Search

Issues Addressed: The increase of youth vaping in Australia has raised concerns, especially with increasing promotions of vaping products. We observed the visibility of vaping products near high‐adolescent‐traffic areas. Methods: We examined stores within walking distance of high schools and the central business district (CBD) in Brisbane, Australia, observing the number and proportion of stores selling or displaying vaping products. Using an observational approach, we analysed advertisements and open displays of vaping products at tobacconists, vape stores, and convenience stores. Results: We identified 61 eligible stores located near schools or in the CBD. Overall, 20% of stores displayed vaping products externally, with higher proportions among vape stores (78%) compared to tobacconists (36%). Additionally, 46% of stores had visible interior displays, with vape stores (89%) displaying them more frequently than tobacconists (71%). Among the 28 stores displaying vaping products, 57% included warnings, one store featured only flavoured products, and 25% showcased nicotine‐containing products. Youth‐appealing features were present in all but one store, with cartoons (61%) as the most common feature. Conclusion: Vapes were displayed near high schools and in the city, often featuring youth‐appealing features, such as colours and flavours. So What?: The exposure to such promotions could normalise vaping and contribute to increased youth uptake. Continued monitoring of vaping product promotions is essential, particularly considering recent policy changes. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco smoking is highly prevalent among alcohol and other drugs (AOD) service clients and, despite interest in quitting, abstinence is rarely sustained. Nicotine products may assist after discharge from residential treatment services, but little is known about client receptivity to them. This study examined AOD withdrawal service clients' experiences of two types of nicotine products for smoking cessation post‐discharge, combination nicotine replacement therapy (cNRT) and nicotine vaping products (NVP). Methods: We held semi‐structured telephone interviews with 31 Australian AOD service clients in a clinical trial of a 12‐week smoking cessation intervention using Quitline support plus cNRT or NVP delivered post‐discharge from a smoke‐free residential service. We asked about health and social factors, nicotine cravings, Quitline experience, and barriers and facilitators to cNRT or NVP, then thematically analysed data. Results: cNRT and NVP were described by participants as feasible and acceptable for smoking cessation. For most participants, cost limited cNRT access post study, as did difficulty navigating NVP prescription access. Quitline support was valued, but not consistently used, with participants noting low assistance with NVP‐facilitated cessation. Participants considered both cessation methods acceptable and socially supported, and sought information on decreasing nicotine use via NVP. Discussion and Conclusions: AOD service clients highly valued receiving cNRT or NVP with behavioural support for smoking reduction or abstinence. Both interventions were acceptable to service clients. Findings suggest a potential need to examine both whether NVP use should be permitted in this context, and guidance on the individual suitability of cNRT or NVP. [ABSTRACT FROM AUTHOR]

As tobacco smoking prevalence is unacceptably high for the one in five Australians reporting a mental health condition in the past year, multiple cessation supports are needed to reduce tobacco-related disease. Nicotine vaping product (NVP)-facilitated smoking cessation is one option requiring a medical prescription in Australia. Yet, people easily obtain NVPs via nonprescription channels. As mental health impacts quitting intentions and health system engagement, this study examined how presence of anxiety and depression symptoms may be associated with perceived health risk of using NVPs from prescription or non-prescription sources for smoking cessation. We used cross-sectional South Australian (15 years +) 2022 survey data on vaping, smoking, anxiety, and depression. Robust linear regression was used to examine the association of anxiety and depression symptoms and nicotine addiction concern on perceived health risk of using NVPs from prescription or nonprescription sources. For prescription NVPs, vaping was associated with lower perceived health risk (b=−0.732). Higher perceived addiction risk was associated with higher perceived health risk from prescription NVPs (b=0.784). For nonprescription NVPs, vaping (b=−0.661) or smoking (b=−0.310) was associated with lower perceived health risk, and higher perceived addiction risk (b=0.733) was associated with a higher perceived health risk. Although anxiety and depression were not directly associated with NVP health risk perceptions, vaping while having depression symptoms was associated with higher perceived health risk ratings for prescription (b=0.700) but not non-prescription sources. People with depression who vape may see health risk barriers in NVP prescription access for smoking cessation, a smoking cessation support gap. [ABSTRACT FROM AUTHOR]

INTRODUCTION Mounting evidence suggests that electronic cigarettes (e-cigarettes) are extensively promoted and marketed using social media, including through user-generated content and social media influencers. This study explores how e-cigarettes are being promoted on Instagram, using a case-study approach, and the extent to which Meta's Restricted Goods and Services Policy (Meta's policy) is being applied and enforced. METHODS We identified the accounts followed by an Australian Instagram influencer who primarily posts e-cigarette-related content. The main foci of these 855 accounts were coded and 369 vaping-focused accounts were identified. These vaping-focused accounts were then further coded by two trained coders. RESULTS All (n=369; 100.0%) of the vape content posted by these accounts was positive in sentiment. One-third of the vape accounts (n=127; 34.4%) had a shared focus, indicating that vape content may permeate into other online communities through shared interests. A total of 64 accounts (17.3%) potentially violated Meta's policy by attempting to purchase, sell, raffle or gift e-cigarette products. CONCLUSIONS The findings of this study suggest that pro-vaping information is available and accessible on Instagram. Much of the content identified in this study promoted the purchase or gifting of e-cigarette products and potentially violates Meta's policy. Greater regulation and/or stronger enforcement of e-cigarette content on social media platforms such as Instagram is necessary to prevent the ongoing promotion of these harmful products. [ABSTRACT FROM AUTHOR]

The vaping industry has been found to employ similar tactics to tobacco industry actors to seek credibility and distort the scientific evidence base around the health harms of nicotine vaping products. As vaping industry interests undermine vaping control efforts, safeguards are necessary to protect against this influence. We aimed to examine health organizations' policies on vaping industry participation in their activities in Australia. A descriptive approach integrating policy analysis and key informant surveys was used to obtain vaping industry participation information from health research stakeholders. Descriptive statistics on organization type, policy document type, policy document industry focus (tobacco or vaping) and respondent role and responsibility were collected. We used framework analysis to identify themes describing organizational allowances, constraints, and rationale for vaping industry research participation. Relevant health organizations were identified within Australia for policy searching (n  = 156), which identified 47 unique policy documents. After contacting 267 key stakeholders from eligible organizations, 31 survey responses were analysed. Research organizations and universities were highly represented in both the policy and survey data. Most health research stakeholders recognized that vaping industry interests counteract public health priorities and opposed vaping industry participation. However, many organizations lacked clear, vaping industry-specific participation policies. To protect the integrity of the emerging evidence base around vaping harms which inform vaping policy, health organizations require strong, comprehensive policies to resist vaping industry participation in research. [ABSTRACT FROM AUTHOR]

