New ACYP report confirms lack of awareness among young people regarding detrimental effects of vaping
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A new report released by the NSW Advocate for Children and Young People, Zoë Robinson, calls for greater supports to help young people stop vaping.
The report, released by the Advocate on Thursday October 19, details findings from consultations with 261 young people across NSW to ascertain their perceptions and experiences of vaping.
Vaping use is on the rise, particularly for young people aged under 24 years. Between 2016 – 2020, the proportion of 18–24-year-olds using e-cigarettes tripled to 27.2%. The NSW Population Health Survey reported use of e-cigarettes was highest among persons aged 16-24 years, for both ever used (32.7%) and currently using (11.1%)..
Despite the view commonly expressed to ACYP by young people that vapes are relatively harmless, the chemicals in vapes are often toxic, cancer causing and unsafe for inhalation. Vapes contain the same harmful chemicals found in cleaning products, nail polish remover, weed killer and bug spray.
As of October 2021, a prescription was required in order to purchase nicotine-containing vape products in Australia. Despite this, many over-the-counter nicotine-free products were found to contain nicotine when tested. They are being sold illegally and easily accessible online.
Evidence finds nicotine in one vape can equal 50 cigarettes.
Vapes are designed to appeal to young people through packaging and flavours. NSW Health notes that young people are a target demographic for tobacco companies looking for new customers, and that vapes are a newer method to get young people addicted to nicotine. Viral online trends involving vapes have become increasingly popular and the rate of vaping amongst young people is steadily rising.
'This is our opportunity to get it right. We cannot afford to play catch up with the evidence and risk another generation’s health and future.' the ACYP states
Ms Robinson said, “Through consultations we have learned that vaping culture is strongly influenced by peer pressure, used as a stress management tool and there is an alarming misunderstanding of how harmful it can be to your health.
“Young people believe that it can’t be that bad for you because if it was, interventions such as banning would already be in place.”
Despite restrictions on trade, young people noted that vapes are easily purchased or accessible through their friends.
They also noted through consultations that the secrecy around vaping and fear of punishment reduced the likelihood of them reaching out for help to stop vaping.
One young person said, “If young people want to quit, it’s hard, because you have to do it alone, you can’t go to your parents or teachers to talk about it.”
“We have an opportunity to work with young people to remove the barriers in place to them accessing support to quit vaping,” Ms Robinson said.
Young people who vape identified in-person support, nicotine gum or sports rather than “happy chemicals”, app-based support and banning vapes, social media based messaging as the top four supports they would access if they were available.
“Young people told us that they didn’t think vaping was dangerous because if it was the adults would have banned it. It us up to policy makers, advocates and myself as Advocate to take the necessary steps to support young people to stop vaping,” said Ms Robinson.
Ms Robinson said, “We’ve heard from young people that it’s not a one-size-fits all, and it’s important that we develop a suite of supports, rather than a single approach to ensure more young people are able to find a support suitable for them.”
The Vaping report: Young People's Perspectives on Vaping in 2023 makes 11 Recommendations, listed below.
The Young people’s perspectives on vaping in 2023 report is available on www.acyp.nsw.gov.au and may be downloaded at:
NSW Government to host Vaping Roundtable
On Wednesday October 18, 2023 the NSW Government announced it will hold its Vaping Roundtable on 16 November as the next step in its commitment to curbing the growing issue of vaping in NSW schools.
This week, invitations were extended to key stakeholders to take part in the NSW Government’s first Vaping Roundtable.
The roundtable will hear from principals, students, health experts, and other key stakeholders about the community-wide issue of vaping.
The Vaping Roundtable will:
- Hear evidence on how vaping is affecting young people and schools
- Discuss effective school-based vaping interventions
Those invited to the roundtable include NSW Chief Health Officer Dr Kerry Chant, Manager of the Cancer Council NSW’s Tobacco Control Unit Alecia Brooks, University of Sydney School of Public Health Associate Professor Becky Freeman, leaders from the NSW Department of Education, along with the NSW Teachers Federation, NSW P & C Federation and the NSW Advocate for Children and Young People.
A number of NSW public, independent and Catholic primary and secondary school principals have also been invited to the roundtable to discuss their experiences of dealing with vaping and vape-related incidents in their schools.
Information and findings gathered at the roundtable will be used to inform future NSW Government policies and interventions into combatting the issue of vaping in schools.
This work comes in addition to $6.8 million invested by the NSW Government in cracking down on the sale of illegal vapes, to support young people addicted to vaping.
This work will also complement measures implemented by the Australian Government, including its commitment to restrict the sale of vapes and e-cigarettes.
Premier of New South Wales Chris Minns said:
“We’re committed to addressing the prevalence of vaping in NSW schools.”
“The evidence suggests that vaping is now becoming a gateway for an increase in smoking rates in young people.
“This is a way to hear directly from schools, health experts and other key stakeholders on how we can begin to address this serious health issue in our schools.”
