Advertising for electronic cigarettes is pushing non-smokers and young people to take up vaping despite the health risks, in a finding that will galvanise opponents of the push to legalise nicotine vaping in Australia.
Researchers from Macquarie University reviewed 43 studies involving 27,303 people globally to examine the effect of e-cigarette marketing on non-smokers.
Legalise Vaping Australia campaign director Brian Marlow with vaper Katarina Perkovic.Credit:Edwina Pickles
The meta-analysis published in the peer-reviewed American Journal of Preventive Medicine found "consistent evidence" that exposure to advertising increases the intention to use e-cigarettes, and mixed evidence about the influence of social factors.
Co-author Liliana Laranjo, a research fellow at Macquarie University's Australian Institute of Health Innovation, said this was the first research to show the clear risk of non-smokers taking up vaping.
"We found that advertising, social connections and social norms, particularly via social media, influence people to take up vaping," said Dr Laranjo, both a medical doctor and PhD.
"This is the case not only for people who want to quit smoking – which is supposed to be the primary goal of electronic cigarettes – but also non-smokers."
E-cigarette brands have used celebrities like British singer Lily Allen and Oscar-winning actor Rami Malek to post product endorsements on Instagram. A loophole meant tobacco companies could not buy regular advertisements on Facebook and Instagram but could turn influencers’ Instagram posts into sponsored content.
However, Instagram announced in a blog post earlier in December that it would no longer allow branded content to promote "vaping, tobacco products and weapons". This would take effect at the end of the year.
Dr Laranjo said marketing of vaping was rampant on social media – for example, YouTube had numerous videos showing vaping tricks with millions of views. Like traditional cigarettes, it is not legal to advertise vaping in Australia – however Australian users can be exposed to vaping on social media and other online platforms.
"At least if we're not facilitating access to electronic cigarettes containing nicotine in Australia, then we are preventing that this new generation gets hooked on e-cigarettes," she said.
In Australia, adults can buy e-cigarettes and non-nicotine "juices" with flavours such as fruit and chocolate but nicotine juices are sold only with prescription.
Tobacco companies have lobbied for reduced regulations for e-cigarettes and Philip Morris is seeking approval from the Therapeutic Goods Administration for a smoke-free "heated tobacco" product.
Federal Health Minister Greg Hunt is strongly opposed to the legalisation of e-cigarettes with nicotine, saying "not on my watch" in 2017. A parliamentary inquiry also rejected the idea last year but a few months later, Mr Hunt bowed to pressure from pro-vaping MPs in his own party and commissioned independent research on the health effects of e-cigarettes. The report is expected by the end of 2020.
Legalise Vaping Australia campaign director Brian Marlow, representing 250,000 vapers and the small business vape shops, said e-cigarettes with nicotine should be available to adults without a prescription.
He said while most vapers use nicotine e-cigarettes, few bother to get a prescription – instead "buying it overseas from countries that don't necessarily have the same sort of consumer protections" as Australia.
Mr Marlow said Australia should not copy the lax laws of the US but "regulate it properly" in line with the British model, where there are restrictions around the size of the tanks and the concentration of nicotine.
The 2017 Australian Secondary Students’ Alcohol and Drug Survey found about 13 per cent of high schoolers had tried vaping and nearly half had never smoked a tobacco cigarette before vaping. Research suggests people who try e-cigarettes are more likely to later try tobacco cigarettes.
In the United States, where regulations are relaxed, one in four 12th-graders are vaping regularly and nearly one in eight vape every day.
The US Centre for Disease Control reports 2409 people have been hospitalised with lung injury and 52 people have died because of vaping.
Heesoo Chung, 25, from Epping took up vaping five years ago on the suggestion of friends after smoking cigarettes for a few months. "As soon as I got into vaping, I just dropped cigarettes," Mr Chung said.
While he had not heard of vaping before that, he said it was now "very common" both on the street and on social media.
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