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ABC News
ABC News
Health
The Context / By John Barron

Is vaping a safer alternative to smoking? We just don't know yet

Remember smoking your first cigarette? (Pexels: lilartsy)

Not so long ago, having your first cigarette was a rite of passage, like a first drink or a first kiss. 

Smoking a cigarette stolen from a parental pack was something kids did in secret, behind the bike shed, down at the footy oval. It was a form of play, pretending to be a grown-up.

Vaping is hailed by some as the safer alternative to smoking, but we don't know the long-term effects of vaping. (Pexels: Dede Avez)

Now that first puff is more likely to come from a vape inhaler as tobacco companies pivot to survive.

Vaping is the new black

Hailed by some as a safer alternative to smoking, there are growing concerns vaping is creating a new generation of nicotine addicts, some of whom will end up as tobacco users.

Vaping fluid, turned into an inhalable vapour by a heating element in an e-cigarette, is widely available in retail stores and online.

While fluid containing nicotine is only legally available in Australia with a prescription, vapers will tell you it's not hard to get.

Many vaping fluids sold over the counter labelled as non-nicotine, do in fact contain nicotine.

Professor Simon Chapman urges caution — and strong regulation — when it comes to vaping. (Supplied: Sydney University Press)

Professor Simon Chapman, who has been at the forefront of public health efforts against tobacco smoking since the 1980s, spoke to The Context this week and said it took decades for the deadly effects of tobacco smoke to become clear, and it may be the same with vaping.

"Some of my biggest concerns are with flavourants," Chapman says.

"The average vaper who vapes daily takes about five to six hundred puffs and we really have no idea what the long-term consequences of that are going to be."

Should vaping be regulated like cigarettes?

Professor Chapman says time is running out to prevent a repeat of the past. He and others want to see all vaping fluid made prescription-only and importation heavily restricted.

"We need to be very, very cautious. We need to err on the side of strong regulation."

Nicola Roxon, who now chairs VicHealth, Victoria's Health Promotion Foundation, is similarly dubious about the tobacco industry's motives in promoting vaping.

Former federal health minister Nicola Roxon — who championed plain packaging for cigarettes — doesn't trust the tobacco industry's promotion of vaping. (ABC News)

"I don't think the industry has earned the right to be trusted, which is kind of their argument on vaping — 'look trust us, it's not as bad as tobacco, at least it will help some people quit' — when the early signs are it's actually being used as an entry product back into smoking."

Researchers at the ANU came to a similar conclusion, stating: "There is strong evidence that non-smokers who use e-cigarettes are three times as likely to go on to smoke combustible tobacco."

Other studies suggest around 10 per cent of 14 to 17-year-olds are now vaping, a higher proportion than regularly smoke.

Some Australians are still smoking – most want to quit

Currently around 12 per cent of men and 8 per cent of women smoke – around half of what it was at the turn of the century.

Yet smoking rates in the Indigenous population are three times that.

A quarter of adult Australians used to smoke but have quit, while more than 60 per cent of us have never smoked. Of those who do, 70 per cent say they want to quit.

People experiencing problems with their mental health are much more likely to be smokers. More than 30 per cent of those with social phobias, more than half of people with general anxiety and two-thirds of people experiencing some form of psychotic disorder smoke.

People with mental health issues are more likely to be smokers. (Pexels: Masha Raymers)

Where you live can also be an indicator of whether you're still likely to smoke.

People living in remote areas smoke at a rate of around 20 per cent. It's 13 per cent in the regions and around 10 per cent in our cities.

People in the lowest-income areas are almost four times more likely to smoke than those in the richest areas.

The highest smoking rates are now among people in their fifties, followed by the forty-somethings.

Fewer than 5 per cent of people aged over 70 smoke, in part simply because many older male smokers have died.

People in their twenties were the biggest smokers 20 years ago — that's fallen from 31 per cent to 13 per cent today.

Smoking used to be cool

Back in the day, smoking was fun and glamourous. (Pexels: cottonbro)

There was a time when smoking was everywhere.

Ornate ashtrays adorned every coffee table, dining table, even the bedside table.

You could smoke on trains, on planes, in taxis, in pubs, clubs and the finest restaurants.

On TV and in the movies, everyone seemed to smoke almost non-stop.

A cigarette draped from Humphrey Bogart's lip was a sign of both toughness and nonchalance; in James Dean's hand it was rebellious, even dangerous; in Audrey Hepburn's long holder, it spoke of elegance.

For a bunch of burning leaves rolled in a piece of paper, a cigarette sure had acting range.

Two Australian soldiers light up cigarettes for each other after heavy fighting when victory had been won against the Vichy French. (Supplied: Australian War Memorial)

At the end of World War II in 1945, 72 per cent of Australian men and 26 per cent of women smoked.

Servicemen were given free cigarettes with their rations.

A smoking soldier was, by definition, at ease, relaxing between battles or after victory had been won.

You couldn't see people smoke on the radio, but the ads told they were rich, mild, tasty and smooth on the throat.

That was our first clue.

Cigarettes and the other 'C' word — cancer

Until smoking became commonplace in the first decades of the 20th century, lung and throat cancers were comparatively rare.

Doctors started noticing more and more cases until by the 1950s it was impossible to ignore.

In 1957, Humphrey Bogart died from smoking-related cancer of the oesophagus.

In 1964, the US Surgeon General announced cigarette smoking was "causally related to lung cancer", and a few months later singer Nat King Cole died from the disease at the age of just 45.

It was only in 1964 that the link between cigarette smoking and lung cancer was officially made by the US Surgeon General. (Pexels: Anna Shvets)

Female smoking rates peaked at 33 per cent in the mid-1970s, after tobacco companies targeted the economically empowered women's movement to make up for lost male smokers.

Faced with overwhelming evidence, and a growing burden on health budgets, the 1970s saw a phased ban on tobacco advertising on Australian television and radio.

It took much longer to remove cigarette ads from billboards, newspapers and magazines.

Plain packaging dulled the glamour of smoking

Tobacco companies still bought their way onto TV screens through sporting sponsorships into the 2000s, until finally a decade ago when their brands were effectively taken from them in Australia with world-first generic packaging.

That reform was championed by then-federal health minister Nicola Roxon, who told The Context it was aimed at stopping younger people from wanting to start smoking in the first place.

"The way that tobacco is appealing, the way that packets looked, making them uglier, making it embarrassing for people to have them on the table at the pub."

Smoking was no longer associated with glamour: the drab packs now linked it to phlegm and gangrene.

Government-mandated increases in tobacco taxes had an impact too.

Back in 1980, a pack of cigarettes cost $1.10 (adjusted for inflation, that's around $5) compared with close to $50 for a pack today.

Price, along with health concerns, is the major reason people say they've quit.

So, all-in-all we have come a long way, although because death from smoking-related illness often involves a time lag of many years, we are still seeing in excess of 20,000 deaths from smoking-related disease each year.

The Context with John Barron puts news and major issues into historical, international and factual context. The new show airs on the ABC on Friday nights at 8PM AEST.

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