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What are electronic cigarettes (e-cigarettes, vapes)?

Electronic cigarettes or e-cigarettes (vapes) are battery operated devices that heat a liquid (e-liquid) to produce a vapour to inhale. Using an e-cigarette is often called 'vaping'. Vapes include both disposable e-cigarettes, such as ‘Cuvies’ and ‘Stigs’, and pod devices, such as JUUL.

What do vapes look and smell like?

Vapes come in many shapes and sizes and can be made to look like everyday items including highlighters, pens, or USB memory sticks.

Vapour from vapes does not usually have a strong odour but they may have a sweet smell depending on the flavour.

What is in a vape?

Vape aerosol is not water vapour. The main ingredient in vapes is propylene glycol, vegetable glycerine or glycerol.

Vapes and e-liquids can contain a range of chemicals such as acetone found in nail polish remover, acrolein found in weed killer and 2-cholorophenol found in cleaning products and bug spray.

Vapes  come in a number of flavours such as blueberry or bubble gum that make them appealing.

Many vapes also contain nicotine, the same highly addictive substance found in tobacco cigarettes.

Testing vapes has shown that those labelled 'nicotine-free' can still contain high nicotine levels. People can think they are using nicotine-free vapes and can unknowingly quickly develop a nicotine addiction.

Vapes are often available in different flavours which can be appealing to young people and children. While some chemicals in vapes are also used in food production and are generally considered safe when eaten, this does not mean they are safe when they are inhaled directly into the lungs.(1)

Do vapes list all the ingredients they contain on the pack?

Vapes are often labelled incorrectly and can contain nicotine, even when they claim not to. The ingredients listed on vape packaging are commonly inaccurate and/or incomplete.

Although vape packaging might list some ingredients, it may not include all chemicals in the vapour. Researchers have found that many of the substances identified in vapes were contaminants from either the e-liquid, the device itself, or emissions following heating of the e-liquid. (2, 3)

Below are some of the chemicals that have been found in vapes. These chemicals are not listed on the pack:

  • 2-chlorophenol used in disinfectant/cleaning products and insecticide (3, 4)
  • Acetone used in nail polish remover (3, 5, 6)
  • Pulegone used in insecticide (3, 6, 7)
  • Acrolein used in herbicides (3, 8)

Australian research has examined vapes to determine their content.(4, 9) Researchers have found a range of chemicals – many of them harmful.

ABC News published a story about the 'suite of chemicals' in the liquids used in vapes, some at 'dangerously high' levels.(10)

2021 Australian research (4) analysed 65 samples of Australian e-liquids labelled as 'non-nicotine'. Every sample contained at least one potentially harmful chemical and all samples were mislabelled, highlighting concerns that consumers are misinformed. Six of the samples contained nicotine, despite being marketed as nicotine-free. They found most of the substances found in vapes are not identified on the pack, raising concerns about what people are inhaling.

For more information visit Tobacco in Australia: Safety and health risks of e-cigarettes.

How many people in NSW are vaping?

The highest users of vapes are young people. In 2019-2020, the NSW Population Health Survey(11) found 21.4 % of people aged 16 to 24 had ever used a vape, compared to 9.6% of people aged over 16 years.

What are the short-term risks of young people who vape?

Short-term health effects of vaping include nausea, vomiting, mouth and airway irritation, chest pain and palpitations.(12)

Vaping can increase the odds of being diagnosed with asthma.(13)

Nicotine vapes can weaken the immune system.(14)

Regular nicotine use can also worsen stress and anxiety and can make you more susceptible to depressive symptoms.(14) Conversely, quitting nicotine can lead to reduced stress, anxiety and depression.(15)

What is nicotine poisoning?

Too much nicotine from vapes can cause nicotine poisoning. Symptoms can vary, but can include sweating, racing heart rate and increased blood pressure, shaking and vomiting.

If you think someone has been poisoned by liquid nicotine, please call the Poisons Information Centre on 13 11 26 immediately or 000 if it is an emergency. For more information see the NSW Poisons Information Centre.

