Vaping: call to action amid new evidence of harm

Public health

By Mardi Chapman

2 Apr 2024

TSANZ President Award recipient for 2024 Associate Professor Michelle Jongenelis has called for TSANZ members to encourage their federal MPs to support the Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024 currently before Parliament.

On receiving her award recognising her contribution to promoting respiratory health particularly in the area of tobacco control, clinical psychologist Associate Professor Jongenelis told TSANZSRS 2024 that e-cigarettes were an “emerging menace.”

Associate Professor Jongenelis, deputy director of the Melbourne Centre for Behaviour Change at the University of Melbourne, said the target market was clearly adolescents and young adults.

She showed examples of colourful vapes mimicking confectionary and even a vape disguised as an asthma inhaler.

“It is not an asthma inhaler. It is actually an e-cigarette product disguised as an asthma inhaler so that kids can use this product at school and the teachers don’t know about it.”

She said “industry actors” were conflating any evidence for e-cigarette use as a strategy to help tobacco smokers quit with claims that e-cigarette use was safe in the non-smoking and never smoked population.

“They want these products normalised. They want these products to be used in places where currently you are unable to smoke. So this is a real problem that we face when it comes to industry interference.”

She said it had taken a concerted effort and collaboration from many organisations including TSANZ to “talk to experts and make sure that policymakers could hear us”, get the Bill into shape and into Parliament.

“It now has to go through the various processes and it has to achieve support. We are up against a billion dollar, well-resourced industry and so our approach needs to be equal in terms of our efforts.”

“So we are advocating heavily with particularly the Liberals and the Independents to try and get this legislation through that will finally allow these products to be there for people who need them to quit smoking, but not in the hands of our children who certainly don’t need these products.”

New concerns

The meeting heard that e-cigarettes were not safe and that the increasing harms associated with vaping by young people outweighed the small and uncertain benefits from smoking cessation in adults.

TSANZ Tobacco and Related Substances SIG convenor Associate Professor Henry Marshall, told the meeting that e-cigarettes were a gateway drug to smoking for many “never would have smoked” young people and that dual use of tobacco products and vapes was increasing.

He said new evidence of potential early harms from e-cigarettes was particularly concerning.

A study, just published in Cancer Research [link here], assessed the epigenetic effects of tobacco or e-cigarette use on DNA methylation in epithelial and immune cells from over 3,500 buccal/saliva, cervical or blood samples from smokers and e-cigarette users.

It found hypermethylation in buccal samples collected from smokers up to 22 years prior to diagnosis predicted lung cancer development.

Similar cell level changes were seen in samples from people who have never smoked but use e-cigarettes for as little as a year.

Associate Professor Marshall, from Brisbane’s Prince Charles Hospital, said e-cigarettes were eroding decades of public health effort in smoking cessation.

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