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 led 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 negative impacts on cardiovascular health markers such as blood pressure and heart rate, impaired lung function, and disruptions to 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.^1–4

Australian governments have taken an evidence-based and precautionary approach to regulating e-cigarettes. It is an approach based on emerging evidence of the negative impacts on health and risks posed to tobacco control and population health such as gateway to smoking initiation, questions over effectiveness for cessation, increasing youth uptake, and dual use with conventional tobacco products.⁵ As such, in 2024 the Queensland government and the Australian federal government passed legislation to regulate e-cigarette usage.^6,7 While the historical trends and the current levels of vaping are concerning, recent interventions such as stronger regulation and wider-reaching information campaigns are intended to address this growing public health problem.

Latest results

Adults

In 2024, 25.9% of Queensland adults had tried an e-cigarette in their lifetime. The proportion of Queensland adults that currently vaped, defined as using e-cigarettes regularly or occasionally in the past 12 months, was 7.7%. Just under half of those, or 3.4% of the total adult population, vaped daily.

Comparing adult Queenslanders across different sociodemographic groups showed current vaping was (Figure 1):

• 48.1% more likely among males than females (9.2% for males and 6.2% for females)
• 2.5 times more likely among adults 18 to 29 years than adults 30 to 44 years.

Comparing adult Queenslanders across different sociodemographic groups showed daily vaping was (Figure 1):

• 52.0% more likely among males than females (4.1% for males and 2.7% for females)
• 49.7% more likely among adults 18 to 29 years than adults 30 to 44 years.⁸

Figure 1: Queensland adult e-cigarette use, 2024

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Dual use of e-cigarettes and tobacco

Dual use of e-cigarettes and tobacco presents a particular public health challenge. High quality evidence for e-cigarettes as an effective cessation tool is limited. To understand the role of e-cigarettes in potential smoking relapse or, more importantly, the risk of long term health impacts requires well designed studies that follow participants over time. Evidence from such studies is building, however, results will take time. The Queensland preventive health survey (QPHS) is a point in time survey and results may not capture the complex inter-relationships between e-cigarette and tobacco use such as infrequent use, intermittent use, or relapse. Therefore, for QPHS data, dual use is defined conservatively as regular daily or weekly use of tobacco and e-cigarettes at the time of the survey.

In 2024, 1.2% of adults in Queensland used both tobacco and vapes regularly, 4.6% of Queensland adults regularly used vapes exclusively, and 10.2% of Queensland adults regularly used tobacco only (Figure 2).

Comparing adult Queenslanders across different sociodemographic groups showed that regular use of both e-cigarettes and tobacco was:

• 80.4% more likely among males than females (1.5% for males and 0.8% for females)
• 2.3 times more likely among adults 18 to 29 years than adults 30 to 44 years (data not shown).⁸

Figure 2: Queensland adult e-cigarettes and tobacco dual use, 2024

Children and young people

The uptake of vaping by children and teenagers is of particular concern among governments, the medical community, families and the education sector. These concerns include acute health harms, the potential for longer term chronic illness and an increased likelihood of future tobacco use. One study reported adolescents and young adults who have ever used e-cigarettes were 3.5 times more likely to start smoking tobacco compared with those who have never used e-cigarettes.⁹ The Australian Secondary School Alcohol and Drug (ASSAD) Survey is a triennial national survey that collects information about vaping directly from high school students 12 to 17 years.

According to the 2022–2023 ASSAD survey, among Queensland high school students:

• 64.4% had never tried an e-cigarette
• 18.6% had only had a few puffs of an e-cigarette
• 9.4% had smoked less than 100 e-cigarettes
• 7.5% had smoked more than 100 e-cigarettes in their lifetime.

In total, 35.6% of Queensland high school students had ever vaped with the proportion higher in older students (Figure 3).

In 2022–2023, 30.0% of Queensland students had vaped in the previous 12 months, while 21.3% of Queensland students had vaped in the previous month. The proportions of Queensland students vaping in the previous 12 months and the previous month were similar by sex and age.

Among Queensland high school students, 3.4% engaged in dual use of e-cigarettes and tobacco, 17.9% vaped exclusively, and less than 1% exclusively used tobacco. Dual use and exclusive tobacco use proportions had high margins of error and should be interpreted with caution.¹⁰

Figure 3: Queensland school student e-cigarette use, 2022–2023

Trends

Vaping continues to increase in the Queensland population among adults and older children, based on the most recent QPHS and ASSAD survey data.

Among Queensland adults, the proportion who currently use e-cigarettes increased by 4.0 times from 2018 to 2024 while the proportion who vape daily increased by 5.9 times in the same period. The increases in the proportion of Queensland adults currently vaping in this period were similar for sex, socioeconomic and remoteness area. Comparing trends from 2018 to 2024 across age groups, showed current vaping (Figure 4):

• increased by 5.9 times among adults 18 to 29 years
• increased by 3.9 times among adults 30 to 44 years
• increased by 54.4% among adults 45 to 64 years
• was stable for adults 65 years or older.⁸

Among Queensland high school students 12 to 17 years, there was a more than 2-fold increase from 2017 to 2022–2023 in the proportion who had ever vaped (from 15.5% to 35.6%) and a 3.7 times increase in past month vaping (from 5.7% to 21.3%).¹⁰

Figure 4: Queensland adult vaping trends

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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 their child’s high school had provided information about vaping. Parents living in urban areas were 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). More than 90% of parents agreed (44.1%) or strongly agreed (46.6%) that high schools should provide more information about e-cigarettes to their students.

Although there were legal limitations on advertising e-cigarettes at the time this data was collected, about 1-in-5 parents (20.3%) had seen advertisements for e-cigarettes and vaping products in physical shops, most commonly tobacconists and vaping stores in 2022. Slightly fewer parents (16.9%) had seen e-cigarette advertisements online, most commonly on social media and online marketplace websites.⁸

Additional information

Data and statistics

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