Parents, school principals, youth centres and researchers have sounded the alarm bell about the rise in young people taking up e-cigarettes across the country.
The devices, also known as vapes, are a relatively new phenomenon compared with traditional smoking, leaving some schools and communities unsure about how to properly address the issue.
What is vaping?
The use of electronic cigarettes (e-cigarettes) is commonly known as vaping and refers to battery-powered devices that heat a liquid to deliver vapour for users to inhale, similar to smoking traditional cigarettes.
An e-cigarette contains a cartridge that is filled with liquid, which may or may not contain nicotine and available in various flavours such as chocolate, fruits and candies.
The liquids may also contain other toxins and heavy metals such as chromium, aluminium, arsenic, copper, lead, nickel and tin.
The physical designs of e-cigarettes have many forms, including traditional cigarettes, cigars, USBs and highlighters. Some have also been designed as part of hoodies' drawstrings.
The first commercialised e-cigarette product was developed in China in 2003.
Is it rising among young people?
In Australia between 2016 and 2019, current e-cigarette users aged 15-24 increased by about 72,000 (95.7 per cent increase) for a total of about 147,000, the department of health stated in December 2020.
For 12-17-year-olds, a 2017 Cancer Council report about Australian secondary school students' use of tobacco and illicit substances found around 14 per cent indicated they had used an e-cigarette at least once and 32 per cent of these students had used one in the past month.
Similarly, the National Drug Strategy Household Survey 2019 said that while e-cigarettes rose across most age groups, the rise among young adults was particularly notable.
"Nearly two in three current smokers and one in five non-smokers aged 18-24 reported having tried e-cigarettes," the survey said.
Among those who had tried them, frequency of use also increased, with more people using them at least monthly - from 10.3 to 17.9 per cent 2016-19.
How are people under 18 accessing vapes?
The 2017 Cancer Council report found that students who had vaped most commonly reported getting e-cigarettes from friends, siblings, parents, or buying the products themselves.
Dr Michelle Jongenelis, a researcher at the University of Melbourne's School of Psychological Sciences, said avenues included social media and online stores.
"It actually isn't that hard to purchase an e-cigarette if you are under 18 as they are readily available online," she said.
"Few online shops have controls on website visitors and those that do have controls simply ask website visitors to click a button confirming they are over 18, which of course anyone can fake."
Dr Jongenelis, who published an article about the myths of e-cigarettes last year, said enforcement was "a big issue".
What does the law say?
It is illegal to sell or buy nicotine for use in e-cigarettes unless prescribed by a doctor for therapeutic purposes (e.g. to quit smoking).
Under the Therapeutic Goods Administration's (TGA) Personal Importation Scheme, a medical prescription allows a user up to three-month supply of nicotine.
It is illegal to sell or supply tobacco products to people under 18.
Penalties for the illegal possession of liquid nicotine varies across states and territories between $1100 and $30,000 in fines and/or up to 24 months jail.
As of October 1 this year, the law for consumers to import nicotine e-cigarettes will align with the law for them to buy such products domestically, the TGA announced in December 2020.
Canberra lawyer Tom Taylor at McKenna Taylor said he supported a move for uniformed laws but that each state and territory should be allowed to govern their own jurisdiction.
He said e-cigarettes among young people needed to be treated as a health problem rather than a moral problem that should be deterred through punitive action.
"We need to understand the broader social factors that influence consumption because the moment that we start trying to manage behaviour in society through punitive action in my mind is a slippery slope," he said.
He said that if Parliament intended to make it an offence for young people to possess e-cigarettes, then police needed to be empowered with using diversionary measures rather than the courts.
What are the health effects?
The Australian Department of Health says that even though scientists are still learning about e-cigarettes' effects, they cannot be considered safe.
"Hazardous substances have been found in e-cigarette liquids ... including formaldehyde, acetaldehyde and acrolein, which are known to cause cancer," the department states.
"Some chemicals can also cause DNA damage."
The department also states that research shows a strong link between the use of e-cigarettes by non-smoking youth and future smoking. Earlier this year, the CSIRO recently undertook a review into the use and health impacts of e-cigarettes and found that "the evidence available suggests that regular use of e-cigarettes is likely to have adverse health consequences".
As for implications on young people, the CSIRO said the evidence was consistent in suggesting that use of e-cigarettes by non-smoking youth predicts future smoking.
In September 2020, a collaborative research by the Australian National University and University of Melbourne found that using e-cigarettes triples the chance of a non-smoker taking up cigarettes and there is "insufficient" evidence that they help smokers quit. However, a University of Queensland study published on April 7 found that e-cigarettes may be more effective in helping smokers quit than nicotine replacement therapies such as patches and gum.
The National Health and Medical Research Council states that evidence to back the claims that e-cigarettes help smokers quit or that they were safer was insufficient.
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