Shortcuts / 29 July 2020

Squiz Shortcut – Vaping

Vaping comes up a bit in the news due to concerns about the health effects.  In this episode we’ll take you through exactly what vaping is, the arguments for and against, as well as how it is regulated both here in Australia, and abroad.

What is vaping?

Terms like “e-cigarettes,” “vapes,” “vape pens,” “Juul” etc. all refer to products. The act of smoking them is called “vaping”, so you ‘vape’ an e-cigarette. An e-cigarette is a battery-powered device used to inhale an aerosol that typically, but not always, contains nicotine. It also has other with flavourings and chemicals, but they don’t contain tobacco.

What do proponents say about vaping?

That it’s a a healthier alternative to smoking, or a way to help people quit. Some studies show found that e-cigarettes were nearly twice as effective as conventional nicotine replacement products, like patches and gum, for quitting smoking. But traditional nicotine replacement therapies have about a 10% success rate, so it’s off a low base.

What do critics say?

Critics say the fruity flavours e-cigarettes come with are like alco-pops that attract a younger crowd. To back that up, the latest National Drug Strategy Household Survey found that while young Aussies are less likely to take illicit drugs, smoke cigarettes or drink alcohol than before, more are vaping. But it’s still very small numbers. 14-17 year olds who have used an e-cigarette at least once in the past year is at about 1.8%. Across the total population, 1.1% vape daily, compared to 0.5% in 2016. For comparison, about 11% of Australians smoke tobacco cigarettes every day.

And while e-cigarettes provide the nicotine smokers crave without the toxic tar and carcinogens that come from inhaling burning tobacco – which is one way advocates present the argument that it’s healthier than cigarettes, nicotine is still highly addictive. Some research suggests it may be as addictive as heroin and cocaine, and being addicted to any toxic chemical isn’t great. But in nicotine’s case, it can raise your blood pressure and spike your adrenaline, which increases your heart rate and the likelihood of having a heart attack.

And of course there’s still other chemicals involved in vaping. But it’s the way it’s pitched as ‘safe smoking’ that has many worried that people – particularly young people who wouldn’t normally try cigarettes – will give vaping a go. That means it could normalise – and an act act as gateway to – regular smoking smoking.

Also of concern is that we still don’t know a whole lot about the effects of vaping, as it’s a relatively new product.

What’s the illness that’s been linked to vaping in the US?

Last year, US health officials linked a number of deaths and more than 1,000 cases of a mysterious lung illness to vaping. Called EVALI, which is short for e-cigarette or vaping product use-associated lung injury, cases are still happening reports from the US and UK say. The illness was largely attributed to people vaping liquids that contain THC, which is the high-inducing part of marijuana. The US regulator said vitamin E acetate, which is a thickening agent sometimes added to illicit THC vaping liquids, was believed to have caused most of the illnesses. And there are concerns about other possible illnesses, but there’s not a lot of long term data to make definitive judgments. But there was a study published at the end of 2019 in the American Journal of Preventive Medicine that’s one of the first longitudinal analysis of the association between vaping and lung disease. Vapers had a 30% higher odds of developing lung disease than those not vaping. Tobacco smokers had 150% higher odds than those not smoking. And then the jury’s still out about the effects vaping might have on cardiovascular disease and respiratory disease, but there are early studies that point to vapers being at higher risk.

What’s the law around vaping in Australia?

In Australia it’s quite difficult to get your hands on e-cigarette products. You can buy an e-cigrattes device here, but you can’t use, sell or buy the nicotine for use in e-cigarettes in Australia. But under the current law, you may be able to import up to a three-month supply of nicotine for use in e-cigarettes for several reasons, including that it’s for a therapeutic reason — such as to help you quit smoking. And that’s something the government’s looking to ban.

There was a plan to ban the importation of those e-cigarette products from July 1 this year. It would still allow those with a doctor’s prescription to import the product, a breach of the ban in anything way could see a fine of up to $222,000. But that was delayed when there was pushback from some Coalition backbenchers and some health lobbyists. They’re of the view that vaping is an effective tool to help people stop smoking. They say that banning e-cigarettes will encourage a black market so they’re really calling for it be regulated. They also didn’t like it being sprung on them at short notice, so they want a consultation process before any ban is put into place. In regards to the other point though, they really leaned heavily on research out of the UK to support their position.

What’s happening overseas? 

In the UK, vaping is legal at the moment, but the amount of nicotine allowed in vaping products is regulated. Many doctors say if it helps people stop smoking tobacco it will save lives. This regulation was in contrast to the US which – prior to those supposed vaping-related deaths we spoke abut earlier – was largely unregulated. Yes, but after that, there were big changes, first of all, vaping companies come under pressure from the public, particularly Juul Labs, which is America’s biggest e-cigarette company. It’s owned by Altria Group, the company that owns Marlboro. It was criticised for targeting the youth market with its flavoured pods that are heavy on nicotine. At the time, Juul’s brand of e-cigarettes at that time, commanded about 70% of the market. In September last year, pressure on the company built to a point where its boss Kevin Burns was forced to step down. Then in October, the company announced it would stop selling flavoured liquid nicotine pods, which are popular with young people. And in January, the US Food and Drug Administration announced that it was ordering companies to pull flavoured liquid nicotine products from the shelves, but its not a permanent ban.

Squiz Recommends:
BBC “The Inquiry – Vaping”
The New Yorker – A Beginner’s Guide to Vaping

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