School children believe vaping is "relatively harmless" and helps them deal with stress and anxiety, according to school teachers and counsellors dealing with the fall-out from the youth vaping crisis.
As the federal government promises to clamp down on the thriving black market in vapes, Perth clinical psychologist Donna Stambulich is one health professional who is seeing evidence of a new generation of nicotine addicts.
She said there had been a significant rise in the number of parents accessing treatment for their children, aged 12 to 24, where vaping was a factor.
"I saw 34 kids as a solo practitioner just last year which is a huge rise from two years ago ... it [vaping] really wasn't on our radar," Ms Stambulich said.
"[It's] perhaps not the main reason why they are walking in the door in the first place, but it is certainly one of the factors as to why they are presenting for treatment.
"Generally speaking, e-cigarettes go hand in hand with something not quite right with the young person in their life.
"It could be social isolation, anxiety, depression."
Ms Stambulich said young girls with body image issues were using vaping as an appetite suppressant.
"Lots of girls coming in, adolescent girls with body dysmorphia, eating disorders and thinking that having an e-cigarette is going to decrease their appetite, instead of eating, which is just incredibly sad," she said.
Popularity rises among under-18s
Under existing laws, nicotine vapes can only be purchased with a prescription by adults trying to quit smoking.
It is illegal to sell or possess nicotine vapes without a prescription.
But in reality, there is a growing cohort of vapers among people under 18, buying mainly disposable vapes on the black market that are being imported and marketed in fluorescent colours and sweet flavours.
Teachers, nurses and students have told a new study that kids as young as 11 are vaping at school and "vape deals" within school grounds, where students buy in bulk and sell to others, are a regular occurrence.
Researchers from Curtin University's School of Population Health were told that some students believed e-cigarettes were harmless, despite some vapes containing the same chemicals found in cleaning products, weed killer and nail polish remover.
One student told the researchers: "You don't see too many 'vaping is bad for you ads' and all that stuff, but also the smell is nicer. Like it just feels cleaner … but I don't actually know."
The researchers interviewed about 70 parents, teachers, school nurses and young people, aged 14 to 18, at schools in the Perth metropolitan area.
Their research is yet to be published.
Lead researcher Jonine Jancey said the study had confirmed that vaping was widespread in schools and teachers were extremely concerned about it.
Teachers told researchers that the vapes were being easily hidden at school because they were being produced to look like everyday items like pens, highlighters and USB drives, and the aroma from the vapour dissipated quickly.
"They also spoke about the impact on them, the teachers themselves, how they were quite distressed about the whole issue, also about how they were having to send young people home after they had vaped too much and they were sick," Professor Jancey said.
In an attempt to combat the rising popularity of vaping, the WA Department of Education and Department of Health has released an anti-vaping toolkit for schools, designed to raise awareness about the health risks of using electronic cigarettes.
School suspensions soar
Figures show suspensions from schools due to vaping have skyrocketed.
In Queensland, drug-related suspensions doubled last year to more than 8,000 with the increase driven by vaping.
In Western Australia, there were 3,732 suspensions in the state's public schools last year due to vaping.
In the first five weeks of the school term this year, there were 570 suspensions.
Young people's growing attraction to vaping is supported by a recent survey by the George Institute for Global Health, which found 14 per cent of 1006 Australians aged 15 to 30 surveyed were e-cigarette users.
The Institute said that was a notable increase from a 2019 National Drug Strategy Household survey that found about 5 per cent of young adults were current users.
Last year, within a six-week period, the WA government seized more than 15,000 disposable nicotine vapes from retailers across the state despite it being illegal to sell nicotine vaping products to anyone, regardless of their age, without a prescription.
Calls to ban vaping
With the normalising of vaping among young people, the federal government is under growing pressure to strengthen border controls on vaping products and even ban them altogether.
John Blakey, a respiratory physician at Perth's Sir Charles Gairdner Hospital, supports the latter option.