What are the long-term health risks for young people who vape?

Vapes can contain cancer-causing agents, toxins, heavy metals, and very fine particles that can can cause adverse health effects. (1)

Vaping can have harmful, life-long impacts, especially on young people’s growing brains and bodies.

Vapes can contain high levels of nicotine. Adolescence is a critical period for brain development and exposure to nicotine can have long-term health consequences, impacting memory, attention and learning.(16)

Even vapes that do not contain nicotine are still not safe and can have negative, long-lasting health outcomes for young people.(17)

Do people who use vapes go onto use tobacco cigarettes?

Most adults who smoke cigarettes became addicted to nicotine as teenagers.(18)

Nicotine is highly addictive and research suggests that young people can become more easily addicted to nicotine than adults.(19)

Research indicates that young people who vape may be three times as likely to go on to use regular cigarettes. (20, 17)

Is selling vapes to a person under 18 years illegal?

Just like tobacco products, selling any vape or vape accessories to anyone under 18 years of age is illegal in NSW, regardless of whether the product contains nicotine or not. This includes sales in stores as well as online sales.

It is illegal for retailers to sell e-cigarettes or e-liquids that contain nicotine, including online sales. Only pharmacies can sell e-cigarettes to people over 18 years old with a valid prescription for the purpose of quitting cigarettes.

If you suspect someone is selling vapes to minors, you can report it to NSW Health by completing the online reporting form or call the Tobacco Information Line on 1800 357 412.

How can I report a complaint?

If you think a retailer (other than a pharmacy) is selling vapes that contain nicotine, or selling vapes to anyone under 18 years of age, please report it to NSW Health or call the Tobacco Information Line on 1800 357 412.

Information collected will help to guide the enforcement of tobacco and vape retailing laws by NSW Health Inspectors.

Non-English speaking people can contact the Tobacco Information Line via the translating and interpreting service (TIS) on 13 14 50.

What can you do as a parent or carer?

There are ways you can help protect your children from vaping:

  • Whether you suspect your child is vaping or not, take the time to talk to them about it and help them understand all of the risks. It is never too late to have the conversation.
  • Try to start the conversation with your child in a relaxed easy-going way, perhaps taking the cue from around you, a note from school, a news story about vaping, or seeing people vaping on the street.
  • If your child is vaping, encourage them to stop and let them know that help is available and you are there for them.
  • Learn about the different types of vapes available and the risks associated with using these products.
  • Set a good example by being tobacco or vape free.
  • Report those who are selling vapes to minors or selling vapes containing nicotine by completing the online reporting form or calling the Tobacco Information Line on 1800 357 412.

What supports can I access to quit vaping?

See your General Practitioner, youth health service, and other health services for young people for help to quit vaping.

Quitline counsellors are available to answer any questions you may have about e-cigarettes on 13 7848 (13 QUIT). Quitline is a telephone-based service, offering information and advice. Quitline counsellors provide tips and strategies, and help people to plan their quit attempts, based on their own needs and preferences. For parents and carers, they can also help you think of ways to approach a conversation with your child or loved one about vaping.

The Aboriginal Quitline is also available on 13 7848. Run by Aboriginal counsellors, the Aboriginal Quitline is a telephone-based confidential advice and support service.

If you require assistance in a language other than English, Quitline has counsellors who speak Arabic, Cantonese, Mandarin and Vietnamese, you can ask to speak to one of these counsellors. For people who prefer to speak in a different language, Quitline uses the Telephone Interpreter Service (TIS).

The Cancer Institute NSW iCanQuit provides information on quitting methods, links to support groups and top tips to help you quit.

