In addition to growing evidence about the impact of vaping on young Australians, new research has found that nearly a third of 14 - to 17-year-olds report vaping, according to the Blue Hole New Consumer Report, October 26.

In addition, the study - a collaboration between the Cancer Council NSW and the University of Sydney, with funding from the Mindrew Foundation and the NSW and Australian governments - found that most young Australians found it easy to access nicotine e-cigarette products.

GenVape project researchers Paul Grogan, Associate Professor Becky Freeman and Anita Dessaix shared their findings, calling on the Australian government to restrict all e-cigarettes outside the TGA prescription pathway, both nicotine and non-nicotine.

Nearly a third of 14 - to 17-year-olds reported using nicotine products, and about half of them had never smoked before.

In addition, most young people find it easy to obtain nicotine e-cigarette products, according to new research from the GenVape project.

The GenVape project is the first study into the e-cigarette experience of young people, parents and teachers before and after Australia's independent Therapeutic Goods Administration (TGA) introduced simplified nicotine prescription rules from 1 October 2021 to protect young people from the dangers of e-cigarettes.

The first report of the GenVape study - a collaboration between the Cancer Council NSW and the University of Sydney, with funding from the Mindrew Foundation and the NSW and Australian governments - was released in September.

While the TGA rules are intended to facilitate access only for individuals who believe e-cigarettes may help them quit smoking, the majority of e-cigarette users are young adults and teens who do not use e-cigarettes to quit smoking.

Limiting smokers' exposure to e-cigarettes is complicated by the proliferation of e-cigarettes that claim to be nicotine-free, but many have been found to contain nicotine and other highly dangerous substances when tested in laboratories.

The first report focused on adolescents through a cross-sectional survey of 721 14 - to 17-year-olds recruited through online groups. It provides new evidence highlighting growing concerns about e-cigarette use and associated health hazards among young people.

A growing body of evidence and media reports over the past two years has shown that despite the TGA's prescribing rules and the illegal sale of all vaping products to minors, teenagers have easy access to e-cigarettes.

A third of the teens who took part in the survey had used e-cigarettes. Of those, four in five said it was easy to mix e-cigarettes through multiple interconnected channels.

Of those who used e-cigarettes but did not buy their last one, the majority obtained them from a friend or other social contact.

Of the 30 percent who bought e-cigarettes, 49 percent bought them from a friend or someone else, and nearly a third (31 percent) bought them from a gas station, tobacco store or convenience store. Teens also buy e-cigarettes through social media, vape stores or websites.

Adolescents reported that taste was a major driver of product preference. Among the most popular varieties are adolescent-friendly flavors such as bubble gum, desserts, fruits and energy drinks.

Teens report that they prefer single-use e-cigarettes (80%) because of their ease of use and low cost, with a single single-use e-cigarette offering hundreds of taps for as little as $5.00.

Respondents observed that disposable products were marketed as suitable for beginners. More than half said they were aware of nicotine in e-cigarettes, while a quarter did not know whether the product contained nicotine.

A systematic review by the Australian National University this year found that vaping increased the risk of smoking by three times in non-smokers.

Studies have shown that e-cigarettes are the strongest risk factor for smoking, and vice versa.

Young people identified as having used e-cigarettes in the past were 18 times more likely to use e-cigarettes than those who had never used them. Of those who had ever vaped, more than half had never smoked before vaping.

This suggests that there is no unidirectional relationship between vaping and smoking in young people, that vaping may not preclude subsequent initiation of smoking, and that dual use of cigarettes and vaping products is common.

The use of other legal and illegal harmful substances by young Australians is steadily declining.

So why does e-cigarette use go the other way?

Four things set e-cigarettes apart:

These products are made for and for young people;

Despite policies designed to protect young people from vaping, business entities and entrepreneurs are clearly breaking the rules;

Without laboratory tests, it is impossible to tell which e-cigarettes contain nicotine and which do not, complicating enforcement (non-nicotinic e-cigarettes do not legally require a prescription);

E-cigarettes are the only harmful products marketed as solving the problem they are creating.

These four events did not happen by accident. They are all the result of ruthless exploitation by commercial interests that acknowledge that mass-produced, addictive over-the-counter products are lucrative in a way that no other industry is.

Governments have created e-cigarette market opportunities and crises for young people by not acting to enforce and tighten existing rules designed to protect young people from the short - and long-term harms of e-cigarettes.

The law is clear. Nicotine e-cigarettes can only be legally used by individuals with a doctor's prescription, the same as other controlled substances (nicotine for evaporation is a Schedule 4 controlled substance because it is highly toxic and addictive).

Any vaporized nicotine products imported without a medical permit should be confiscated at the border, as authorities do for other Schedule 4 substances.

It's federal law, but it's not being enforced. Any retailer selling nicotine-vaporized products other than pharmacies is violating state and territory laws, but these laws are also poorly enforced.

Online and social media sales are also illegal because, at some point, a controlled substance is transported, stored, or sold in violation of the laws of the jurisdiction.

Studies and others have shown that mislabeling of e-cigarettes is widespread. Enforcement is complicated by the need to conduct laboratory tests on products before they can be confiscated.

The solution is simple. Remove e-cigarettes from the market that claim to be nicotine-free or are not labeled as containing nicotine. They are marketed under the shadow of misinformation about e-cigarettes being a safer alternative to smoking - when they have no place in quitting - and they are filled with harmful toxins and marketed to children.

Removing them would make it easier to capture nicotine e-cigarettes under established rules and help ensure that only individuals with a prescription can use them.

The adolescent e-cigarette users in the study are acquiring e-cigarettes through organized commercial interests, regardless of their primary source. Key access points (importers, wholesalers, online, social media, over the counter sales) are evident and facilitate the illegal sale of harmful, addictive products to children on a commercial scale.

A new generation of young Australians is facing lung damage and nicotine addiction. It also risks undoing decades of success in tobacco control among adolescents and young adults.

The Australian government must act immediately to restrict all e-cigarette use outside the TGA prescription pathway, both nicotine and non-nicotine. This will not only prevent children, young people and non-smokers from having easy access to harmful products, but will also strengthen prescription-only policies.

About the author

Paul Grogan is a senior consultant at The Daffodil Centre, a joint cancer research facility between the Cancer Council NSW and the University of Sydney. He is a former chair of the National Committee on Tobacco at the Cancer Council of Australia.

Becky Freeman is an Associate professor in the School of Public Health at the University of Sydney.

Anita Dessaix is Director of Cancer Prevention and Advocacy at the Cancer Council NSW and Chair of the Cancer Council's Public Health Committee.