He is worried about the serious damage Australia's young people are doing to their lungs, both in the long and medium term.
"For example, they will cause an increase in inflammation in the lung, they cause an increase in the stickiness of bacteria to the airway wall so people are more likely to get infections and infections are more likely to be severe," he said.
"We've done so well reducing the amount of nicotine dependence in Australia.
"And this is one way in which large tobacco companies are trying to recruit new smokers to replace those who have either died or quit.
"And we don't want that problem to rear its head again and cause those hundreds of thousands of preventable deaths that it could cause if our smoking or nicotine dependence rates go up again."
Many of the disposable vapes that young people buy don't provide any information about nicotine content, yet studies have shown most of the products do actually contain the drug.
Dr Blakey, who is also senior clinical research fellow at the Institute for Respiratory Health, said even without nicotine, vapes were potentially dangerous.
"If you are taking organic compounds and heating them and inhaling them and you're not quite sure what's in those organic compounds, they certainly can be harmful," he said.
Regulation on the way
Sweeping changes to the regulation of vapes across the country are expected this year.
The Therapeutic Goods Administration has made recommendations to the federal government about possible reforms following a public consultation process.
In its submission, the Thoracic Society, for which Dr Blakey is the WA branch president, described vaping as a "public health emergency", saying that since nicotine vapes arrived on the market as "untested consumer products", the evidence for direct harm to the lung had steadily accumulated.
At the other end of the scale, the Australian Association of Convenience Stores is pushing for a similar model to New Zealand where nicotine vapes can be sold to adults, much like cigarettes.
Both sides want the end of the current black market.
But Dr Blakey cannot see the value of allowing vapes at all, saying there are more effective ways of getting smokers off cigarettes, for good.
"Studies show most people who switch onto vaping just carry on vaping," he said.
"It's not sufficient just to move people from cigarettes onto vaping and leave them on that."
The federal government is currently working with state health ministers on a suite of new measures around vaping.
Coping with the fallout
In the meantime, parents and teachers are trying their best to deal with the latest, highly damaging school craze.
"Most parents are just in fear, they are absolutely petrified and terrified that their child is vaping and also what that's going to lead onto," Donna Stambulich said.
"They feel guilty, 'how did I miss this? Why wasn't I present enough?'"
Ms Stambulich advised parents not to overreact but also not to go into denial if they found their child was vaping.
She said parents had to educate themselves about the harms and pick the right moment to talk to their children.
"In the car, going for a walk with the dog down the beach, just in a very non-confrontational way," she said.
WA's Mental Health Commission said its Drug and Alcohol Youth Service (DAYS) provided a free and confidential service to young people aged 12 to 21 and their families including counselling, rehabilitation, medical and psychological services.
"DAYS clinicians offer information and support to young people to help reduce smoking or vaping, however young people using the DAYS are primarily seeing help to cease or reduce other drug use," Mental Health Commission Deputy Commissioner Operations Ann Marie Cunniffe said.
The commission said DAYS doesn't collect data on vaping, but it estimated the number of enquiries to be very low.
- For confidential, one-on-one assistance from a qualified mental health and alcohol and other drug counsellor call the Here For You helpline on 1800 437 348 between 7 am and 10 pm.
- Anyone concerned about their own or another person’s alcohol or other drug use can call the 24/7 Alcohol and Drug Support Line on 08 9442 5000 (metro) or 1800 198 024 (regional).
- Mental Health Emergency Response Line (MHERL): 24/7 support for people experiencing a mental health emergency and if required, referral to local mental health services 1300 555 788 (metro) and 1800 552 002 (regional).
- In a crisis call Lifeline on 13 11 14 or call beyondblue on 1300 224 636 for free counselling.
- In a life-threatening emergency call 000 or visit your nearest emergency department.
- Visit the MyServices directory (www.mhc.wa.gov.au/getting-help/my-services-online-directory) to find mental health, alcohol and other drug services close to you.