Deputy Premier and Minister for Education and Early Learning Prue Car said:
“Many principals, teachers, parents and schools are struggling with the growing issue of vaping, and how best to deal with it.
“Vaping is a community-wide issue, and the Minns Labor Government is committed to addressing it with an evidenced-based approached.
“It is important we take on board what we are hearing form health experts, and we listen to what our teachers and principals are telling us.”
Minister for Health and Minister for Regional Health Ryan Park said:
“The Minns Labor Government is committed to doing all we can to protect our students from the dangers posed by vaping.
“We know the number of young people vaping is growing, and it’s important we move ahead with an evidenced-based measures to tackle this concerning issue.
“It’s important we take the time to consult with experts as we formulate the best step forward as we look to curb the issue of vaping within our schools.”
Key Findings of the NSW Advocate for Children and Young People
Perceptions of vaping
Young people who participated in consultations had diverse perceptions about vaping and vaping culture in schools.
• When asked what vaping was like at their school, the majority said vaping was common at their school, most popular with younger cohorts and started from year 7.
• Almost half of the young people ACYP consulted with had either tried vaping or were vaping1.
• Acceptance of vaping as a habit was strongly influenced by their social circles and the social norms associated with their peer groups.
• The experience of vaping as both an individual and a social habit came out strongly.
• Despite the restrictions and laws on vapes, most young people know where to access vapes.
• Young people are willing to share vapes and will make a communal effort to hide or conceal locations of vapes.
Why young people choose to vape
Young people who participated in consultations identified the reasons why young people chose to vape was mainly associated with the social influence of a friend or peer.
• With vaping seen as a normalised behaviour in most schools, ACYP notes there was a common understanding that vaping could help a young person “fit in.”
• There was also a lack of understanding about the negative long-term health impacts and consequences of vaping. Some level of understanding of the health impacts was not a strong deterrent among vapers.
• The flavour, packaging and taste were seen as appealing to young people. Vaping was also seen as cost-effective.
• Young people shared the ability to relieve stress as a reason to vape and that some young people who tried it, then became addicted.
• Addiction was listed as the strongest deterrent they would use to convince a friend not to vape among vapers.
1ACYP consulted with 116 young people who self-reported they either vaped or have tried a vape.
Why young people do not vape
Despite the potential health impacts not being a deterrent for some, young people who participated in consultations shared that this was the main reason young people provided about why young people would not vape.
• All focus groups mentioned the physical health impacts on the body including “black lung”, “cancer”, “breathing” issues. However, many young people were unable to articulate how and why vaping impacted them. Often, they would say there “isn’t enough research” or would refer to their knowledge of cigarettes when explaining the impacts of vapes.
• Prioritising opportunities to excel in sport was an important reason young people would choose not to vape.
• The fear of getting into trouble deterred some young people from vaping.
• Graphic imagery (i.e., vapes exploding in cars, graphic images) was mentioned to be a deterrent for some young people. Young people encouraged greater use of confronting images to discourage young people to vape.
• Young people in consultations reported someone to talk to was the most important feature of supports to help a young person to quit vaping.
• Confidentiality and trust were key to this, as was any support being provided by a young person (under 35 years).
• After social supports, vapers were likely to suggest alternative activities (e.g., toys, hobbies) or substitutes (nicotine gum and spray) as most effective diversions from vaping. This was followed by greater regulation to ban or limit access to vapes.
• Some young people called for more education and awareness on the harms and addiction associated with vaping, most commonly non-vapers. While further education is likely an effective preventative measure for some, those who vape felt it was a minimum expectation but was not likely, in isolation, to change their behaviour.
• When testing their response to tools or services to support young people to stop vaping, the top three choices were in person support, app-based support and social media.
• Overall, vapers were slightly more likely to use an app.
• When asked, young people spoke passionately about how schools could respond to vaping, including that it starts with a conversation.
Regulatory context and ongoing work: Regulatory change
ACYP acknowledges the ongoing work of both the Commonwealth and State Governments to address vaping – particularly among young people – and notes there have been commitments at the Federal level that are still in the process of being implemented across states and territories. .
This includes the recently concluded public consultation on the need for reforms to address potential limitations of the tobacco control framework and streamline existing regulation under the Public Health (Tobacco and Other Products) Legislation 2023, as well as proposed regulations in relation to graphic health warnings and health promotion inserts that are scheduled for future consultation. .
ACYP also recognises the Federal Government’s commitment to:
• Limit the use of appealing names that imply reduced harm and capture vapes in advertising restrictions; and
• Implement new controls on e-cigarette importation, contents and packaging and commitment to work with States and Territories to address the black market for cigarettes..
Public health messaging
There has also been significant investment in public health campaigns about vaping. ACYP acknowledges this is a priority for the State Government in NSW, with its continued investment in the Do you know what you’re vaping? campaign and associated toolkit materials, targeted to address vaping among young people.
