Health of the Nation 2024: The lowdown on smoking and vaping

Smoking and vaping have been increasing among Australian teenagers, a study by the Cancer Council has found.

The latest data from 2023 shows an increase in tobacco smoking by 14 to 17-year-olds, from 2.1 per cent in 2018 to 12.8 per cent in the first quarter of last year, while vaping has increased significantly* from fewer than 1 per cent of 14 to 17-year-olds in 2018 to 14.5 per cent in early 2023.

“The earlier a person starts experimenting with cigarettes, the greater their likelihood* of becoming a regular, long-term user,” said Centre for Behavioural Research in Cancer acting head and lead researcher Professor Sarah Durkin.

The health effects of cigarette smoking are considerable. They can include cancer, breathing and respiratory* problems, heart disease, stroke and blood circulation problems, diabetes*, hearing and vision loss and dental problems, among many others.

In fact, according to the Australian Institute of Health and Welfare, tobacco smoking is the single most important preventable cause of ill health and death in Australia.

VAPING
Vapes are electronic devices designed to deliver vaporised* liquids into your lungs when you breathe in. With their range of flavours such as grape and bubblegum, they are intended to be appealing to youths and are considered a way to get young people addicted* to nicotine (a chemical that vapes often contain), which can be hard to quit.

A study by researchers at Curtin University tested the chemicals and toxicity* of 52 flavoured e-liquids available for sale over the counter in Australia.

The results found 100 per cent of the vapes tested contained chemicals with unknown effects on respiratory health, 62 per cent contained chemicals likely to be toxic* if vaped repeatedly and 100 per cent of the e-liquids were inaccurately labelled.

“Our research, and that of other groups around the world, has identified a long list of potentially harmful chemicals in vapes,” study co-lead Associate Professor Alexander Larcombe said. “Some are known toxins, some irritate the lungs when inhaled and some can impair your ability to fight off lung infections. For many others, the long-term health effects of breathing them in are unknown.”

While the ingredients or solutions used in e-cigarettes vary, common e-liquids which can add a fruit, alcohol or confectionary flavour, include toxins such as formaldehyde* and heavy metals, the same harmful chemicals found in cleaning products, nail polish remover, weed killer and bug spray. E-liquids also contain flavouring chemicals such as diacetyl (a chemical linked to serious lung disease) and may contain nicotine.

HEALTH EFFECTS OF VAPING
“There is no safe level of cigarette smoking or vaping at any age,” said Raising Children Network director Derek McCormack. “However, for those under 18, the risks can be greater because kids’ brains and bodies are still developing.”

Public health physician Professor Emily Banks, along with her team at Australian National University, recently published a review of the health effects of vaping — the largest and most comprehensive of its kind in the world.

“Recent evidence shows vaping is becoming more popular, especially among children and adolescents*, even though it is illegal except on prescription*,” Professor Banks said.

“Almost all e-cigarettes deliver nicotine, which is extremely addictive. Addiction is common in people using vapes and young people are especially vulnerable to addiction.”

Research shows vaping can lead to mental health issues, both in the short- and long-term, with increased symptoms of depression within 12 months of starting. Over time, nicotine vaping can increase the likelihood of developing depression, anxiety and substance use disorders because of the way nicotine changes the brain’s reward pathway.

“For children and adolescents, that can mean having difficulty sitting through a lesson or a meal with family,” said Prof Banks.

Other risks include:

• Poisoning, especially in small children
• Seizures and loss of consciousness caused by nicotine overdose
• Headaches
• Cough
• Throat irritation
• Burns and injuries, largely caused by exploding batteries

Another concern with vaping is the link between this habit and the uptake of smoking cigarettes.

“Studies that track young people over time find that those who vape are around three times as likely to take up cigarette smoking later,” said Prof Durkin.

HEALTHIER WAYS TO COPE
Many teenagers claim they feel they need to smoke or vape to cope when they are feeling stressed or anxious. Experts suggest trying other, healthier ways to cope instead. Some of these include:

• Getting active: When you exercise, your brain releases similar feel-good chemicals to nicotine. Stay busy and plan your day. Create a schedule or stick to a daily routine.
• Having fun: Find ways to incorporate fun activities into your life, and make sure to do something you enjoy every day.
• Being positive: Accept that there will be bad days, but…