Electronic cigarettes

Introduction

Electronic cigarettes (e-cigarettes) heat liquid, which usually contains nicotine, into a fine vapour to inhale into the lungs. E-cigarette use, or vaping, continues to rise in popularity, particularly among younger people, while the evidence of potential harms continues to mount.

A recent Australian review concluded there was strong evidence that non-smokers who vape are three times more likely to go on to smoke combustible tobacco cigarettes. There was limited evidence that vaping is effective for smoking cessation, and when used for this purpose it leads to longer nicotine exposure than other cessation methods. It may also be associated with relapse in ex-smokers. Risks include lung damage, injuries and burns, acute nicotine toxicity, poisoning, and environmental waste. Use has been associated with cardiovascular health markers such as blood pressure and heart rate, lung function, and adolescent brain development. Newer products that contain high concentration nicotine salt and are small and easily concealed, are increasing in popularity, and are a particular concern.¹

Australian governments have taken an evidence-based and precautionary approach to regulating e-cigarettes based on the risks they pose to tobacco control and population health in terms of gateway to smoking initiation, questions over effectiveness for cessation, increasing youth uptake, and dual use with conventional tobacco products.

Latest results

Adults

In 2022, 19.7% Queensland adults had tried an e-cigarette in their lifetime—5.0% were currently vaping and 1.9% were vaping daily. Current vaping includes any regular or intermittent use of e-cigarettes in the previous 12 months. Adults who currently vaped are more likely to be:

• male
• younger
• current tobacco smokers.

Children and youth

In 2017, in Queensland high school students:

• 84.5% had never tried an e-cigarette
• 7.8% had only had a few puffs of an e-cigarette
• 6.7% had smoked less than 100 e-cigarettes and
• 1.1% had smoked more than 100 e-cigarettes in their lifetime.

Boys and older children were more likely to have ever vaped.

Of those high school students who had ever tried an e-cigarette, 6.9% of students had vaped in the past month. The prevalence of vaping in the past month was similar between boys and girls, age groups, and regions.²

Trends

Using all available years of data from 2018 to 2021 for trend analysis, prevalence of current vaping for Queensland adults increased by about 40% over the period. Figure 1 shows prevalence estimates for the initial and final year of data only.

The largest increase in vaping was for young people 18 to 29 years. The increase in vaping over this period was similar for males and females.

Parents views of vaping

In 2022, 2,553 parents completed a telephone survey on their views about vaping and how they have engaged with their children.

Less than half of parents interviewed (44.4%) had spoken to their child about vaping. There was a large age effect, with 69.5% of parents of older children (12 to 17 years) reporting a vaping discussion with their child compared to 23.6% of parents of younger children (5 to 11 years).

When asked why they talked to their child about vaping, the two most common responses were

• “To teach my child about the risk of using vapes”
• “Seeing someone vaping”.

When parents were asked why they had not discussed vaping with their child, the two most common responses were:

• “No-one smokes or vapes in our household”
• “My child is too young”.

About one third of parents reported that the child’s secondary school had provided information about vaping. Parents living in urban areas were much more likely than parents living in more rural areas to report their child’s high school had provided information about vaping (42.4% for major cities, 23.0% for inner regional areas and 16.3% for outer regional areas). Meanwhile, more than 90% of parents agreed (44.1%) or strongly agreed (46.6%) that secondary schools should provide more information about e-cigarettes to their students.

Although there are legal limitations on advertising e-cigarettes, about 1-in-5 parents (20.3%) had seen advertisements for e-cigarettes in physical shops, most commonly tobacconists and vaping stores. Furthermore, about 1-in-6 parents (16.9%) had seen e-cigarette advertisements online, most commonly on social media and online marketplace websites.

National comparisons

In 2019, the current vaping prevalence for Queensland adults was similar to national results (2.9% compared to 2.5%). State and territory results were similar, although Queensland ranked 2nd highest of the Australian jurisdictions.³

Additional information

Data and statistics

Visit the Tobacco in Australia website E-cigarettes and other alternative nicotine products for more information about e-cigarette use.

Summary results from the Queensland preventive health survey (QPHS) for Hospital and Health Services and other regions can be found within this report and more detailed and historical results can be accessed at Preventive health surveys.

Strategies and information

Visit the

• National Health and Medical Research Council for the latest advice from the 2022 CEO statement on electronic cigarettes
• Queensland Health Smoking laws in Queensland.

Section technical notes

Where presented, ratios were calculated using higher precision estimates than in text. Ratios calculated using estimates in text may differ.

Data for this section were sourced from:

• the Queensland preventive health survey (QPHS) (See Preventive health surveys for further information)
• the Australian Secondary School Alcohol and Drugs Survey (ASSAD) (See Australian secondary school students alcohol and drug survey for further information)
• the National Drug Strategy Household Survey 2019 (NDSHS) (See National Drug Strategy Household Survey 2019 for further information.

References

1. Banks E., Yazidjoglou A., Brown S., Nguyen M., Martin M., Beckwith K., Daluwatta A., Campbell S. & Joshy G. 2022. Electronic cigarettes and health outcomes: systematic review of global evidence. doi: 10.25911/XV0F-6C42.
2. Cancer Council Queensland. 2018. Selected Queensland results from the 2017 ASSAD survey. Brisbane.
3. Australian Institute of Health and Welfare. 2020.  National drug strategy household survey 2019. Drug statistics series no. 32. PHE 270. Canberra: AIHW.