They are often brightly coloured, fruit-flavored, compact enough to fit in your back pocket or the side of your school bag.

They are “nicotine-free,” at least, according to the packaging. They are just a bit of harmless fun. Right?

The Problem

E-cigarettes, or vapes, are devices that heat liquid into an aerosol, which can then be inhaled. E-cigarette consumption among teens has rapidly increased in recent years across the globe. In Australia, the Matilda Centre for Research in Mental Health and Substance Use at Sydney University found that in 2023, 26% of surveyed Australians aged 14 to 17 have vaped at some point in their lives. This increased from 10% in a separate study three years before.

Originally, e-cigarettes were invented as a cessation tool for adult smokers. These e-cigarettes, initially known as “electronic nicotine delivery systems” (ENDS), work by vaporizing a nicotine-laden liquid. While there are many negative side effects to using ENDS, they are a healthier alternative to smoking and thus gained popularity. Disposable vapes, which are highly popular among teen users, evolved from these medically prescribed e-cigarettes. According to Drug and Alcohol Research and Training Australia, these small devices are mass-produced with a lack of transparency in the production process. Makers bypass laws surrounding nicotine regulations by labeling them “nicotine-free” despite many containing the addictive substance. Their colorful packaging and sapid flavoring creates an innocuous appearance that appeals to teens especially. As a result, many young individuals develop an e-cigarette addiction that harms their physical and mental health.

As a relatively new phenomenon, vaping’s health effects are still being researched and uncovered. In the short term, users may experience headaches and breathing difficulties. The consistent consumption of vapes points to an increase in the risk of cardiovascular and respiratory diseases. Furthermore, the consumption of nicotine at a young age can stunt brain development. Disposable vapes pose much greater risks. They are often mass produced in unsanitary work conditions, without any health regulation of the chemical makeup of the liquid. This may cause nicotine poisoning and poisoning by other unknown, unlabelled chemicals.

Beyond the threats to physical health that vapes pose, users also often face a decline in mental health in the short and long term. Teens specifically may experience greater mental health issues due to the fact that they are often unaware of the negative health effects of vaping. Layla Oueidat, a Youth Alcohol and Other Drug Counsellor in Access Health and Community and Headspace, explains this problem:

“If you have an exam coming up, it's sitting in the back of your mind the entire time — what's going to happen? How's that going to work? Are my results going to be okay? Am I going to pass? If you're vaping, and you're wondering: ‘I know that this might be bad for me, we don't really know what's going on.’ Subconsciously, there's a bit of stress on the mental health of ‘I don't know what's going to happen to my body.’ And that can take a toll.”

Moreover, the seemingly inconsequential short term effects, such as headaches, can take a toll. These symptoms often disrupt the daily lives of teens, causing greater stress in their schooling and family lives. As a result, the mental health of teens often declines with the consumption of vapes.

Why Teens Vape

There are many factors contributing to the rise in vaping among teens in Australia. In recent years, the use of vapes in our society has steadily grown, and their prevalence among young people had a notable surge since the onset of the COVID-19 pandemic. Throughout the past few decades, there has been a discernable transition from traditional smoking to vaping. As shown by Figure 2, there has been a consistent increase in the number of teenagers and young adults who vape in Australia since the start of 2020. Meanwhile, the number of smokers in Australia has decreased among all age groups except among 65- to 74-year-old people. Clearly, there has been a cultural shift from consuming cigarettes to vapes, and this change is caused by many factors, including the price difference between vapes and cigarettes. The high price of cigarettes drove people to find other cheaper substitutes; according to SmokeFree Clinic, the average cost of a pack of cigarettes is $40 AUD, yet the cost of disposable vapes is only $13 AUD (reported by Caktus Vape).

Additionally, the social stigmas surrounding smoking have prompted teens to seek out alternatives. Educator and founder of Drug and Alcohol Research and Training Australia (DARTA), Paul Dillon, describes this societal shift: “We need to change community attitudes…we made smoking uncool, but vaping is seen as really cool.”

The “cool” aspect of vaping is spurred by the use of social media. Influencers, some unaware of the risks of vaping, showcase e-cigarettes as trendy and fun without divulging the possible ramifications. According to Cancer Council Victoria, the hashtag #vape is posted more than 18.1 billion times on TikTok. By normalizing vaping through posts, stories, and videos on various platforms between peers and friends, a culture of exclusion for those who deny partaking is created.

Alongside the significant social media influences, peer pressure also plays a large part in the initiation and continuation of vaping among young people. According to the Australian Institute of Health and Welfare, e-cigarette use among Australians aged 14 or older has more than doubled from 2016 to 2019 and is most common among smokers aged 18–24 at 18.7%. With the ever-increasing number of youths who vape, adolescents may feel pressured to conform to peer norms and behaviors, thus motivating them to experiment with vaping products. Likewise, with the intensifying societal pressure from academic studies, work, or family life, individual youths may use vaping as a method of stress relief while ignoring the health impacts vaping brings. Most vaping products contain nicotine, which is an addictive drug that can bring a sense of pleasure to people. Therefore, vapes are often advertised and perceived by many as a way to alleviate negative emotions or improve mental health. This can mislead youths to believe that the benefits that vaping brings to their mental state outweighs its impacts on their health, thus resulting in the widespread use of vapes.