INTRODUCTION The World Health Organization recommends banning all forms of e-cigarette advertising, promotion, and sponsorship. The aims of the present study were to: 1) examine young people's exposure to e-cigarette advertising across a wide range of media in four diverse countries; and 2) identify any association between the number of different types of media exposures and e-cigarette use. METHODS A cross-sectional online survey was administered to approximately 1000 people aged 15-30 years in Australia, China, India, and the United Kingdom (n=4107). The survey assessed demographic characteristics, e-cigarette and tobacco use, numbers of friends and family members who vape, and exposure to multiple forms of e-cigarette advertising (e.g. television, radio, print, and various types of social media). Descriptive analyses were conducted on those who had heard of e-cigarettes (n=3095, significance threshold p<0.001) and a logistic regression analysis was used to identify factors associated with e-cigarette ever use (significance threshold p<0.05). RESULTS The majority (85%) of respondents who had heard of e-cigarettes reported being exposed to e-cigarette advertising on at least one type of media, and the average number of types of media to which respondents were exposed was 5 (range: 0-17). The number of media types was significantly associated with ever use of e-cigarettes (OR=1.05; 95% CI: 1.02-1.08, p=0.001). CONCLUSIONS Despite advertising restrictions in place in all four countries, large majorities of young people reported being exposed to e-cigarette advertising. Social media and advertising on/around vape shops and other retailers appear to be key exposure locations. Urgent attention is needed to address these forms of exposure given their apparent association with e-cigarette use. [ABSTRACT FROM AUTHOR]

Background: Vaping is an increasingly popular mode of cannabis use. Few studies have characterized the role of flavors in cannabis e-liquids. Objectives: To explore the prevalence of flavored vaping liquids, including differences between countries and correlates of use. Methods: Data were from Wave 4 (2021) of the International Cannabis Policy Study with national samples aged 16-65 in Canada, the United States (US), Australia, and New Zealand. The sample comprised 52,938 respondents, including 6,265 who vaped cannabis e-liquids in the past 12-months (2,858 females, 3,407 males). Logistic regression models examined differences in the use of flavored e-liquids between countries and sociodemographic characteristics. Results: The prevalence of vaping cannabis e-liquids was highest in the US (15.3%) and Canada (10.7%) compared to Australia (4.0%) and New Zealand (3.7%). Among past 12-month cannabis consumers, 57.5% reported using flavored vaping liquids, 34.2% used unflavored vaping products and 8.3% did not know. People who vape in Australia were most likely to report using flavored liquids compared to New Zealand (OR = 2.29), Canada (OR = 3.14), and the US (OR = 3.14) (p < .05 for all). Fruit was the most reported vaping flavor (40.8%), followed by candy/dessert (20.4%) and vanilla (15.2%). Use of flavored vapes was greater among younger, ethnic minorities, female, higher education and income adequacy, and more frequent consumers (p < .05). Conclusion: Many cannabis consumers reported using flavored e-liquids, with highest levels among young people aged 16-35. Given the high prevalence of vaping in legal markets, regulators should consider the role of flavored vaping products in promoting cannabis use among this group. [ABSTRACT FROM AUTHOR]

In Australia, nicotine vaping products are regulated as prescription‐only medicines which can only be sold from a pharmacy, with the aim of preventing youth access and allowing use by adult smokers with a doctor's support. The Therapeutic Goods Administration has acknowledged that this policy has not achieved its goals. Instead, a thriving black market has developed which sells unregulated vape products to children and adults. Very few adult vapers use the legal prescription pathway. Regulation should find the optimal balance between facilitating legal access for adult smokers while restricting access by youth. The preferred approach is a tightly regulated consumer model with nicotine vaping products sold by licenced retail outlets with strict age‐of‐sale verification. Regulations should be proportionate to risk and reflect the lower harms of vaping relative to smoking. A consumer model would bring Australia into line with other Western countries and improve population health. [ABSTRACT FROM AUTHOR]

This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body. [ABSTRACT FROM AUTHOR]

Background: Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia. Methods: A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12–14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term. Discussion: If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control. Trial registration: The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023). [ABSTRACT FROM AUTHOR]

Electronic cigarette (e-cigarette) smoking, also known as vaping, is a trend that has proliferated rapidly in the last decade. Initially heralded as a "better" replacement for the "more dangerous" tobacco smoking, we are starting to see several potential harms in the use of these devices. These include inflammatory lung damage from novel inhaled toxins and subsequent addiction to smoking. The workplace, where many spend a large part of their days at, may hold the key to controlling e-cigarette use - just as it did in Australia's successful campaign against tobacco smoking. Several stakeholders such as the government and worker unions are essential in making the necessary changes, amidst resistance by e-cigarette manufacturers and users. [ABSTRACT FROM AUTHOR]

Aims: To measure the prevalence and changes in smokers' discussions with health professionals (HPs) about nicotine vaping products (NVPs) and HPs' recommendations about NVPs between 2016 and 2020, and their associations with tobacco product use transitions. Design: Cohort study using multinomial logistic regression analyses on data from waves 1 (2016), 2 (2018) and 3 (2020) from the International Tobacco Control Four Country Smoking and Vaping Surveys. Setting: Four countries with varying NVP regulatory environments: 'most restrictive' (Australia), 'somewhat restrictive' (Canada) and 'less restrictive' (England and the United States). Participants: Adult exclusive daily smokers who did not report NVP use at the time of their baseline survey and had visited a HP in the last 12–24 months. Prevalence data came from 4125, 4503 and 4277 respondents, respectively, for each year. Longitudinal data were from 4859 respondents who participated in at least two consecutive surveys. Measurements Prevalence of self‐reported discussions with HPs and recommendations from HPs about NVPs. Longitudinal transitions from smoking to vaping (either exclusively or concurrently with smoking) and quitting (regardless of NVP uptake). Findings The prevalence of NVP discussions was low among countries with varying regulatory environments and study waves (range = 1.4–6.2%). In 2020, a low percentage of smokers who discussed NVPs with a HP reported that their HPs recommended they use NVPs in the United States (14.7%), Australia (20.2%), Canada (25.7%), with a higher percentage in England (55.7%) where clinical guidelines for smoking cessation include NVPs. Compared with 12.0% of smokers who reported no discussion, 37.0% of those whose HPs recommended NVPs transitioned to vaping at follow‐up. Transition to quitting was 9.6% with HPs' recommendation of NVPs versus 13.5% without discussion, a non‐significant difference. Conclusions: In Australia, Canada, England and the United States between 2016 and 2020, health professionals' discussions with smokers about nicotine vaping products (NVPs) were infrequent. NVP discussions were associated with NVP uptake, but not with quitting smoking. [ABSTRACT FROM AUTHOR]

