Understanding the Vaping Challenge in Australian Schools - and what can be done about it
Our Futures Institute
Author: Francesca Wallis.
With expert review by researchers at the Matilda Centre for Research in Mental Health and Substance Use.
From toilet breaks to lunchtime dealing, vaping has become a concerning presence in schools across Australia - prompting educators to ask not just how bad it is, but what can we do about it?
In a 2022 survey of Australian teachers and students, 86% of educators expressed high concern about vaping in their schools. Teachers have felt the need to police students by searching bags and pencil cases, and that managing the disciplinary issue of vaping disrupts teaching time [1].
In an effort to tackle vaping, some schools have resorted to locking school bathrooms, suspending students, or even installing vape-detectors at high costs. While the concerns that drive these measures are understandable and show how big the issue is, they are unsustainable, and there’s no evidence to suggest they work.
We know e-cigarette use is harmful, especially to young people with developing brains and bodies. We also know it has become a critical behavioural issue in Australian schools in recent years. Therefore, knowing how to tackle the issue effectively, and with an informed, harm-minimisation approach, is crucial. This article will explore the harms and risks of vaping and how schools can effectively address it, including through the OurFutures Vaping Prevention Program, which is now available for free to high schools nationwide via government funding.
Back to the first question:
Just how harmful is vaping (and what’s involved)?
The term ‘vaping’ refers to using an e-cigarette, whereby users inhale an aerosol produced by a liquid heated in the device (e-liquids). The first misconception is often that the “mist” inhaled is a vapour (hence the word “vape”), when it’s actually an aerosol, which is a mixture of gases and ultrafine chemical droplets. E-liquids contain flavourings and hundreds of chemicals, many of which are known causes of cancer and lung damage [2]. Other drug liquids (such as cannabis) can also be used [3].
The only legal e-cigarettes in Australia are those sold in pharmacies for the purpose of quitting smoking. These ‘therapeutic’ vapes are produced following tight regulations, including on the nicotine concentration, Most e-cigarettes contain nicotine, some in very high concentrations [4]. Illegally sold, unregulated vapes often contain nicotine at unknown quantities, even if they’re not labelled as doing so. In these vapes, chemicals are added to e-liquids to make the high concentrations of nicotine more palatable and to stop them from producing a ‘burning’ feeling when inhaled. This means it is very easy for young people to consume a lot of nicotine in a short period of time [5]. Concerningly, over half of adolescents who use nicotine e-cigarettes develop symptoms of dependence [6-8].
Nicotine is a highly addictive and harmful drug that can interfere with brain development in young people, affecting attention, learning, memory, and mood. Adolescent brains are particularly vulnerable to the effects of nicotine as they are still developing. Early nicotine exposure can “wire” your brain to be more addicted to nicotine, as well as increase the likelihood of co-morbid substance use and other addictions, memory impairments and other mental disorders such as anxiety and depression [9].
However, whether an e-cigarette contains nicotine or not, there are risks involved.
E-liquids and their aerosol can contain dangerous substances such as [6-8, 10]:
- Formaldehyde (used in industrial glues and for preserving corpses)
- Acetone (found in nail polish remover)
- Acetaldehyde (used in chemicals, perfumes, and plastics)
- Acrolein (found in weedkiller)
- Volatile organic compounds (VOCs)
- Heavy metals such as nickel, chromium, tin, arsenic, and lead
- Multiple flavouring chemicals and particulates – some of which are known carcinogens and found in products such as paint stripper, petrol, weed killer, and rat poison.
While some components of e-cigarettes have been deemed safe to eat or drink, they have not proven safe for inhalation.
Vaping Risks [6-8, 10]:
- Burns and injuries
- Mouth inflammation, gum disease, and oral health problems
- Throat irritation, cough, dizziness, headache, and nausea
- Nicotine overdose, including seizures and poisoning
- Nicotine dependence (adolescents are at higher risk)
- Respiratory illness, including risk of lung disease and EVALI (E-cigarette or Vaping use-Associated Lung Injury)
- Exposure to harmful chemicals as listed above
- Risk of developing chronic diseases such as lung cancer or cardiovascular disease
- Potential negative effect on brain function and development
- Potential negative effect on mental health and links with depression and anxiety
- Higher likelihood of taking up tobacco smoking (12-year-olds who have vaped are 29 times more likely to go on to try cigarette smoking [11])
It’s also important to remember that we don’t know the long-term health implications of e-cigarettes yet.
How big of an issue is vaping in Australian schools?
Vaping has become a huge burden on schools in recent years and only compounds the diverse challenges faced by teens. Data shows that 1 in 6 high school students have vaped recently, and as Minister Mark Butler stated, vaping has become “the number one behavioural issue in high schools” [12].
