're literally in withdrawal."

Those who were most addicted needed nicotine patches or rehabilitation, he said, talking about 13 and 14-year-olds.

Earlier this month the Australian government decided enough was enough and introduced a range of new restrictions. Despite vapes already being illegal for many, under new legislation they would become available by prescription only.

The number of vaping teenagers in Australia soared in recent years and authorities said it was the "number one behavioural issue" in schools across the country.

And they blamed disposable vapes - which some experts said could be more addictive than heroin and cocaine - but, at least for now, were available in Australia in every convenience store, next to the chocolate bars at the counter.

For concerned teachers like Chris, their hands were tied.

"If we suspect they have a vape, all we can really do is tell them to go to the principal's office.

"At my old school, my head teacher told me he wanted to install vape detector alarms in the toilet, but apparently we weren't allowed to because that would be an invasion of privacy."

E-cigarettes had been sold as a safer alternative to tobacco, as they do not produce tar - the primary cause of lung cancer.

Some countries continued to promote them with public health initiatives to help cigarette smokers switch to a less deadly habit.

Last month, the UK government announced plans to hand out free vaping starter kits to one million smokers in England to get smoking rates below 5 percent by 2030.

But Australia's government said evidence that e-cigarettes help smokers quit was insufficient for now. Instead, research showed it could push young vapers into taking up smoking later in life.

'Generation Vape'

Vapes, or e-cigarettes, are lithium battery-powered devices that have cartridges filled with liquids containing nicotine, artificial flavourings, and other chemicals.

The liquid is heated, turned into a vapour and inhaled into the user's lungs.

Vaping took off from the mid-2000s and there were some 81 million vapers worldwide in 2021, according to the Global State of Tobacco Harm Reduction group.

Fuelling the rise was the mushrooming popularity of flavoured vapes designed to appeal to the young.

These products could contain far higher volumes of nicotine than regular cigarettes, while some devices sold as 'nicotine-free' could actually hold large amounts.

The chemical cocktail also contained formaldehyde and acetaldehyde - which had been linked to lung disease, heart disease, and cancer.

There was also the suggestion of an increased risk of stroke, respiratory infection, and impaired lung function.

Experts have warned not enough is known about the long-term health effects. But some alarming data had already been drawn out.

In 2020, US health authorities identified more than 2800 cases of e-cigarette or vaping-related lung injury. The Centres for Disease Control and Prevention found 68 deaths attributed to that injury.

In Australia, a major study by leading charity The Cancer Council found more than half of all children who had ever vaped had used an e-cigarette they knew contained nicotine and thought that vaping was a socially acceptable behaviour.

School-age children were being supplied with e-cigarettes through friends or "dealers" inside and outside school, or from convenience stores and tobacconists, the report said.

Teens also reported purchasing vapes through social media, websites and at pop-up vape stores, the Generation Vape project found.

"Whichever way teenagers obtain e-cigarettes, they are all illegal, yet it's happening under the noses of federal and state authorities", report author and Cancer Council chair Anita Dessaix said.

"All Australian governments say they're committed to ensuring e-cigarettes are only accessed by smokers with a prescription trying to quit - yet a crisis in youth e-cigarette use is unfolding in plain view."

In addition to the government's move to ban the import of all non-pharmaceutical vaping products - meaning they could now only be bought with a prescription - all single-use disposable vapes would be made illegal.

The volume and concentration of nicotine in e-cigarettes would also be restricted, and both flavours and packaging must be plain and carry warning labels.

But these new measures were not actually all that drastic, said public health physician Professor Emily Banks from the Australian National University.

"Australia is not an outlier. It is unique to have a prescription-only model, but other places actually ban them completely, and that includes almost all of Latin America, India, Thailand and Japan."

'We have been duped'

Australia's Minister for Health Mark Butler said the new vaping regulations would close the "biggest loophole in Australian healthcare history".

"Just like they did with smoking... 'Big Tobacco' has taken another addictive product, wrapped it in shiny packaging and added sweet flavours to create a new generation of nicotine addicts."

"We have been duped", he said.

Medical experts agree.

Prof Banks argued the promotion of e-cigarettes as a "healthier" alternative was a classic "sleight-of-hand" from the tobacco industry.

As such, vaping had become "normalised" in Australia, and in the UK too.

"There's over 17,000 flavours, and the majority of use is not for smoking cessation", she told the BBC.

"They're being heavily marketed towards children and adolescents. People who are smoking and using e-cigarettes - that's the most common pattern of use, dual use."

Professor Banks said authorities needed to "de-normalise" vaping among teenagers and to make vapes much harder to get hold of.

"Kids are interpreting the fact that they can very easily get hold of [vapes] as evidence [they're safe], and they're actually saying, 'well, if they were that unsafe, I wouldn't be able to buy one at the coffee shop'.

But could stricter controls make it harder for people who do turn to vapes hoping to quit or cut down on tobacco?

"It is important to bear in mind that for some people, e-cigarettes have really helped. But we shouldn't say 'this is great for smokers to quit', said Prof Banks.

"We know from Australia, from the US, from Europe, that two-thirds to three-quarters of people who quit smoking successfully, do so unaided."

"You're trying to bring these [vapes] in saying they're a great way to quit smoking, but actually we've got bubble gum flavoured vapes being used by 13-year-olds in the school toilets. That is not what the community signed up for."

-BBC