The fake news of a harmful youth vaping epidemic in Australia
Posted on August 8, 2020
RECENT REPORTS in Australian media have raised fears of a youth vaping epidemic that will “addict a new generation of young people to smoking”. The latest national survey provides some hard evidence about youth vaping in Australia and the results are reassuring.
The National Drug Strategy Household Survey by the Australian Institute of Health and Welfare is conducted every 3 years. In 2019, over 22,000 Australians aged 14 and over were asked about their use of legal and illegal drugs.
In Australia in 2019, 3.2% of youth (14-17 years old) were smokers and 1.8% were current vapers (vaped at least once in the last year)
Young people should not smoke or vape, but the reality is that some will do either or both whether we like it or not.
One in 6 teen smokers also vapes and this may be a good thing. Unlike smoking, vaping does not generate the thousands of toxic chemicals released from burning tobacco which cause almost all of the harm to health. If young smokers are smoking fewer cigarettes and vaping more it is likely to be beneficial.
Furthermore, some young smokers reported vaping to help them quit (5.3%) or to prevent relapse to smoking (3.7%), just like adults.
The good news is that vaping is rare in Australian youth who don’t smoke. Only 1.3% of non-smokers had vaped at least once in the last year (this figure also includes ex-smokers). Most of this vaping is likely to be very infrequent
The frequency of vaping was not reported in the Australian study. However, even in the US where fears of a youth epidemic began, 70% of never-smoking youth who vaped did so on only 1-5 days in the last month
The risks of vaping by youth who have never smoked are hotly debated. There is a legitimate concern that vaping may lead some young people who would not have otherwise smoked to go on to become regular smokers (the gateway theory).
While young people who vape are more likely to later smoke cigarettes, there is no convincing evidence that vaping causes young people to take up smoking. It is more likely that young people who vape are just more likely to try risky behaviour, such as vaping, smoking, alcohol and other drugs. Many would have tried smoking anyway.
There are also concerns that young vapers may become addicted to nicotine.
However, nicotine dependence is rare in young people who vape but have never previously smoked
In the 2018 US National Youth Tobacco Survey, less than 4% of young never-smokers reported symptoms of nicotine dependence.
Furthermore, many young vapers do not use nicotine. In the UK, only one in three teens said they always used nicotine. In the US, 66% of 12th graders used nicotine. Nicotine use is less common in those who have never smoked.
There is evidence from animal studies that nicotine may affect brain development. However, it is unclear whether this translates to humans and there have been no human studies to date.
The evidence from overseas suggests that vaping is decreasing youth smoking rates
A study in the US found that the decline in youth smoking accelerated by 2-4 times after 2014 when vaping became popular. In the UK, which has the highest vaping rate globally, smoking in young people continues to decline rapidly. Rather than being a gateway into smoking, vaping is a net gateway out of smoking for young people.
Banning nicotine for vaping in Australia because of unfounded fears of harm to youth will deny addicted adult smokers the use of an effective quitting aid which could help lower smoking rates in Australia.
A better solution is to regulate nicotine vaping products to allow access for adult smokers who are unable to quit with conventional treatment and to restrict access by young people. The benefits to public health could be substantial.
Further reading
2019 National Drug Strategy Household Survey, Australian Institute of Health and Welfare
Is there really an epidemic of youth vaping? ATHRA blog, October 2019
Teen vaping is way less common than the news claims. Triple J Hack, July 2020
Posted by Colin Mendelsohn, colin@athra.org.au