Vaping is everywhere. Can we really ban it?

Sam Hawley: Hi, I’m Sam Hawley, coming to you from Gadigal Land. This is ABC News Daily. Australia’s efforts to combat smoking have been revered around the world. But now we’re breeding a new generation of nicotine addicts. Vaping has taken off and the Government is trying to catch up with a ban on the recreational use of e-cigarettes. But will it work or just push sales further into the black market? Today, a leading researcher in the field, epidemiologist Dr. Emily Banks, on the vaping epidemic.

Reporter: A major crackdown on e-cigarettes is on the way, with the federal government set to introduce plain packaging and restrictions on colours and flavours. It’s been labelled.

Reporter: The vaping epidemic one of the most significant smoking reforms across the country in nearly a decade.

Sam Hawley: Emily This sounds like a really big deal, like we’re leading the world when it comes to cracking down on vaping.

Emily Banks: Well, 41 per cent of the world’s population lives in countries where e-cigarettes are actually completely banned. So I don’t think it’s fair to say that no other country has done anything like this. But it is unique to be really having a prescription only model, which is trying to balance availability for people who want to use e-cigarettes to quit smoking, with avoiding widespread use, particularly among non-smokers and among young people.

Sam Hawley: Okay. It was announced by the Health Minister, Mark Butler, at the Press Club. He argues, Mark Butler, that the tobacco industry, through these electronic cigarettes, through vaping, is trying to create a whole new generation of nicotine addicts.

Mark Butler, health minister: Big Tobacco has taken another addictive product, wrapped it in shiny packaging, added sweet flavours to create a new generation of nicotine addicts.

Sam Hawley: Do you agree with that?

Emily Banks: Well, certainly looking at all the evidence nicotine is one of the most addictive substances known to humanity, and that addiction is a really key risk of electronic cigarettes, but also that what we’re seeing is much more common use among young people than among older people and this aggressive marketing of electronic cigarettes to children. These are being brought into our community as if they are being promoted as being good for quitting smoking. But then there’s 17,000 flavours. The products have cartoon characters all over them. They’re actually incredibly strong products as well. So I found an e-cigarette on the ground just near where I work at the university, and it was Apple flavoured. It had a superhero on the front of it and it was the nicotine equivalent of 10 to 15 packets of cigarettes.

Sam Hawley: Yeah, that’s really worrying given also we know there’s a problem with vaping in schools. I mean, more and more school kids are actually doing this, aren’t they?

Emily Banks: Well, that’s right. Well, I think the other issue is that when you are young and your brain is plastic, it’s learning. It’s the time when lifelong habits are laid down. And so young people’s brains are much more susceptible to addiction than older people’s brains. And in fact, if you look at the tobacco epidemic, people who are lifelong smokers usually started as teenagers and then it actually sets them up for addiction long term.

Sam Hawley: So let’s talk about those health issues in a moment. But when did this start to become such a big issue that vaping became so popular?

Emily Banks: So e-cigarettes were first invented in their current form in around 2003, and they’ve been on global markets since around 2006-07. But they really didn’t take off in Australia until like the last five years and we’ve seen really rapid increases since about 2016-2017.

Reporter: Vaping is more popular than ever. It’s only been around since the mid 2000, but more and more people are using e-cigarettes, particularly children.

Emily Banks: And we’re now at the point where it’s sort of one in six 14 to 17 year olds have ever vaped and one in four 18 to 24 year olds. So it’s increasing. But what we do really know is that the use is concentrated in young people. So it’s actually quite uncommon in the older smokers.

Sam Hawley: And as you mentioned, when they first came in to place the tobacco companies were really marketing them as a way for people who smoke cigarettes to quit. They’re meant to be useful in helping people stop smoking.

Emily Banks: Well, that’s right. So I think there’s a difference between the sort of rhetoric of these companies and then their actions. And these companies have been taken to court for aggressively marketing to young people. So it’s on the public record that that’s what they have been doing.

Reporter: E-cigarette maker Juul Labs has agreed to pay $438.5 million to settle claims by nearly three dozen US states and territories that it downplayed its products risk and targeted underage buyers.

Emily Banks: But the thing that’s very telling is the one thing the tobacco companies could do to stop smoking is to stop advertising and marketing cigarettes. They’re not doing that. They’re still opposing tobacco control laws. They’re still pushing their products nationally and internationally. And then they’re also confusing things and marketing these other products.

Sam Hawley: It does confuse me somewhat the addiction that you talk about because not all vapes have nicotine in them, do they?

Emily Banks: That’s correct. So there are non nicotine vapes, but they are also kind of a distraction. So when they did surveys in the US about the proportion of e-cigarettes that were sold that had no nicotine in them, it was less than 1 per cent and when you talk to young people here, they say, well, why would I use those ones? I do it because I get this sort of head rush and there’s no point with these non nicotine products.

Sam Hawley: And what do we know, Emily, so far about the health impacts of these vapes?

