Jason* is a general practitioner used to treating those addicted to tobacco, but he is at a loss as to how to help his 14-year-old son quit vaping.
His son started the habit when he was just 12 years old, and was the same age when he was arrested for shoplifting vapes containing nicotine from a convenience store. He got away with a caution, but New South Wales police did nothing to reprimand the store owners illegally selling nicotine vaping products.
Jason ended up reporting the store to the NSW health department, which raided the shop and confiscated $10,000 worth of illegal vapes .
“I’ve tried talking to my son, warning of the health impacts of vaping and nicotine, and I’ve tried shouting and all of that sort of thing to get him to stop,” Jason said.
“It doesn’t work, because nicotine is highly addictive. We tried giving him nicotine gum but it was a waste of time because the amount of nicotine in gum is so minimal compared to the amount you get from vaping that it did nothing for his cravings.”
Jason has resorted to giving his son two cigarettes a day to replace the vape. He knows tobacco is harmful and comes with significant health consequences, but is facing a quandary that is common to many health practitioners and parents when young people come to them and say they are addicted to vaping.
How do you help a teenager – or someone even younger – addicted to high quantities of nicotine, delivered through vaping, to quit? It is a relatively new phenomenon, with youth vaping rates in Australia doubling between 2016 and 2019. Doctors, teachers and psychologists who spoke with Guardian Australia said that anecdotally, rates of youth vaping have climbed particularly rapidly in the past 12 months.
“The amount kids are vaping each day could be equivalent to the amount of nicotine from smoking three or four packets of cigarettes,” Jason says. “Getting off vapes is not easy.”
On Wednesday the federal health minister Mark Butler announced public consultation on vaping reforms will begin, which he said are needed to tackle rising youth vaping rates.
Possible reforms include a ban on the import of all vaping products (whether they contain nicotine or not), plain packaging laws similar to those that apply to tobacco, and a ban on flavoured vapes that appeal to children.
“We now have a very serious challenge ahead of us,” Butler said.
“Parents know that vapes are being marketed out in our community with pink unicorns on them and bubble gum flavours. It’s no mystery who those are being pitched to … not just adolescents, but in some cases, younger children.”
Even vaping products labelled as nicotine-free, or that do not have nicotine on the ingredients list, most likely contain nicotine. Manufacturers do this to get around legislation that bans the import and sale of nicotine vaping products without a prescription.
A spokesman for health regulatory agency the Therapeutic Goods Administration told Guardian Australia that “all vaping products seized by the TGA under warrant were found to contain nicotine”.
Paediatric respiratory and sleep physician at the Royal Children’s Hospital Melbourne, Dr Moya Vandeleur, said along with the immediate and short-term impacts of nicotine such as throat irritation, increased blood pressure and heart rate, and coughing, “we are also very concerned about the long-term implications of nicotine addiction in young people”, especially given children’s brains continue to develop until the age of 25.
“There are known cardiovascular side-effects such as hypertension. There are known effects neurocognitively and on mood,” she said.
“But we also don’t know what other chemicals are being inhaled. Our fear is that similar to tobacco, these products may in the long-term be associated with oral and lung cancers but because they haven’t been around for as long as tobacco, the long-term data isn’t there.”
She said children and teenagers struggling with nicotine addiction can call the Quitline, talk to their general practitioner, and may also be referred to a psychologist. Vandeleur has been working with Quit Victoria to develop resources for general practitioners to help train them in talking to young people about vaping.
General paediatrician Dr Sarah Arachchi, who works throughout Melbourne, said she is concerned that addiction to vaping is confounding developmental and learning difficulties in some children.
“It adds to behavioural problems because children get agitated if they can’t access their vape. Addiction to vaping can exacerbate attention problems and relationship difficulties both at home and at school,” she said.
“I have also seen kids where vaping seems to have triggered their asthma, and I’ve seen children who only developed symptoms like coughing and chest pain after they started vaping.
“Some parents also have an attitude of ‘it’s just vaping, at least it’s not as bad as cigarettes’ so we really need better information for carers as well.”
Melbourne parent Justine* said she is well aware of the dangers of vaping, and was “horrified” when her now 17-year-old son began vaping at age 12. Her 14-year-old daughter has now started too.
While vaping, her son is irritable, sniffs and coughs and sometimes develops respiratory infections, she said. “When he’s clean from vapes he’s an early, good sleeper,” she said. “But on vapes he stays up late and can’t get up for school, and he also has pimply skin and bladder and bowel irritation.”
When he attempts to quit, he becomes verbally abusive and once even pushed her because she would not tell him where she had hidden his vape.
“He’s not like this when he’s clean,” Justine said. “My daughter is a completely different child now she vapes too. She misses school due to tiredness from a distorted sleep cycle, and she misses class due to frequent toilet breaks to vape.”
Justine said both of her children had been high academic achievers until they began vaping and suffering the symptoms of addiction and withdrawal. Her son was eventually expelled from his private school for the habit, despite previously being in the top 10% of students academically.
“I would detox him knowing that once he got to school it would be all lost again because of the mix of peer pressure and addiction,” she said.
“He has also used Snapchat to get vapes and drugs delivered, and they arrive faster than Uber Eats. You can get most things delivered to your home in 15 minutes. This year my son was using one product which has 3,500 puffs in it, the equivalent of 12 packets of cigarettes. It didn’t even last him a week.”
She said her children also bought their vapes “easily” over the counter at service stations, vape stores and from tobacconists.
“Nobody bothers with ID or, if they do, there’s a thriving market in fake IDs,” she said. “Older users become suppliers – effectively dealers – for the younger addicted children at schools.”
Justine said that despite standing by her children, trying to have open conversations with them and offering to help, she feels like she has failed.
“I now watch as they injure their health and completely alter their educational and life trajectory. Their relationship with me has been impacted,” she said.
“I have lost my children to vaping, and it is heartbreaking.”
*Names have been changed to protect the identities of children.