Social factors play a role in e-cigarette uptake, but Australian evidence is limited. This study evaluated associations between social factors and e-cigarette intention and use. Australian participants surveyed between March 2019 and July 2019 using a cross-sectional survey design, measuring e-cigarette intentions and use, and factors including smoking status and social acceptability. Of 243 respondents, 185 were included in the final analysis, measuring e-cigarette intention and use, and factors including smoking status and social acceptability. Of 185 participants, daily, occasional, and ex-smokers (123 participants) were more likely to have used e-cigarettes (OR = 9.33; 95% CI 4.63–18.80) or intend to use e-cigarettes (OR = 4.86; 95% CI 2.32–10.21), relative to nonsmokers (62 participants). Participants reporting acceptability among people they study or work with (70 participants) were more likely to have used e-cigarettes relative to the reference group (OR = 16.76; 95% CI 3.70–75.83; p = 0.001) and were more likely report intending to use e-cigarettes relative to the reference group (OR = 3.40; 95%CI 1.58–7.30; p = 0.002). With caveats related to the survey participant composition, the results suggest that places of work or study may be an appropriate place to consider interventions aimed at reducing e-cigarette uptake among nonsmokers. [ABSTRACT FROM AUTHOR]

Background and Aims: With the prevalence of e-cigarette use among Australian youth increasing significantly in recent years, greater attention is being paid to encouraging and supporting cessation. However, research to inform such efforts is lacking. The present study sought to (i) measure desire to quit e-cigarette use and actual quitting attempts among young Australians and (ii) explore correlates of quitting-related cognitions and behaviours., Design, Setting and Participants: This was a cross-sectional on-line survey conducted in Australia. The participants were 14-25-year-old e-cigarette users (n = 602; 53% women)., Measurements: Desire to quit vaping and attempts to quit vaping were the primary dependent variables. The independent variables included several individual (e.g. harm perceptions, perceived appeal of vapes), social (descriptive norms) and environmental (e.g. ease of e-cigarette access) factors., Findings: A majority of respondents (61%) expressed a desire to quit vaping, and just over half (55%) had made a quit attempt. Finding vapes easy to access was associated with both a lack of desire [odds ratio (OR) = 0.71] and attempts to quit (OR = 0.77), while self-reported addiction to vaping (OR = 1.42 and OR = 3.11) and perceiving vaping to be associated with mental health risks (OR = 1.30 and OR = 1.40) were positively correlated with these variables. Perceiving that vaping is common among people of one's age (OR = 0.82) and finding vapes appealing (OR = 0.55) were associated with a lack of desire to quit, while perceiving vaping to have physical health risks was positively associated with quitting desire (OR = 1.58). School-based education on vaping was associated with reporting an attempt/s to quit (OR = 0.47)., Conclusions: This survey of young Australian e-cigarette users suggests a high level of desire to quit using e-cigarettes and attempts to quit. Increasing knowledge regarding the physical and mental health risks associated with e-cigarette use may assist with promoting quitting-related intentions. Changing social norms, reducing the accessibility of e-cigarettes and reducing the appeal of the products also constitute potential means of increasing the desire to quit., (© 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Purpose: To understand from the perspectives of school professionals, parents and young people the socio-ecological factors that may facilitate and prevent e-cigarette use among young people in Perth, Western Australia., Methods: Purposive sampling was used to recruit school professionals, parents and young people for one-on-one ( n  = 35) or joint ( n  = 3) interviews (in-person n  = 11 or online n  = 27). Data were analysed using thematic analysis and classified into four domains based on the socio-ecological model: i) individual, ii) interpersonal, iii) organizational/community and iv) societal/policy., Results: Factors that were found to support vaping among young people included sensation-seeking and risk-taking behaviour; a low-risk perception of vapes; attractive characteristics of vapes; ease of access; perception vaping is a social activity; and lack of knowledge about vaping among parents and school professionals. Vaping prevention messages originating from the familial, educational and community spheres are lacking but wanted by adults and young people., Conclusions: The pervasiveness of the e-cigarette trade and persistent challenges related to surveillance and enforcement need to be addressed to reduce exposure and access to e-cigarettes. A mixture of "hard" and "soft" public policy tools involving key stakeholders in a range of settings is needed to prevent e-cigarette access and uptake by young people.

Issue Addressed: E-cigarette awareness and use has increased globally, but little is known about the social factors that influence uptake in Australia. We explored the reasons why people started, continued and stopped using e-cigarettes in Australia.Methods: This was a qualitative study comprising 14 semi-structured interviews with past and current e-cigarette users in Australia. Interview transcripts were analysed thematically to explore reasons why people started, continued or stopped using e-cigarettes.Results: The following three themes emerged from interviews: "social" reasons, including issues of peer influence and social norms; "health" reasons, with aspects related to the reduction in use of cigarettes and health effects of using e-cigarettes; and "access and other personal" reasons, including the cost of e-cigarettes, the ability to access e-cigarettes and participants' experiences with e-cigarettes.Conclusions: The study revealed that social norms and peer influence were reasons why people started and stopped using e-cigarettes. Smokers often cited health reasons for starting, while non-smokers cited social reasons for both starting and stopping. SO WHAT?: The social and non-social reasons for why people say they start or stop using e-cigarettes appear to vary between smokers and non-smokers. Future studies may benefit from measuring these factors, differentiating between smokers and non-smokers, and considering these factors as part of interventions for limiting e-cigarette uptake among non-smokers. [ABSTRACT FROM AUTHOR]