Emily Banks: So we reviewed the worldwide evidence and it was over 400 studies were synthesised and there are a range of health impacts of e-cigarettes. They increase the probability that non-smokers will take up smoking, particularly young non-smokers. They also can lead to poisoning to toxicity through inhalation seizures. We also see injuries and burns from exploding products. One of the biggest issues that we see with e-cigarettes is that we actually don’t know their long term effects on a range of really common diseases. So respiratory health, cardiovascular disease, cancer, mental health, reproductive health. And that’s actually not a benign situation to have very widespread exposure to something where we don’t know what it does. What we also see is addiction in young people. So often people downplay addiction. They say, Oh, I’m addicted to chocolate or I’m addicted to this streaming service or whatever. But they don’t understand what it means to be really addicted. And that’s sort of for a lot of smokers and e-cigarette users or vapers, they only feel normal just in the period after they’ve had that vape and then they start to go into withdrawal where they start to feel irritable, anxious, craving, and then they have the nicotine again. And if you can imagine going through that cycle repeatedly during the course of a day or an hour. So we have kids who have real difficulty sitting through a lesson or through a meal with their family. There are people who wake up to vape in the middle of the night or they have the vape under their pillow first thing in the morning. So it is this cycle of withdrawal and craving that characterises addiction. And when I talk to young people about what they want from their future, all of them say they want an independent future that they define. They want to be able to go and do great things. And addiction is kind of the opposite of independence. It’s a dependence.

Sam Hawley: Let’s have a look at the changes that the Government’s proposing. Mark Butler says there’ll be more than $200 million in funding in next week’s budget for this.

Mark Butler, health minister: A whole new generation of Australians will need support to quit their new nicotine dependency and they won’t be alone in their quest to kick the habit.

Sam Hawley: But what exactly, Emily, is going to change?

Emily Banks: So that overall package includes things like mass media campaigns and tackling indigenous smoking as well as electronic cigarettes measures. My understanding of the electronic cigarettes measures is that they include stronger control of importation, and that’s going to be in concert with the states as well. It also includes changes to what is permitted in terms of the products themselves. So it’s about pharmaceutical packaging on them rather than cartoon characters. It’s about limiting flavours and then also about banning disposables, and that’s about reducing appeal to children, but also making them more clearly smoking cessation products.

Sam Hawley: So will they be banned? I guess that’s the question. Are they banned for kids?

Emily Banks: Well, I think the thing it’s an interesting word to use because essentially these are prescription products. You wouldn’t say that antibiotics are banned. We don’t say the oral contraceptive is banned. We don’t say that a lot of these products are banned. They’re just not for sale at the corner shop. So it will be illegal to sell them not on prescription. And in fact, it is currently illegal not to sell them on prescription. So so that legislation is already there. It is already illegal to not have them on prescription. This is really about enforcing that law. I mean, when I talk to young people, they say, oh, you can go into this convenience shop or this service station. You can just get these things freely. And the surveys show that four out of five young people would say it’s quite easy to get access to e-cigarettes, even though that is currently illegal.

Sam Hawley: So it’s trying to sort of reinforce the laws we already have to make them a bit tougher.

Emily Banks: It’s to make them more effective. So one of the things that’s happening is there’s just this flooding of the market. And I think the other thing we should be really clear, people are sort of they can get angry at the regulators and say, look, you’re banning this, but these are actually actively being promoted by these companies. So they’re the ones flooding the market. They’re saying to us, this is really effective for smoking cessation, but there’s not a single one of these products that’s been approved by a regulatory authority for smoking cessation. They haven’t been submitted to the FDA, to the Therapeutic Goods Administration or to the European agencies, the UK. If it was truly this is a smoking cessation product, then they would have put those things through to the regulators, but they want them widely available and then they are being very aggressively marketed to young people.

Sam Hawley: Yeah, and as you say, with quite attractive packaging, which is going to end. They’re going to have a much plainer packaging, pharmaceutical like packaging. That’s a sort of big change that happened about ten years ago as well with with cigarettes, wasn’t it, under Nicola Roxon that plain packaging came in.

Nicola Roxon, former health minister: Put simply, tobacco does kill people and with the introduction of these plain packaging it will be plainly obvious for everybody to see the harm that can be caused from smoking.

Sam Hawley: Was that effective?

Emily Banks: That’s correct and it was effective. And in fact there’s more than 20 countries worldwide that are now using plain packaging from Australia. You know that Australian initiative. So it’s a real it’s an amazing thing that we’ve exported to the rest of the world.

Sam Hawley: Yeah, that plain packaging strategy that was introduced back then was a real success for smoking. So I guess the question is for vapes, will this strategy be effective? Will it actually work?

Emily Banks: The action that’s being taken currently to reduce availability to young people and to non-smokers is consistent with the evidence. And I think that what we do need to see is that really widespread comprehensive tobacco control, cutting off supply, making sure that there’s not as much availability and particularly not as much advertising to young people. Those are examples of things that have been effective in the past.

Sam Hawley: Yeah, right. And if we don’t make vaping less common, which is what we’re trying to do or the government’s trying to do here, what does that mean for society? Will we have a whole new generation addicted to vaping?

Emily Banks: Well, I think that that is a possibility and certainly if we look at the example of New Zealand where they’ve made very these e-cigarettes very widely available, they have around 18.6 per cent of their 15 to 24 year olds using e-cigarettes every single day. So that’s the level of addiction that you can see if you have widespread availability. I think the bottom line is that we have a long and successful history in Australia of taking things which are widespread and putting public health measures in place to reduce them. So smoking is a really good example, but you know, it used to be quite common to drive when you were drunk or to drive at high speed outside schools. We’ve worked really hard to take things that are common and make them not normal anymore. So just because something is widespread doesn’t mean we shouldn’t be confident that we can take action about it.

Sam Hawley: Professor Emily Banks is an epidemiologist at the ANU. The new rules around vaping will need to be passed through the Parliament. This episode was produced by Flint Duxfield, Veronica Apap, Chris Dengate and Sam Dunn, who also did the mix. Our supervising producer is Stephen Smiley. I’m Sam Hawley, ABC News Daily will be back again tomorrow. Thanks for listening.