References

  1. Australian Government NH&MRC. NHMRC CEO Statement: Electronic Cigarettes (E-Cigarettes). Australian Government; 2017.
  2. Zhao D, Aravindakshan A, Hilpert M, Olmedo P, Rule AM, Navas-Acien A, et al. Metal/Metalloid Levels in Electronic Cigarette Liquids, Aerosols, and Human Biosamples: A Systematic Review. Environmental health perspectives. 2020;128(3):36001.
  3. Department of Health National Industrial Chemicals Notification and Assessment Scheme. Non-nicotine liquids for e-cigarette devices in Australia: chemistry and health concerns. 2019.
  4. Larcombe A, Allard S, Pringle P, Mead‐Hunter R, Anderson N, Mullins B. Chemical analysis of fresh and aged Australian e‐cigarette liquids. Medical journal of Australia. 2021.
  5. Grondin CJ, Davis AP, Wiegers JA, Wiegers TC, Sciaky D, Johnson RJ, et al. Predicting molecular mechanisms, pathways, and health outcomes induced by Juul e-cigarette aerosol chemicals using the Comparative Toxicogenomics Database. Current Research in Toxicology. 2021;2:272-81.
  6. Sleiman M, Logue JM, Montesinos VN, Russell ML, Litter MI, Gundel LA, et al. Emissions from Electronic Cigarettes: Key Parameters Affecting the Release of Harmful Chemicals. Environmental science & technology. 2016;50(17):9644-51.
  7. Omaiye EE, Luo W, McWhirter KJ, Pankow JF, Talbot P. Flavour chemicals, synthetic coolants and pulegone in popular mint-flavoured and menthol-flavoured e-cigarettes. Tobacco control. 2021:tobaccocontrol-2021-056582.
  8. Kuntic M, Oelze M, Steven S, Kröller-Schön S, Stamm P, Kalinovic S, et al. Short-term e-cigarette vapour exposure causes vascular oxidative stress and dysfunction: evidence for a close connection to brain damage and a key role of the phagocytic NADPH oxidase (NOX-2). European heart journal. 2020;41(26):2472-83.
  9. Chivers E, Janka M, Franklin P, Mullins B, Larcombe A. Nicotine and other potentially harmful compounds in “nicotine‐free” e‐cigarette liquids in Australia. Medical journal of Australia. 2019;210(3):127-8.
  10. Alison Branley. New Australian vaping research finds 'suite of chemicals' in liquids used in vapes, some at 'dangerously high' levels. ABC News. 11 October 2021.
  11. Centre for Epidemiology and Evidence. NSW Population Health Survey (SAPHaRI). St Leonards: NSW Ministry of Health.; 2019.
  12. Gotts JE, Jordt S-E, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019;366:l5275-l.
  13. Byrne S BE, Williams G, Anastasiou KM, Tonkin A, Battams S and Riley MD,. E-cigarettes, smoking and health. A Literature Review Update. Australia: CSIRO; 2018.
  14. Christensen D. 6.9 Predictors of nicotine dependence. 2018. In: Tobacco in Australia: Facts and issues [Internet]. Melbourne: Cancer Council Victoria.
  15. Greenhalgh E, & Scollo, MM;. InDepth 18B: Electronic cigarettes (e-cigarettes). In Scollo, MM and Winstanley, MH (editors) Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021.
  16. Gotts JE, Jordt S-E, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019;366:l5275-l.
  17. Byrne S BE, Williams G, Anastasiou KM, Tonkin A, Battams S and Riley MD,. E-cigarettes, smoking and health. A Literature Review Update. Australia: CSIRO; 2018.
  18. Christensen D. 6.9 Predictors of nicotine dependence. 2018. In: Tobacco in Australia: Facts and issues [Internet]. Melbourne: Cancer Council Victoria.
  19. Greenhalgh E, & Scollo, MM;. InDepth 18B: Electronic cigarettes (e-cigarettes). In Scollo, MM and Winstanley, MH (editors) Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021.
  20. Baenziger O, Ford L, Yazidjoglou A, Joshy G, Banks E. E-cigarette use and combustible tobacco cigarette smoking uptake amongst non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis. BMJ Open 2021;11:e045603

Current as at: Thursday 22 June 2023
Contact page owner: Centre for Population Health