Posted on September 3, 2023 By Colin
ON 2 MAY 2023, HEALTH MINISTER MARK BUTLER claimed that “vaping is creating a whole new generation of nicotine dependency in our community” and this is the main driver of his vaping crackdown.
This claim has been used repeatedly by health and medical organisations and academics since then and is frequently referenced as a serious concern in the media, eg here, here and here.
This would be a concern if it was true. However based on Australian data it is patently wrong and the Minister should withdraw the claim
Recent Australian research indicates that few non-smoking teens vape regularly and many do not use nicotine.
In fact, less than 2% of non-smoking 14-17-year-old Australians are currently vaping nicotine frequently enough to be at-risk of developing nicotine-dependence
Note that young smokers are deliberately excluded from these calculations. Smokers who take up vaping are already exposed to nicotine and may transfer their nicotine dependence (if they are dependent) to a much safer product. However vaping does not cause nicotine dependence in these cases.
Nicotine dependence can lead to unpleasant, short-term withdrawal symptoms and cravings. This can be problematic in situations where smoking is not permitted, such as school classrooms.
However, nicotine presents very little health risk to the user and has some beneficial effects. It does not cause cancer or lung disease and only has a minor role in cardiovascular health.
Importantly, there is no evidence that nicotine vaping is a significant gateway to smoking. In fact, it is diverting young people away from smoking overall [Foxon 2020, Selya 2021, Sokol 2021, Walker 2020].
Numerous studies have shown that dependence on vaping nicotine is significantly weaker than from smoking [Shiffman 2020; Foulds 2015; Fagerstrom 2018; Hughes 2019; Liu 2018].
There are the calculations used to assess this claim based on recent Australian research:
How many teens vape frequently?
Only frequent vaping will lead to nicotine dependence. In the US, frequent vaping is defined by the CDC as vaping on 20 or more days in the past 30 days. In the UK, regular vaping is defined as weekly or more.
Most teen vaping in Australia is occasional and short term and nicotine dependence is very unlikely. Watts (2022) found that only 3% of 14-17-year-olds vaped on 20-30 days in the last month. In another study, Gardner (2023) found only 5.7% vaped at least once or more weekly.
Average: say 4.5% vape frequently (note that this average mixes two different definitions of frequent vaping).
How many vapers were already smokers?
In the study by Watts (2022) 54% of all 14-17 year-old vapers had not tried smoking prior to trying vaping. In the National Drug Strategy Household Survey (2019) 65% of 14-17-year-olds who vaped had not yet smoked.
Average: say 60% overall.
Were they using nicotine?
Watts (2022) found that only 53% of ever-vapers had used a vape they knew contained nicotine, and 27% did not know if they if they were using it or not. Lets say 65% were using nicotine. Jongenelis (2023) reported that 58% of 12-17-year-olds adolescents who vaped in the last 30 days used nicotine weekly or more.
Average: say 62% were using nicotine.
These data can be used to calculate a rough estimate of the risk of nicotine dependence in 14-17-year-old Australians from vaping:
Result: A rough estimate of 1.7% of non-smoking 14-17-year-old Australians are currently vaping nicotine frequently enough to be at-risk of becoming nicotine-dependent