Meanwhile, the 2022-2023 Australian secondary schools survey found:
- 30% of secondary students had tried vaping at least once
- 13% of 12-15-year-olds had vaped in the last month
- 22% of 16-17-year-olds had vaped in the last month
Young people with higher depressive symptoms and stress have also been found to be more likely to vape, suggesting the importance of mental health support in addressing root causes of vaping [13]. Read more on this here.
So now for the big question: what can we do about it?
Schools need more effective tools and resources to help prevent students from vaping before harms occur, while also supporting them to quit through non-judgmental conversations and strategies.
Rethinking disciplinary measures
In 2022, the Australian Medical Association (AMA) conducted a study to explore students’, teachers’ and parents’ knowledge, attitudes and experiences of e-cigarette use to inform school-based prevention strategies [14]. Some strategies being used by schools included: handing out information sheets for students and parents, one-off talks from guest speakers, locking the toilets during class times, monitoring the toilets during lunchtimes, and one-on-one conversations with the Deputy Principal if caught vaping. Schools have also reported installing vape detectors in the school bathrooms.
A few notes can be made on these measures to help highlight what is helpful and what isn’t.
- Information sheets (containing evidence-based information) are a great idea, as it’s crucial to be armed with the facts. Young people are very impressionable and having information from evidence-based, reputable sources is a must. However, this is insufficient on its own for changing behaviour.
- ‘One-off’ talks from guest speakers may help get the conversation about vaping started, but they are not effective on their own. Often these one-off talks can give the impression that vaping has been “dealt with” and no further action needs to be taken. These talks rarely result in any change in vaping at schools and have no impact in the long term.
- Locking toilets (or installing vape detectors) and policing them may offer an immediate response to the problem but aren’t sustainable in the long run. These actions don’t directly deal with the issue or address underlying causes of vaping and may backfire. Students may feel unsupported, cornered, and will only find other (less supervised) areas to vape. Vape detectors can be easily “tricked” by spraying deodorant after vaping (which triggers them and then students claim it went off because of the deodorant, not the vape), or by vaping directly into the toilets and flushing. Locking the toilets can also be highly inconvenient to other students, particularly those with health conditions or special needs.
- One-on-one conversations with the principal can be beneficial, provided the conversation is productive. This means being supportive and non-judgemental. More tips for how to have a conversation with a teen about vaping can be found here.
School-based prevention approaches also preferably incorporate further measures to be most effective, such as:
- Utilising a social influence and social competence approach (which the most effective interventions are grounded in). This focuses on developing problem solving, decision-making, and resistance and assertiveness skills that help young people overcome pressure to use tobacco, alcohol or other drugs [7]. It is important to empower teens with behavioural control and self-efficacy, so they can feel confident enough to say no, and are equipped with strategies to do so.
- Taking a normative education This is an evidence-based approach that challenges students’ misconceptions about the prevalence and acceptability of risky behaviours, such as vaping. Teenagers may think they need to vape in order to fit in, as they have an exaggerated sense of the number of their peers who vape.
Accurate descriptive norms can be used to help students understand that most young people do not vape. Normalise non-use and reinforce positive social norms – highlighting the healthy majority over focusing on the unhealthy minority.
- Being personalised to the teen audience, using a targeted, engaging narrative and preferably using anecdotes.
- Using rewards to prevent uptake or motivate quitting. This could involve setting achievable and specific targets for reduction, possibly paired with a friend (or “accountability buddy”).
- Using different formats. E.g., group, 1:1, during and outside school, mobile apps.
- However, the more people involved, the better. Engaging parents and the broader community in conversations about vaping can reinforce the messages delivered within schools. This engagement. ensures that students receive consistent guidance and support both at school and at home.
More tips and information from Matilda Centre’s vaping expert, Associate Professor Emily Stockings, can be found here, including strategies to manage vaping in schools, following a harm-minimisation approach.
All of this and more has been put together into an evidence-based, online Vaping Prevention Program for high school students. To address the issue of youth vaping, the research team at the University of Sydney’s Matilda Centre for Research in Mental Health and Substance Use have co-designed the OurFutures Vaping Prevention Program with educators and students, using the best available evidence. The program has been undergoing evaluation in a cluster randomised controlled trial across 40 schools in NSW, QLD, and WA. This trial is Australia’s most rigorous evaluation of a vaping prevention program, and uses the same effective prevention education methodology as the other award-winning OurFutures programs. Initial results have shown that immediately after receiving the program, students had significantly reduced intentions to vape, as well as improved knowledge about the harms and risks associated with vaping. Almost all students said the skills and information they learnt would help them deal more effectively with vaping situations in the future.
The OurFutures Vaping Prevention Program is now available for free to high schools nationwide via funding from the Australian Government.
How does OurFutures Vaping Prevention work?