Background and objective: E-cigarette use has become increasingly prevalent, but there is some evidence demonstrating potential harms with frequent use. We aimed to identify the profiles of e-cigarette users from a regional community in Australia and investigate the associations of e-cigarettes with respiratory symptoms and lung function. Methods: A total of 519 participants completed a cross-sectional study. Exposure to ecigarettes was collected via a validated questionnaire. Respiratory symptoms were evaluated via a self-reported questionnaire and lung function measured with spirometry and forced oscillation technique (FOT). Linear and logistic regression models were fitted to investigate the associations between e-cigarettes and outcomes, while controlling for confounders such as tobacco smoking. Results: Of the 519 participants, 46 (9%) reported e-cigarette use. Users tended to be younger (mean x SD 45.2 x 14.5 vs. 55.3 x 16.0 years in non-users), concurrently using tobacco products (63% vs. 12% in non-users), have a mental health diagnosis (67% vs. 37% in non-users) and have self-reported asthma (63% vs. 42% in nonusers). After controlling for known confounders, chest tightness (OR = 2.4, 95% CI 1.2-4.9, p = 0.02) was associated with e-cigarette use. Spirometry was not different after adjustment for confounding. However, FOT showed more negative reactance and a greater area under the reactance curve in e-cigarette users than non-users. Conclusion: E-cigarette use was associated with increased asthma symptoms and abnormal lung mechanics in our sample, supporting a potential health risk posed by these products. Vulnerable populations such as young adults and those with mental health conditions have higher usage, while there is high concurrent tobacco smoking. [ABSTRACT FROM AUTHOR]

Background: The sale of nicotine-containing electronic cigarettes (e-cigarettes) is prescription only in Australia, regulated under the Standard for Nicotine Vaping Products (TGO110). Australian e-cigarette users, however, are purchasing e-cigarette products outside of the intended pathways., Methods: The labelling of e-cigarette packaging (N = 388 boxes) and the chemical composition of disposable e-cigarettes and pods (N = 428) were analysed for adherence to the current Australian regulations. These samples were confiscated from over-the-counter retailers in NSW by the NSW Ministry of Health during 2022 for non-compliance with Australian regulations., Results: Following the announcement of the prescription only model for nicotine-containing e-cigarettes in Australia in mid-2021 there was a clear shift in the labelling of products. Any mention of the word 'nicotine' was removed from e-cigarette packaging by early 2022 and nicotine warnings were replaced with generic underage sale warnings. Despite this labelling, the vast majority (98.8 %) of devices analysed contained nicotine, most (89 %) at high concentration (>30 mg/mL) and 4.2 % contained at least one chemical prohibited by the TGO110., Conclusions: It appears that manufacturers have removed any mention of nicotine from the original packaging of nicotine-containing disposable e-cigarettes to circumvent restrictions on nicotine-containing products and continue their sale. The packaging of e-cigarette products in Australia is generally not indicative of their contents, particularly nicotine, and most did not display required warnings. Ingredients with associated health risks, prohibited in legal vapes by the TGO110, were found in samples. Consequently, the risks of e-cigarette use cannot be appropriately identified from the information supplied on the packaging or device., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Aims: The United Kingdom and Australia have developed highly divergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations and policy networks, anti‐smoking organizations, 'vaper' activist networks and advocates of harm reduction policies towards injecting drug use. Methods: We analysed key government reports, policy statements from public health bodies and non‐government organizations (e.g. cancer councils and medical organizations) on ENDS; submissions to an Australian parliamentary inquiry; media coverage of policy debates in medical journals; and the history of tobacco control policy in Australia and England. Key discourses about ENDS were identified for each country. These were compared across countries during a multi‐day face‐to‐face meeting, where consensus was reached on the key commonalities and divergences in historical approaches to nicotine policy. This paper focuses on England, as different policy responses were apparent in constituent countries of the United Kingdom, and Scotland in particular. Results: Policymakers in Australia and England differ markedly in the priority that they have given to using ENDS to promote smoking cessation or restricting smokers' access to prevent uptake among young people. In understanding the origins of these divergent responses, we identified the following key differences between the two countries' approaches to nicotine regulation: an influential scientific network that favoured nicotine harm reduction in the United Kingdom and the absence of such a network in Australia; the success of different types of health activism both in England and in Europe in opposing more restrictive policies; and the greater influence on policy in England of the field of illicit drug harm reduction. Conclusions: An understanding of the different policy responses to electronic nicotine delivery systems (ENDS) in England and Australia requires an appreciation of how actors within the different policy structures, scientific networks and activist organizations in each country and region have interpreted the evidence and the priority that policymakers have given to the competing goals of preventing adolescent uptake and encouraging smokers to use ENDS to quit smoking. [ABSTRACT FROM AUTHOR]

The Australian Government recently walked away from changes to the importation of nicotine‐containing electronic cigarette fluids, originally due to come into force on 1 January 2021. Additionally, the Therapeutic Goods Administration is in the process of rescheduling nicotine for use in e‐fluids. We are concerned that the 270 000 daily vapers in Australia will purchase high concentrations of nicotine (≥100 mg/mL) for mixing with nicotine‐free locally purchased e‐fluids, which is a pathway of increased relative harm. We would like to see regulation of these products to limit the maximum concentration of nicotine, ensure appropriate child‐resistant containers and compulsory labelling for all nicotine‐containing e‐fluid bottles. [ABSTRACT FROM AUTHOR]

• Our results suggest that Australian 14–17-year-old teenagers regard vaping as being safer and less harmful than parents do. • The risk of smoking and vaping uptake among teenagers significantly increased if they had an ever-smoker or ever-vaper parent. • Parents of never-vaper teenagers were considerably better at correctly predicting the vaping-status of their child than the parents of ever-vaper children. • Tobacco control and vaping policies and interventions should take a whole of population approach, including population-based policy measures addressing e-cigarette marketing and accessibility. Vaping by young people in Australia is a rapidly emerging public health issue. Evidence shows that parental behaviours and attitudes can play a key role in influencing adolescent behaviours. Considering the health harms of vaping and evidence that it can be a gateway to tobacco smoking for never-smokers, it is important to understand whether parents' smoking and vaping behaviours influence their teenage children's smoking and vaping behaviours. Online cross-sectional surveys as part of the Generation Vape study, conducted in Australia in 2021/2022, were used to assess parents' influence on, and awareness of, one of their 14–17-year-old child's vaping and smoking behaviours. Participants were 3242 parents and 3242 14–17-year-old teenage children. The risk of vaping and smoking uptake among 14–17-year-old teenagers was 42% (p = 0.003) and 97% (p < 0.001) higher, respectively, if their parent was an ever-vaper. The risk of vaping and smoking uptake among teenagers was 81% (p < 0.001) and 159% (p < 0.001) higher, respectively, if their parent was an ever-smoker. Parents of teenagers who have not vaped were considerably better at correctly predicting this (97% correct) than parents of teenagers who have vaped (70% correct). Compared to parents, teenagers tended to have less agreement with statements suggesting vaping is unsafe or harmful, and more agreement with statements suggesting vaping is relatively safe. Parental smoking and vaping behaviours are associated with those of their children. Hence, it is important that both tobacco and vaping control policies and interventions are designed to influence behaviours of all demographics, consistent with the evidence. [ABSTRACT FROM AUTHOR]

