Medical groups including the Lung Foundation Australia are urging the government to further restrict vaping following a new report showing it is encouraging young people to start smoking.

Commissioned by the Australian Department of Health and conducted by the National Centre for Epidemiology and Population Health, the report found use of nicotine e-cigarettes is increasing and is greatest in young people in Australia.

In 2019, 11% of the total Australian population aged 14 and over reported ever having used e-cigarettes, around a quarter of people aged 18–24 reported ever-use and 5% of this group reported current use. Over one-third of current e-cigarette users in Australia were aged under 25, and half were aged under 30.

There was evidence supportive of a ‘gateway effect’ with non-smokers who use e-cigarettes being three times as likely to go on to smoke combustible tobacco cigarettes as non-smokers who do not use e-cigarettes.

The report found more than half (53%) of current e-cigarette use in Australia was by people who also smoke, 31.5% was by past smokers and 15.5% was in people who have never smoked.

Lead author Professor Emily Banks said the report showed limited evidence that nicotine e-cigarettes were effective to help people quit smoking in the clinical setting, and that most people who quit smoking successfully do so unaided.

“E-cigarettes may be beneficial in the small number of smokers who use them to quit smoking completely and promptly, but there is a huge uncertainty about their effectiveness and the overall balance of risks and benefits for quitting.”

E-cigarettes were also likely to be harmful for people who use them while continuing to smoke — the commonest use pattern currently — by prolonging their overall exposure to tobacco, she added.

Respiratory physician Professor Guy Marks said the report was “showing that, at population level, e-cigarettes are having exactly the opposite effect to what is claimed for them”.

In an article in The Conversation, he said there was legislation to restrict the use of e-cigarettes but it needed to be more tightly enforced.

“It’s still easy to buy e-cigarettes online, they are available without prescription from petrol stations, tobacconists, specialty “vape” stores and are on-sold by entrepreneurs — all of them acting unlawfully. Heavy fines will end their cash incentive,” he wrote.

“The review shows the risks to public health posed by e-cigarettes will only grow unless governments enforce their laws.”

Lung Foundation Australia described the report findings as ‘damning’ and urged the Federal Government to strengthen and launch the National Tobacco Strategy in 2022 with an amplified focus on addressing the rising health concerns of e-cigarettes.

Lung Foundation Australia CEO Mark Brooke said vaping was the latest ploy by big tobacco companies to reinvent themselves to stay relevant in the modern age.

“These companies sold the world cigarettes with effective advertising and addictive ingredients, and it was a long time before the truth about their dangers came out. The government was forced into action but it was too late for many,” Mr Brooke said.

“Now, the writing’s on the wall for e-cigarettes and it’s time for the Federal Government to step in to protect Australia’s youth from lifelong health impacts including lung disease.”

The RACGP responded to the report by calling on the Federal Government to set ambitious goals and act decisively to reduce tobacco use across the nation.

It recommended the Federal Government devise a robust anti-smoking strategy including an ambitious target of zero uptake of tobacco use. The College also called on all political parties to reject donations and lobbying from the tobacco industry.

“It’s great news that the Australian Labor Party and Liberal Party of Australia no longer accept donations from tobacco companies, and the Greens have a long-standing policy of not accepting tobacco company donations. Let’s go a step further and encourage the National Party in the strongest possible terms to follow suit and urge all independents and minor parties to also have a blanket policy of not accepting Big Tobacco donations,” said RACGP president Professor Karen Price.

“The strategy should also staunchly recommend against any politicians, and their staff, from meeting with any tobacco company lobbyists. Gaining access to politicians and their staff is not something that these companies deserve given the immense harm they cause to the public year on year.”