Vaping regularly makes headlines, with some campaigning to make e-cigarettes more available to help smokers quit, while others are keen to see vaping products banned, citing dangers, especially for teens.
So just how dangerous is it? We have undertaken an evidence check of vaping research. This included more than 100 sources on tobacco harm reduction, vaping prevalence and health effects, and what other countries are doing in response. Here's what we found.
How does vaping compare to smoking?
Smoking is harmful. It's the leading preventable cause of death in Australia. It causes 13% of all deaths, including from lung, mouth, throat and bladder cancer, emphysema, heart attack and stroke, to name just a few. People who smoke regularly and don't quit lose about ten years of life compared with non-smokers.
Nicotine, a mild stimulant, is the active ingredient in both cigarettes and nicotine vaping products. It's addictive but isn't the cause of cancer or the other diseases related to smoking.
Ideally, people wouldn't be addicted to nicotine, but having a safe supply without the deadly chemicals, for instance by using nicotine patches or gum, is safer than smoking. Making these other sources available is known as harm reduction.
Vaping is not risk-free, but several detailed reviews of the evidence plus a consensus of experts have all estimated it's at least 95% safer to vape nicotine than to smoke tobacco. The risk of cancer from vaping, for example, has been estimated at less than 1%.
These reviews looked at the known dangerous chemicals in cigarettes, and found there were very few and in very small quantities in nicotine vapes. So the argument that we won't see major health effects for a few more decades is causing more alarm than is necessary.
Is everyone' vaping these days?
Some are concerned about the use of vaping products by teens, but currently available statistics show very few teens vape regularly. Depending on the study, between 9.6% and 32% of 14-17-year-olds have tried vaping at some point in their lives.
But less than 2% of 14-17-year-olds say they have used vapes in the past year. This number doubled between 2016 and 2019, but is still much lower than the rates of teen smoking (3.2%) and teen alcohol use (32%).
It's the same pattern we see with drugs other than alcohol: a proportion of people try them but only a very small proportion of those go on to use regularly or for a long time. Nearly 60% of people who try vaping only use once or twice.
Smoking rates in Australia have declined from 24% in 1991 to 11% in 2019 because we have introduced a number of very successful measures such as restricting sales and where people can smoke, putting up prices, introducing plain packaging, and improving education and access to treatment programs.
But it's getting harder to encourage the remaining smokers to quit with the methods that have worked in the past. Those still smoking tend to be older, more socially disadvantaged, or have mental health problems.
Should we ban vapes?
So we have a bit of a dilemma. Vaping is much safer than smoking, so it would be helpful for adults to have access to it as an alternative to cigarettes. That means we need to make them more available and accessible.
But ideally we don't want teens who don't already smoke to start regular vaping. This has led some to call for a crackdown on vaping.