Background: Deciding how to regulate nicotine vaping products (NVPs) is a challenge for many countries. Balanced regulation should consider the potential harms to young people from uptake of NVPs alongside the possible benefits of NVPs as a smoking cessation aid. One option is to make NVPs only available via medical prescription to adults who smoke. From October 2021, Australia adopted a unique model that allows prescription access to NVPs that meet a product standard without requiring the NVPs to be approved as therapeutic goods. This research explored the impact of this regulatory model on the smoking cessation practices of health professionals, and their views on the model., Methods: Semi-structured interviews were conducted with 39 Australian health professionals recruited from professional networks and social media. Health professionals were eligible if they provided smoking cessation advice as part of their role, and included medical practitioners (n = 9), pharmacists (n = 9), and other health professionals that provided smoking cessation counselling (n = 21). Interviews were mostly completed by phone and online teleconferencing software. Questions focused on smoking cessation practices, advice and information provided to patients about NVPs, views about the effectiveness of the model for supporting use of NVPs for smoking cessation and preventing youth uptake, and barriers and facilitators to prescribing and dispensing NVPs. Coding and analysis used a combination of inductive and deductive approaches., Results: Findings indicated a lack of consensus amongst the participants about NVPs as a cessation or harm reduction tool. Participants broadly agreed that the model has not been effective in improving quality control of NVPs, or in reducing youth access. Many participants eligible to prescribe or dispense NVPs felt that the current regulatory model placed an undue time and responsibility burden on clinicians., Conclusion: Our research identified several limitations associated with the current Australian prescription-only regulatory model. These were perceived by healthcare professionals to limit the potential for the regulations to reduce youth use and to increase access to safer NVP products for people who smoke to use for smoking cessation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: E-cigarettes are becoming increasingly popular in Australia, especially amongst the younger population. The synthetic cooling molecules WS-3 and WS-23 have been identified in e-cigarette products from the United States and Europe. The extent of inclusion of these synthetic coolants in Australian e-liquids is unknown, particularly in newer disposable e-cigarettes., Aims and Methods: E-cigarettes and e-liquids were purchased within Australia and anonymously donated by Australian users. Nicotine, WS-3, WS-23, and menthol were quantified in the e-liquids using gas chromatography-mass spectrometry (GC-MS)., Results: WS-23 and nicotine were detected in all of the disposable e-cigarettes with WS-23 often present in high concentrations. There was no correlation between cooling terms in the flavor name and the inclusion of cooling agents. Only three bottled e-liquids were found to contain WS-23 while none contained WS-3 above the limit of detection., Conclusions: Synthetic coolants were a common addition in disposable e-cigarettes while rarely added to e-liquid bottle refills. Their inclusion in these products is reflective of trends observed in United States and European e-cigarette products., Implications: The increase in synthetic cooling agents as components of e-liquids, particularly disposable e-cigarette devices, has been observed within Australian samples across a range of brands and flavors. WS-23 was present in every disposable e-cigarette analyzed in this study, often in relatively high concentrations. Its inhalational toxicology should be considered when evaluating the safety of these products., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.)

Introduction: Electronic cigarette (e-cigarette) use in Australia has rapidly increased since the 2017 National Health and Medical Research Council (NHMRC) Chief Executive Officer (CEO) statement on e-cigarettes. The type of products available and the demographic characteristics of people using these products have changed. New evidence has been published and there is growing concern among public health professionals about the increased use, particularly among young people who do not currently smoke combustible cigarettes. The combination of these issues led NHMRC to review the current evidence and provide an updated statement on e-cigarettes. In this article, we describe the comprehensive process used to review the evidence and develop the 2022 NHMRC CEO statement on electronic cigarettes., Main Recommendations: E-cigarettes can be harmful; all e-cigarette users are exposed to chemicals and toxins that have the potential to cause adverse health effects. There are no health benefits of using e-cigarettes if you do not currently smoke tobacco cigarettes. Adolescents are more likely to try e-cigarettes if they are exposed to e-cigarettes on social media. Short term e-cigarette use may help some smokers to quit who have been previously unsuccessful with other smoking cessation aids. There are other proven safe and effective options available to help smokers to quit., Changes in Management as a Result of This Statement: The evidence base for the harms of e-cigarette use has strengthened since the previous NHMRC statement. Significant gaps in the evidence base remain, especially about the longer term health harms of using e-cigarettes and the toxicity of many chemicals in e-cigarettes inhaled as an aerosol., (© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)