ACYP also acknowledges the Federal Government’s commitment in the 2023-2024 Budget to provide $63.4 million over four years for national public health campaigns to prevent uptake and reduce smoking and vaping, including funding for a targeted youth campaign. In addition, the National Tobacco Strategy 2023-2030 outlines actions related to public health campaigns and other communications mechanisms under Priority Area 2.
Vaping cessation supports
ACYP notes there has a been a commitment from the Federal Government in the 2023-24 budget for funding towards Vaping Regulation Reform and Smoking Cessation Package, including $29.5 million over 4 years to increase and enhance smoking and vaping cessation support.
ACYP also notes the ongoing work of the Cancer Institute in managing the NSW Quitline and their collaboration with ACYP about understanding young people’s preferences for support.
ACYP would be eager to participate in discussions about how high school students – particularly older students – might access support from school counsellors in line with their emerging capacity to consent in health contexts outside of a school environment.
Throughout the recommendations of this consultation report, ACYP has highlighted the need to co-design and evaluate resources and supports with young people and does so while acknowledging that existing public health campaigns have already been informed by research with young people.
ACYP’s recommendation is that young people’s voices drive the ongoing work to address vaping across NSW.
Promoting youth participation
ACYP has been collaborating with the NSW Ministry of Health and Cancer Institute to ensure young people’s perspectives are at the centre of their ongoing work and acknowledges the investments they have made into research. In addition, the NSW Department of Education has sought the feedback of the NSW Youth Advisory Council as they developed classroom resources on vaping.
ACYP notes that concerns about confidentiality when accessing wellbeing support is a common theme across our consultations – particularly with school-based supports. In some cases, ACYP acknowledges this may be a degree of miscommunication between the practitioner and the young person about the limits of confidentiality.
However, this indicates a need for greater clarity for young people to understand what aspects of their conversation will or will not be confidential. ACYP also acknowledges the considerable time, resources and work that schools already dedicate to addressing vaping.
The following recommendations have been made based on the findings of this consultation report, and ACYP notes that some align with ongoing work or commitments that have already been made by government, reinforcing the need for change. Further detail about this overlap can be found in the ‘Regulatory context and ongoing work’ section of this report.
1.1: As proposed as new legislation at the time of drafting, the Australian Government Department of Health and Aged Care should expand existing legislation related to tobacco advertising, plain packaging and graphic health warnings to include e-cigarette products.
Responsibility; Australian Government Department of Health and Aged Care, working with the Australian Competition and Consumer Commission and the NSW Ministry of Health.
1.2: The eSafety Commissioner should explore opportunities to prohibit advertising of e-cigarettes, if able to be classified as Class 2 material “inappropriate for children and young people under 18 years old” under the Online Safety Act 2021, on social media platforms
Responsibility; The eSafety Commissioner.
1.3: Invest in NSW Health inspectors to continue existing enforcement work regarding the illegal sale of e-cigarettes in retail settings and online
Responsibility; NSW Health Inspectors, in partnership with NSW Police, Australian Border Force.
1.4: Local councils should continue to invest in free and accessible recreation programs and spaces to provide young people with positive alternatives to engaging in vaping. This will also act as a diversion away from engaging in alcohol and other drugs, as well as promoting positive community engagement.
Responsibility; Local Councils across NSW.
2.1: Advertising campaigns should include a variety of different information points to remain fresh and equip young people with a deeper understanding of the health harms of vaping. ACYP welcomes the ongoing commitment to test advertising campaigns with young people.
Responsibility; NSW Ministry of Health, Australian Government Department of Health and Aged Care.
3.1: Supports for young people should be co-designed with, tested and evaluated by young people.
Responsibility; NSW Ministry of Health, in collaboration with the Cancer Institute, Office of the Advocate for Children and Young People, Australian Government Department of Health and Aged Care.
3.2: Develop a suite of supports, rather than a single approach, to ensure more young people are able to find a support suitable for them.
Responsibility; NSW Ministry of Health, in collaboration with the Cancer Institute, Australian Government Department of Health and Aged Care.
3.3: Develop an online tool and app with young people that provides factual information and provides supports for cessation.
Responsibility; NSW Ministry of Health, in collaboration with the Cancer Institute, Australian Government Department of Health and Aged Care.
3.4: Teachers, school counsellors and student support officers should receive material and training about vaping and how to support and help students.
Responsibility; NSW Department of Education in collaboration with Ministry of Health and the Cancer Institute.
4.1: Universal provision of education about the specific health harms of vaping, should be co-designed with young people, and coupled with advice and referral to supports for both parents and young people
Responsibility; NSW Department of Education, Office of the Advocate for Children and Young People, Association of Independent Schools NSW and Catholic Schools NSW.
4.2: Department of Education, Australian Independent Schools NSW, and Catholic Schools NSW should not pursue the use of vape detectors as a method to reduce vaping in schools, given young people indicated they were not a useful approach to prevent young people from taking up vaping or to prevent them from vaping on school grounds
Responsibility; NSW Department of Education, Association of Independent Schools NSW and Catholic Schools NSW.