The OurFutures Vaping Prevention Program is PDHPE/HPE curriculum-aligned, and delivered in class for years 7-8. It consists of 4 lessons, each containing a relatable 20-minute cartoon story with accompanying activities such as interactive quizzes and class discussions. The program cuts through misinformation, adopting the same comprehensive harm-minimisation and social influence approach that all the OurFutures programs use. This involves providing evidence-based information about e-cigarettes and tobacco smoking and the harms involved, normative education to correct misconceptions on use, and resistance skills training, as well as strategies to break the cycle of nicotine dependence. It also provides all the most up-to-date legal and regulatory information. Booster and add-on programs for other age groups are being developed and tested to address specific issues, which will be coming soon.
Read more about the OurFutures Vaping program https://ourfuturesinstitute.org.au/positive-schools/
Addressing the vaping issue in schools is complex and requires a supportive, multifaceted approach that goes beyond short-term punitive measures. By focusing on evidence-based prevention education using harm-minimisation strategies, along with non-judgmental conversations, community engagement, and mental health support, schools can take a step towards lowering the risk of a new generation dependent on nicotine. Together, we can work towards a brighter and healthier tomorrow.
Author: Francesca Wallis.
With expert review by researchers at the Matilda Centre for Research in Mental Health and Substance Use.
References:
[1] B. Freeman, “Vaping and behaviour in schools: what does the research tell us?,” The Conversation, May 01, 2023. https://theconversation.com/vaping-and-behaviour-in-schools-what-does-the-research-tell-us-204794
[2] National Health and Medical Research Council (NHMRC), “Inhalation toxicity of non-nicotine e-cigarette constituents: risk assessments, scoping review and evidence map,” Australian Government, Feb. 2022. Available: https://www.nhmrc.gov.au/sites/default/files/documents/attachments/ecigarettes/Scoping_review_on_the_inhalation_toxicity_of_non-nicotine_e-cigarette_constituents.pdf
[3] Alcohol and Drug Foundation, “Vaping,” adf.org.au, 2024. https://adf.org.au/talking-about-drugs/vaping/
[4] Australian Government Department of Health and Aged Care, “About vaping and e-cigarettes,” About Vaping and e-cigarettes, Oct. 04, 2024. https://www.health.gov.au/topics/smoking-vaping-and-tobacco/about-vaping
[5] C Jenkins et al., “Chemical Analysis and Flavor Distribution of Electronic Cigarettes in Australian Schools”, Nicotine & Tobacco Research, 2024;, ntae262, https://doi.org/10.1093/ntr/ntae262
[6] Everything we know so far about vaping. www.vichealth.vic.gov.au. https://www.vichealth.vic.gov.au/our-health/everything-we-know-so-far-about-vaping
[7] L. A. Gardner et al., “Study protocol of the OurFutures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents,” BMC Public Health, vol. 23, no. 1, Apr. 2023, doi: https://doi.org/10.1186/s12889-023-15609-8.
[8] E. Banks et al., “Electronic cigarettes and health outcomes: systematic review of global evidence,” Australian Department of Health, Apr. 2022. Available: https://www.nhmrc.gov.au/sites/default/files/documents/attachments/ecigarettes/Electronic_cigarettes_and_health_outcomes_%20systematic_review_of_evidence.pdf
[9] F. Wallis, “How to Tackle Vaping in Schools: With Dr. Emily Stockings,” Our Futures Institute, Jul. 31, 2023. https://ourfuturesinstitute.org.au/how-to-tackle-vaping-in-schools-some-tips-from-matilda-centres-vaping-expert-dr-emily-stockings/
[10] Becker TD, Arnold MK, Ro V, Martin L, Rice TR. Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults. Nicotine and Tobacco Research [Internet]. 2020 [23.02.2024]; 23(3):[415-25 pp.].
[11] S. Egger et al., “The association between vaping and subsequent initiation of cigarette smoking in young Australians from age 12 to 17 years: a retrospective cohort analysis using cross-sectional recall data from 5114 adolescents,” Australian and New Zealand Journal of Public Health, vol. 48, no. 5, pp. 100173–100173, Sep. 2024, doi: https://doi.org/10.1016/j.anzjph.2024.100173.
[12] Department of Health and Aged Care, “National anti-vaping program for young Australians,” Australian Government Department of Health and Aged Care, Nov. 13, 2024. https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/national-anti-vaping-program-for-young-australians?language=en
[13] L. A. Gardner et al., “Research Letter: E-cigarette use and mental health during early adolescence: An Australian survey among over 5000 young people,” Australian & New Zealand Journal of Psychiatry, vol. 58, no. 12, Sep. 2024, doi: https://doi.org/10.1177/00048674241267908.
[14] Australian Medical Association, “Unpacking vaping in schools,” Australian Medical Association (NSW), May 13, 2022. https://www.amansw.com.au/unpacking-vaping-in-schools-2/