Objective: To audit the number and location of dedicated e-cigarette retailers ("vape stores") in Western Australian (WA), measure proximity to schools and model the association between vape store density and socio-economic disadvantage., Methods: Vape stores were identified via internet search and geocoded. Proximity to schools was measured. Regression modelling was used to investigate the association between vape store density and socio-economic disadvantage., Results: 194 stores were identified, with 88% located within one kilometre of a school. In metropolitan WA, vape store density was nearly seven times higher in the most socio-economically disadvantaged areas than in the least disadvantaged areas (rate ratio 6.9, 95% confidence interval 3.4-15.5)., Conclusions: There has been rapid, recent growth in the number of vape stores in WA, with most located within walking distance of schools. In metropolitan WA, vape store density is strongly associated with socio-economic disadvantage, mirroring the pattern observed globally for tobacco outlets., Implications for Public Health: This is the first Australian study demonstrating that vape stores are more densely located in socio-economically disadvantaged areas. Vape stores' proximity to schools may increase young people's access and exposure to promotional signage. There is a need to address ready e-cigarette availability through strong regulatory and compliance measures., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective New legislation to curb the rapid increase in e-cigarette use among youth is underway. We estimated the future healthcare costs for chronic diseases from e-cigarette use among never smokers who transition to tobacco smoking. Methods Using population-attributable fractions, we estimated the health expenditure attributable to e-cigarettes based on the prevalence of e-cigarette use, uptake of tobacco smoking, and risk of smoking on developing chronic disease. Data for men and women were derived from published reports on e-cigarette use prevalence, risk of smoking-related disease and addiction, and health expenditure for 25 diseases. Sensitivity analyses were undertaken to address data input variation. Results Future healthcare costs attributed to new e-cigarette-initiated smokers were conservatively estimated to be (in Australian dollars) $179.6 million annually. Collectively, the estimated costs were highest for respiratory diseases ($102.2 million; 57% of total costs), malignant cancers ($49.6 million; 28%), and cardiovascular disease ($27.7 million; 15%). The uptake rate of e-cigarettes was more important in driving healthcare costs than the proportion moving from e-cigarettes to cigarette smoking. Conclusion High avoidable health system costs are predicted for the treatment of chronic conditions created by e-cigarette-initiated smoking. These costs exclude the immediate and direct healthcare harms of e-cigarette-related poisoning, lung injury, and respiratory problems, and costs associated with the unknown health harms of e-cigarette use alone. The proposed regulations to curb recreational e-cigarette use in Australia are set to prevent expensive health care arising sometime in the future from new cigarette smokers.

Use of electronic cigarettes (e-cigarettes or 'vapes') has risen rapidly among young Australians in recent years. To combat this, on 2 May 2023, the Albanese Government announced a suite of reforms to reduce the desirability and accessibility of e-cigarettes to young people-including a ban on disposable e-cigarettes, restricting flavours, colours and nicotine content and requiring pharmaceutical-like packaging. While many have welcomed this announcement, the efficacy of such reforms in reducing the availability of e-cigarettes to young people remain to be seen, particularly given the current prescription-only model has done little to curb youth vaping. We argue that, in an uncertain landscape where e-cigarettes will likely remain accessible and desirable to young people, it is critical that we also upskill, empower and arm our young people with the skills, resilience, resources and knowledge to make informed and positive health decisions so that: (i) fewer young people opt to take up vaping (primary prevention); and (ii) among those who already do vape, more seek help earlier on to reduce or cease their use before dependency develops (secondary prevention). Schools are an ideal setting for the delivery of these programs, where they can be delivered en masse, integrated into existing alcohol and other drug programs and aligned with school curricula. Skills-based school prevention programs have demonstrated significant and sustained reductions in drug-related harms up to 7 years post-intervention. For as long as vapes remain widely available, desirable and purposefully marketed towards young people, we believe our best defence is self-defence., (© 2023 Australasian Professional Society on Alcohol and other Drugs.)

Aims: To determine whether a simple combination of level of smoking and level of vaping results in a useful typology for characterizing smoking and vaping behaviours. Methods: Cross‐sectional data from adults (≥ 18 years) in the 2016 wave 1 ITC Four Country Smoking and Vaping Survey in the United States (n = 2291), England (n = 3591), Australia (n = 1376) and Canada (n = 2784) were used. Participants who either smoked, vaped or concurrently used both at least monthly were included and divided into eight groups based on use frequency of each product (daily, non‐daily, no current use). This resulted in four concurrent use groups (predominant smokers, dual daily users, predominant vapers and concurrent non‐daily users). These groups were compared with each other and with the four exclusive use groups, on socio‐demographics, nicotine dependence, beliefs and attitudes about both products, and quit‐related measures using data weighted to reference population surveys in each country. Results: Of the sample, 10.8% were concurrent users, with daily smokers vaping non‐daily (predominant smokers), constituting 51.6% of this group. All eight categories differed from other categories on at least some measures. Concurrent daily nicotine users reported higher levels of indicators of nicotine dependence, and generally more positive attitudes toward both smoking and vaping than concurrent non‐daily users. Among daily nicotine users, compared with exclusive daily smokers, reports of interest in quitting were higher in all concurrent use groups. Dual daily users had the most positive attitudes about smoking overall, and saw it as the least denormalized, and at the same time were equally interested in quitting as other concurrent users and were most likely to report intending to continue vaping. Conclusions: In Australia, Canada, England and the United States in 2016, daily nicotine users differed considerably from non‐daily nicotine users. Among daily nicotine users, dual daily users (those who smoke and vape concurrently) should be treated as a distinct grouping when studying relationships between smoking and vaping. The eight‐level typology characterizing concurrent and exclusive use of smoking and vaping should be considered when studying both products. [ABSTRACT FROM AUTHOR]

Background and Aims: Government regulations of nicotine vaping products (NVP) have evolved rapidly during the past decade. The impact of NVP regulatory environment and vaping on cigarette demand is unknown. The current study aims to investigate whether or not respondents' reported cigarette demand, as measured by a hypothetical cigarette purchase task, varies with (1) smoking status, (2) vaping status or (3) NVP regulatory environment (country used as proxy). Design Cross‐sectional survey data from wave 1 of the International Tobacco Control (ITC) Four Country Smoking and Vaping (4CV) Survey (2016). Setting: Australia, Canada, England and the United States. Participants: A total of 10 316 adult smokers. Measurements A hypothetical purchase task asked smokers to estimate how many cigarettes they would purchase for consumption in a single day across multiple cigarette prices. Responses were used to derive measures of cigarette demand. Overall sensitivity of cigarette consumption to price increases was quantified to index cigarette demand elasticity, whereas estimated consumption when cigarettes are free was used to index cigarette demand intensity. Findings A majority of the non‐daily smokers had previously smoked daily (72.3%); daily vapers were more likely to be former daily smokers (89.9%) compared to non‐daily vapers (70.1%) and non‐vapers (69.2%) (P < 0.001). The smoking status × vaping status interaction was significant for cigarette demand intensity (F = 4.93; P = 0.007) and elasticity (F = 7.30; P = 0.001): among non‐daily smokers, vapers reported greater intensity but lower elasticity (i.e. greater demand) relative to non‐vapers (Ps < 0.05). Among daily smokers, daily vapers reported greater intensity relative to non‐vapers (P = 0.005), but vaping status did not impact elasticity (Ps > 0.38). Intensity was higher in Australia compared with all other countries (Ps < 0.001), but elasticity did not vary by country (F = 2.15; P = 0.09). Conclusions: In a hypothetical purchase task, non‐daily smokers showed lower price elasticity if they used e‐cigarettes than if they did not, while there was no clear difference in elasticity between e‐cigarette users and non‐users among daily smokers or according to regulatory environment of their country with regard to e‐cigarettes. [ABSTRACT FROM AUTHOR]

