National advice on the use of electronic cigarettes based on the most up-to-date scientific evidence has been delivered by Australia’s health and medical research agency, the National Health and Medical Research Council (NHMRC).
The 2022 NHMRC CEO Statement on E-Cigarettes is the most current advice on health impacts of e-cigarettes and is based on in-depth evidence reviews and an extensive toxicology report.
The advice states clearly that the vapour from e-cigarette devices can be harmful and there is limited evidence that e-cigarettes are effective at helping smokers quit.
Australia’s Chief Medical Officer and Chief Health Officers from all states and territories support the findings and welcome the statement which will inform public health advice and policy decisions.
Based on the latest scientific evidence, the advice states:
- All e-cigarette users are exposed to chemicals and toxins that have the potential to cause harm. In addition to nicotine, more than 200 chemicals have been associated with e-liquids.
- E-cigarettes containing nicotine are addictive and people who have never smoked are more likely to take up tobacco smoking.
- E-cigarettes are not proven safe and effective smoking cessation aids. There are other proven safe and effective options to help smokers quit.
“The design and technology behind e-cigarettes continue to evolve but the method is the same – e-cigarettes deliver harmful substances direct to the lungs,” said NHMRC CEO Professor Anne Kelso AO.
“We know from data gathered nationally that the number of e-cigarette related calls to Australian Poisons Information Centres doubled between 2020 and 2021," Professor Kelso said.
“If you have never used e-cigarettes, don’t start – the evidence shows there is a possibility you will go on to smoke tobacco cigarettes.
“As for smokers, the evidence remains unclear whether e-cigarettes help people quit – for example, it is common for smokers to become dual users of both e-cigarettes and tobacco products instead. There are many proven quitting aids to try before considering e-cigarettes.”
NHMRC is the Australian Government’s lead agency for health and medical research and provides transparent, systematic and robust evidence to support public health advice. The updated statement replaces the previous version issued in 2017 and provides public health advice through the review of the evidence on the safety of e-cigarettes and their efficacy for smoking cessation.
The CEO Statement is intended as a resource for individuals, organisations, policy and decision-makers, health professionals, parents and family members, and educators.
What we found:
This is not just about nicotine
E-liquids can also contain nicotine, even if labelled “nicotine free”. Nicotine is well understood as the addictive component of tobacco cigarettes.
E-liquids used in e-cigarettes are a mixture of many chemicals, which can include flavours, solvents and humectants.
Recent reports have found more than 200 unique chemicals used in e-liquids. This is constantly changing and the chemicals in e-liquids may vary. These chemicals have the potential to cause adverse health effects.
Poisoning and health effects
E-cigarette-related calls to Australian Poisons Information Centres doubled between 2020 and 2021.
Use of e-cigarettes can result in seizures.
Use of e-cigarettes can result in E-cigarette or Vaping Associated Lung Injury (EVALI).
Use of e-cigarettes that contain nicotine can cause throat irritation, cough, dizziness, headaches and nausea.
More research is needed on the potential impacts of e-cigarette use on conditions such as cancer, cardiovascular disease, reproductive health, respiratory outcomes and mental illness.
Getting the message to young people
According to the 2019 National Drug Strategy Household Survey, while fewer Australians are smoking tobacco daily, the use of e-cigarettes is increasing. In Australia, between 2016 and 2019 the proportion of people who had ever used e-cigarettes rose from 8.8% to 11.3% with a notable increase among youth and young adults. Nearly 2 in 3 (64%) current smokers and 1 in 5 (20%) people who had never smoked aged 18–24 reported having tried e-cigarettes.
When first using e-cigarettes, 64.5% of youth aged 14–17 and 39% of young adults aged 18–24 were never smokers. Among those who had tried them, frequency of use also increased, with more people using them at least monthly (from 10.3% in 2016 to 17.9% in 2019), weekly (from 2.9% in 2016 to 5.1% in 2019) and daily (from 5.8% in 2016 and 9.4% in 2019).
E-cigarettes are not a proven aid for smoking cessation
No brand of e-cigarette has been evaluated or approved by the Therapeutic Goods Administration (TGA) as a smoking cessation aid.
The safety, efficacy and performance of specific products and components are not known, even when they are obtained on prescription.
Due to the high level of uncertainty in the evidence of efficacy of e-cigarettes for smoking cessation, smokers wishing to quit should seek further information about e-cigarettes from reliable sources, such as the relevant Commonwealth, State or Territory Health Department, their healthcare practitioner or quit services. There are several proven alternative safe and effective cessation aids available to try before e-cigarettes.
Read the revised NHMRC CEO Statement on E-Cigarettes.
Resources are available in the download section.
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