The high accessibility of vapes is another factor leading to the increasing number of teens who vape. While the Australian Government classifies vapes as illegal to sell over the counter without a prescription, there are still a large amount of vape stores around that allow young people to access vapes easily. In Melbourne alone, there are more than 10 vape stores that anyone can walk into and purchase vapes without the need for any legal or medical proof. Most of them are located in the central business district of Melbourne, where most young people live and spend their free time. Such a high accessibility not only encourages young people to vape, but also assures them that there will be a continuous supply of vapes, which further aggravates their addiction to this harmful product.

Can vaping habits actually be changed? Yes!

With an increasing number of young people around the world consuming and becoming addicted to vapes, there has also been a rise in the number of educators and local support services that provide helpful information and assistance to young people, guiding them to recognise the long-term consequences of vaping and to potentially quit this harmful habit. Having worked in the area of drug and alcohol education for almost 30 years, Paul Dillion has promptly responded to the rise of vaping by traveling around the country to present speeches in primary and secondary schools to educate young people about vaping. Dillon states that the main goal of his job has always been to guide “young people to think about [vaping] a little bit more carefully” so that they can maximize the quality of their lives. During our interview with Dillon, he shared a real-life story about a high school girl in Australia sending him a photo of herself disposing of all her vapes and claiming that she will “never be vaping again” after hearing Dillon’s speech. This demonstrates that becoming more knowledgeable about the manufacturing process of vapes and the long-term health effects of vaping can drive youths to reconsider their consumption. Thus, in the long run, education on the topic of vaping may help society to develop a different attitude toward vaping and label it as an “uncool” behavior.

Headspace National Youth Mental Health Foundation views the issue of vaping through a broader lens — they intend to change young people’s vaping habits by resolving the mental stresses that drive them to vape. During our interview with two representatives from Headspace, they shared that an indigenous client who had a traumatic childhood has been successful in significantly reducing her consumption of cigarettes and vapes.

“For us, sometimes our biggest stories aren't always about stopping 100%,” Oueidat shared, when asked to describe significant moments in her work as a youth counselor. “It's about the fact that maybe they have stopped, and they have a relapse here and there. And they can carry themselves from that relapse and not let it break them down.”

This client’s change in her vaping habit was achieved through Headspace’s regular counseling sessions, which helped alleviate her mental stress and changed her outlook on life. This story emphasizes the beliefs of Headspace — the issue of vaping is caused by many other underlying factors that need to be resolved in order to see changes in an individual’s dependency on vaping.

The role of government in bringing changes to vaping

According to the Department of Health and Aged Care in the Australian Government, “Australians require a prescription to lawfully access nicotine-containing e-cigarette products” starting from October 1, 2021. By enforcing this policy, the government intends to track the distribution of vapes, thus minimizing their consumption for recreational purposes. However, this policy has failed to effectively reduce access to vapes, as individuals can still purchase them from underground drug businesses that bypass government regulations. Other changes that governments worldwide could adopt to regulate the current crisis of vaping is finding and penalizing underground drug dealers so that there is less accessibility to vapes. Government regulations are certainly one of the most efficient methods to resolve the issue of vaping, yet they need to be more pragmatic and potent.

The rise of vaping among teens in Australia and the world poses a complex and multifaceted challenge that extends beyond health concerns. This phenomenon is deeply intertwined with social and cultural trends that are ingrained in the lives of adolescents. Moving forward, policy changes and educational initiatives are the key to dispelling misconceptions and reducing ignorance on the matter. Teens will then be empowered with the knowledge and the ability to break harmful habits and make healthier choices.

Sources:

Australian Government Department of Health and Aged Care (2023) About vaping and e-cigarettes, Australian Government Department of Health and Aged Care. Available at: https://www.health.gov.au/topics/smoking-vaping-and-tobacco/about-vaping#:~:text=In%20recognition%20of%20the%20health,nicotine%20containing%20e%2Dcigarette%20products. (Accessed: January 2024).

Busby, Dr.D. (2024) Cost of cigarettes in Australia: Prices and tax laws, Smokefree Clinic. Available at: https://smokefreeclinic.com.au/articles/cost-of-cigarettes-in-australia/#:~:text=As%20of%202023%2C%20a%20pack,2023. (Accessed: January 2024).

Cancer Council Victoria (2023) New research exposes the manipulative tricks the e-cigarette industry uses to normalise vaping among teens on social media, Cancer Council Victoria. Available at: https://www.cancervic.org.au/get-support/stories/new-research-exposes-the-manipulative-tricks-the-e-cigarette-industry-uses-to-normalise-va.html. (Accessed: January 2024).

Know the Risks (n.d.) E-cigarettes and Brain Development, Know the Risks Available at: https://e-cigarettes.surgeongeneral.gov/knowtherisks.html (Accessed: March 2024)

Online vape shop: Nicotine vape juice: Caktus Vape Australia (no date) Caktus Vape. Available at: https://caktusvape.com/#:~:text=Disposable%20vapes%20start%20as%20low,as%20low%20as%20AUD%20%2428. (Accessed: January 2024).

Vaping and e-cigarettes - darta.net.au (No date). Available at: https://darta.net.au/wp-content/uploads/2023/05/YOUNG-PEOPLE-VAPING-FS-FINAL-2022.pdf. (Accessed: January 2024).

Young people think vapes aren’t harmful because they are so easy to buy, study finds (2023) The Guardian. Available at: https://www.theguardian.com/australia-news/2023/oct/25/young-people-think-vapes-arent-harmful-because-they-are-so-easy-to-buy-study-finds. (Accessed: January 2024).