Aim: To assess (1) how far smoking patterns, depression and smoking‐related beliefs and intentions predict vaping uptake, current vaping and vaping frequency among daily smokers; and (2) how far the aforementioned predictors and baseline vaping frequency predict current vaping among those who reported ever vaped. Design Analysis of data from six waves of a longitudinal survey over 8 years. Longitudinal associations between predictors and outcomes were examined using multi‐level models. Setting: United Kingdom, United States, Canada and Australia. Participants: A total of 6296 daily smokers (53% females) who contributed data to at least two consecutive survey waves. Measurements The outcome variables were vaping uptake, vaping frequency and current vaping at follow‐up. The key predictor variables, measured in previous waves, were time to first cigarette, cigarettes smoked per day, depressive symptoms, intention to quit smoking, quitting self‐efficacy and worry about adverse health effects of smoking. Findings Number of cigarettes smoked daily was associated with (1) subsequent vaping uptake [odds ratio (OR) = 1.69, 95% confidence interval (CI) = 1.19, 2.39 for 30+ cigarette per day; reference category: 0–10 cigarettes] and (2) a higher frequency of current vaping (OR = 1.97, 95% CI = 1.36, 2.85 for 30+ cigarettes). Intention to quit was associated with a higher frequency of current vaping (OR = 1.48, 95% CI = 1.21, 1.82). Among those who reported ever vaped, higher baseline vaping frequency (OR = 11.98, 95% CI = 6.00, 23.93 for daily vaping at baseline; reference category: vaped less than monthly) predicted current vaping. Conclusion: Among daily smokers, amount smoked and intention to quit smoking appear to predict subsequent vaping uptake. Vaping frequency at baseline appears to predict current vaping at follow‐up. [ABSTRACT FROM AUTHOR]

• Reducing uptake of vaping among adolescents is critical to minimizing related harms. • Understanding susceptibility to vaping can inform prevention efforts. • Susceptibility to vaping was observed in 45 % of adolescent never smokers. • Attitudes and social norms were found to be related to susceptibility. • Communications that address social norms related to vaping maybe important. Preventing uptake of e-cigarette use among adolescents is critical to minimizing vaping-related harms. To inform the development of effective prevention programs and policies, this study explored potential determinants of susceptibility to e-cigarette use among young Australians. A cross-sectional online survey was administered to 12- to 17-year-old Australians who had never smoked nor vaped (N = 973; 53 % women). The survey assessed susceptibility to e-cigarette use (curiosity about use, willingness to use, and intentions to use) and a comprehensive range of potential correlates that included individual, social, and environmental factors. Regression analyses were conducted to identify factors significantly correlated with each of the dependent variables. Susceptibility to e-cigarette use was observed in 45 % of respondents. Individual factors associated with susceptibility included respondents' (i) overall opinion of e-cigarettes, (ii) attitudes toward e-cigarettes, (iii) affect regulation expectancies, and (iv) quitting perceptions. Significant social factors included both descriptive and injunctive norms, specifically: perceiving that use is ok for people of one's age, approval from important others to use, and having at least one family member or close friend who vapes. Susceptibility to vaping was observed in a substantial proportion of adolescents who have never smoked. Shifting attitudes and social norms around e-cigarette use appears critical to reducing susceptibility. Recommended prevention efforts include the development of communications addressing misperceptions about the benefits of vaping on affect regulation and stricter regulations on e-cigarette advertising to reduce young Australians' exposure to claims that may result in favourable attitudes to e-cigarette use. [ABSTRACT FROM AUTHOR]

