Teen vaping is way less common than the news claims

21July 2020

ABC

Last week, Australian school playgrounds were reportedly awash with vaping smoke: Over 65 per cent of adolescents (14-17 year olds) were using e-cigarettes, one major news site said, quoting a new national survey of drug use.

And it wasn’t just the kids: 39 per cent of young people (aged 18-24) were vaping. The smoke was spreading. This wasn’t just smokers vaping on the side, the article said: e-cigarette use among non-smokers had quadrupled in six years.

Another news site reported the rate of vaping among 18-24 year olds had rocketed from 7 per cent to 20 per cent in three years. Admittedly, this was lower than what had been reported elsewhere, but still alarming stuff.

What was going on? Vaping had become more popular, but surely we would have noticed if vape pens were now as common as the iPhone.

Who were these mysterious juvenile vape-lords? 

Where were they?

Hack can report that on closer analysis they do not exist.

The figures being quoted were from an unimpeachable source: the 2019 National Drug Household Strategy Survey conducted every three years by the Australian Institute of Health and Welfare. It’s considered the most comprehensive snapshot of what Australians of all ages have been popping, snorting and inhaling.

This time around, the survey’s figures for vaping among young people had been especially anticipated. In previous weeks we’ve seen breathless coverage of “a significant increase in vaping among teenagers at Sydney schools” forcing principals to take the extreme step of writing to parents to warn them.

Teachers had caught Year 7 students “becoming dealers”, one news site said.

This followed last month’s announcement that sale of nicotine e-cigarettes and refills would be banned in Australia from July 1. The reason? Young people were vaping too much. Ex-smokers argued that vaping had helped them quit and now they would have to go back to cigarettes, which were more dangerous. After a week of pressure from his own backbench, Health Minister Greg Hunt extended the deadline by six months.

This panic in Australia mirrored that in the US, where fears of a teenage vaping epidemic have been climbing since November 2018, when the US Centre for Disease Control and Prevention reported that among high school students “current e-cigarette use” had increased from 1.5 per cent to 21 per cent in seven years.

This led to some schools installing vape detectors, removing bathroom doors and even drug testing students for nicotine. 

Then in January 2020 an independent analysis showed that the ‘epidemic’ didn’t really exist. Much of the increase was due to experimental rather than frequent use. Only about 4 per cent of high-school students were regular e-cigarette users. The majority had given it a go and decided it wasn’t for them. Only one percent had never smoked: rather than hooking ‘naive teens’, most of the e-cigarette users would have been smoking anyway.

The ‘epidemic’ had been all smoke and not much fire.

Rate of teen vaping at 1.8 per cent – not 65 per cent

Which brings us back to the claim last week that e-cigarette use among non-smokers has increased four-fold in six years.

This is misleading, said Associate Professor Coral Gartner, head of the Nicotine & Tobacco Regulatory Science Research Group at University of Queensland. 

It turns out ‘e-cigarette use’ here refers to lifetime use: If you’ve ever had a single puff of a vape, you’re included in this statistic. 

That’s arguably not a very useful measure of whether vaping has become more popular among young people. A better statistic would be the number of current users, but working out how many people are regularly vaping is hard: The National Drug Household Strategy Survey (NDHSS) defines ‘current users’ of e-cigarettes very broadly as anyone who has vaped at least once in the past year. That’s a very broad definition.

Among young adults (18-24 year olds) who are non smokers, rates of ‘current use’ vaping have gone up marginally in the past three years: from 2 per cent to 2.9 per cent. According to the NDHSS, that’s not statistically significant. The reported increase is so small that experts can’t be sure more young non-smokers are vaping now than they were three years ago.

“The numbers are so low here we can’t get a good measure of current use,” Dr Gartner said.

The statement that 65 per cent of adolescents were using e-cigarettes was also factually incorrect, she said. The figure is actually the proportion of adolescents who have ever used an e-cigarette who reported having never smoked when they first used one. Confusing, yes. The point is, it’s definitely not the rate of teen vaping.

The real rate of teen vaping, she said, was about 1.8 per cent.

That’s the proportion of 14-17 year olds who have used an e-cigarette at least once in the past year. So much for the “significant increase” in vaping in playgrounds. Less than 10 per cent of this age group have ever tried vaping, the survey shows.

“There may even be no participants in the youngest age groups who are daily vaping,” Dr Gartner said.

“I wouldn’t be panicking over the increase in vaping among adolescents.”

How did the mistake happen? It went out in a media release that was later corrected, but by then it was too late: the stories had already been published. Mistakes happen (though in some cases the articles themselves haven’t yet been corrected). A better question might be: How could anyone believe that two-thirds of teenagers were vaping? The misreading of the survey suited an existing ‘epidemic’ narrative.

After all this, it turns out the NDHSS’s vaping figures are much less sensational. Use is going up, but it’s still relatively low. It’s nowhere close to an epidemic, Dr Gartner said.

Among 18-24 year olds, current use has gone up from 2.8 to 5.3 per cent in three years. Among 25-29 year olds it’s up from 1.2 to 4.8 per cent.

For the whole population, 1.1 per cent vape daily, compared to 0.5 per cent in 2016.

About 11 per cent of the population smokes tobacco cigarettes every day.

“No-one wants to see young people using substances, but we have to be honest with the data in our interpretation,” Dr Gartner said.

“We should be restricting access to the nicotine product that is causing the greatest harm in Australia, the tobacco cigarette.”