Nicotine vaping products (NVPs) pose health risks associated with nicotine dependence and increased likelihood of tobacco consumption. Despite having a secondary role in smoking cessation, recreational NVP use is increasing among younger people. Vaping prevention campaigns aim to influence views on the health risks of vaping. This study examined perceptions of Australian and international vaping prevention campaigns among 27 young South Australians aged 16-26 years who do and do not use NVPs, to inform targeting and framing of vaping risk messaging. Participants viewed example materials from three vaping prevention campaigns: 'Epidemic', 'Do you know what you're vaping' and 'Unveil what you inhale'. Focus groups and interviews assessed whether materials were easily understood, appropriate, relevant, credible and effective in health communication. Participants indicated that all campaigns would influence their thoughts and actions related to vaping. The 'Do you know what you're vaping' campaign prompted thoughts about uncertainty about individual health risks, though participants did not indicate that this was enough to motivate vaping cessation. Participants considered the 'Unveil' campaign effective, with those who did not vape indicating they would click through to access resources, and those who did vape responding well to the 'challenge' aspect of the messaging. The 'Epidemic' campaign fear appeal did not clearly prompt change in vaping views or behaviours. Campaigns using a challenge approach may generate conversation about vaping harms, while fear appeals can be dismissed by younger audiences. Evidence-based short messages and the presentation of multiple versions of content were considered effective approaches., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Introduction and Aims: Despite regulatory barriers for accessing nicotine liquid, use of nicotine vaping products (NVPs) has increased rapidly in Australia. Legal use of NVPs to aid smoking cessation requires a prescription, and pharmacies report receiving enquiries about the use of and access to NVPs. In this study, we assessed vaping product use, harm perception and policy support among community pharmacy customers.Design and Methods: A cross-sectional survey was conducted among customers (n = 470) from a large community pharmacy chain in Brisbane, Australia. Multivariable logistic regression was used to examine perception of NVPs as less harmful than combustible cigarettes and regulatory recommendations in relation to demographics, smoking status and NVP use.Results: Almost one-third of the sample (31%) had either tried NVPs in the past (16%) or were current vapers (15%), the majority of them being current smokers (67%) who are trying to quit (31%) or substitute smoking (41%). Vapers primarily depended on family/friends as a source of information (76%). Current smokers and vapers were more likely to perceive NVPs as less harmful than cigarettes than non-smokers and non-vapers. Perceiving NVPs as safer than cigarettes was correlated with a recommendation to regulate as a tobacco product.Discussion and Conclusions: There was widespread misperception about relative risk of nicotine-containing products, with 37% of respondents perceiving nicotine-containing NVPs to be as harmful as combustible cigarettes. Community pharmacies represent an ideal setting for educating smokers about smoking and vaping. Thus, pharmacy staff needs educational support to ensure that they are equipped to provide current evidence-based information to customers. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Vaping products have been growing in popularity in recent years, including in Australia. Australian laws covering vaping products are complex and vary significantly between jurisdictions. It has been acknowledged that there is public confusion about these laws. This study aims to explore publically-available information about vaping products-related laws disseminated via mainstream media and key stakeholder websites.Design and Methods: A content analysis was conducted on 302 news articles identified in the Factiva database, and on 73 key stakeholder websites that provided information about vaping product regulations in Australia between January 2005 and January 2018. Items were coded for the type of regulations discussed, the source of information and the information provided about the legal status of vaping products.Results: Public advice covered regulations around sales, public use, nicotine importation, nicotine's classification as a poison and nicotine possession. In the majority of news articles, journalists did not cite the source of the information pertaining to vaping products laws, making it difficult for the public to judge its accuracy. We identified several inconsistencies in the information being disseminated through both channels.Discussion and Conclusions: The inconsistent information provided to the public regarding vaping products likely reflects Australia's complex and varying laws governing the sale, use and possession of vaping products with and without nicotine. We recommend that relevant Australian federal, state and territory health agencies provide a clear and consistent message that covers all relevant information pertaining to vaping products and nicotine within respective jurisdictions. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Information available to consumers about nicotine vaping products varies according to the regulatory environment. A common information source in Australia, where nicotine vaping products are highly regulated, is advice from vapers. The aim of this study was to report on what advice current vapers would give to someone new to vaping.Design and Methods: Australian vapers were recruited in 2016 via the International Tobacco Control Four-Country Smoking and Vaping survey of smokers and ex-smokers, as well as a separate recruitment process that targeted vapers. A total of 384 of 559 eligible participants responded to an open-ended question about barriers to switching from smoking to vaping, and what advice they would give to new vapers.Results: While some participants reported switching from smoking to vaping easily, others described an adjustment period. Difficulties included learning about technical aspects of nicotine vaping products, finding the 'right' combination of device and liquid, and accessing nicotine liquid given that it cannot legally be sold. Many accounts of satisfaction with quitting smoking and improved health were provided.Discussion and Conclusions: Advice from current vapers is likely to be particularly influential in Australia, where information about vaping is not easily available from health organisations or official government sources. This research shows that advice to new vaper centres around experimentation with devices and flavours and finding trustworthy suppliers of nicotine liquid. It provides an insight into the initial challenges associated with switching from smoking to nicotine vaping products in environments where access to nicotine liquid is highly restricted. [ABSTRACT FROM AUTHOR]

E‐cigarettes are increasingly common around the world, particularly among youth. Ingestion of nicotine‐containing e‐liquid, while relatively rare, is the major toxicological risk associated with their use. Current Australian regulation has nicotine for use in e‐cigarettes listed as a dangerous poison in Schedule 7, with its supply or sale illegal in all states and territories, while regulation on the sale of e‐cigarettes and accessories varies by state. However, with increasing evidence that e‐cigarettes produce far fewer toxic by‐products than their combustible counterparts perhaps it is time to review this regulation. [ABSTRACT FROM AUTHOR]

In response to rapid and substantial increases in rates of e-cigarette use among young people, Australia's Therapeutic Goods Administration (TGA) made changes to the regulations governing nicotine vaping products. As part of the regulatory change process, Australians were invited to comment on the proposed regulations, which featured the introduction of a prescription model for nicotine vaping products. To inform strategies to enhance compliance with the tightened regulations, this study examined submissions made by self-reported e-cigarette users to the TGA's public consultation (n = 1405). A content analysis was conducted to identify and quantify key arguments. Claims about possible negative consequences associated with the regulations (e.g. people will return to smoking, inconvenience) featured in most submissions (84%). Around half (55%) of submissions mentioned perceived benefits of e-cigarettes, including favourable health outcomes (e.g. improved breathing) and enhanced tobacco cessation. Around half (52%) featured concerns about inconsistency in treatment and the argument that e-cigarettes should not be restricted when more harmful tobacco products are readily available. Alternative approaches to a prescription model were offered in nearly one-third (31%) of submissions. One-quarter (26%) included text provided by an industry-led astroturfing campaign. The arguments made in the analysed submissions suggest a lack of appreciation of (i) the negative health outcomes associated with e-cigarette use and (ii) evidence linking these devices to smoking relapse. Results highlight the need for targeted health campaigns that address (i) gaps in consumers' knowledge and (ii) vaping-related misinformation being promulgated by the industry and its allies., (© The Author(s) 2023. Published by Oxford University Press.)

Background: This study examined the prevalence and correlates of (1) perceived social acceptability of personal vaporizer (PV)/e-cigarette use, and (2) reported vaping in public and private places, in the UK and Australia with different regulatory environments for PVs.Methods: Data analyzed come from 2849 smokers and recent ex-smokers in the UK and Australia who participated in the 2014 wave of the International Tobacco Control Survey.Results: UK respondents were more likely to think vaping is socially acceptable than Australians (56.4% vs. 27.9%; p < 0.001). Having quit smoking, observing vaping in smoke-free (SF) public places, and believing vaping is less harmful than smoking was all significantly associated with greater perceived social acceptability of vaping in both countries. However, vaping status and that of friends and family were more influential in Australia than in the UK. Vaping was reported as much more common in private, than public, settings in both countries. UK vapers were more likely to report vaping in SF public places (OR = 2.66; 95% CI = 1.5-4.7; p < 0.01) and at home (OR = 2.44; 95% CI = 1.5-3.9; p < 0.001), but not in their car when controlling for demographic factors and vaping and smoking status.Conclusion: The acceptability of vaping was greater among those who were more exposed to vaping and not just among those with some personal experience of vaping, suggesting no strong social barriers to increased use. Vaping in SF public places was less common than in homes, and both were more common in the UK than in Australia, suggesting some social constraints on use, particularly in Australia. [ABSTRACT FROM AUTHOR]