What are e-cigarettes?
Electronic cigarettes (e-cigarettes) are battery-powered
devices that come in many forms. They all heat liquids, called e-liquids, into
an aerosol that users breathe in. They may contain nicotine, flavourings and a
range of harmful and toxic chemicals. Many e-liquids come in flavours that are
attractive to young people, such as mango, lime and mint. The e-cigarette heat
may also produce toxic substances.
They are also known as e-cigs, electronic nicotine delivery
systems (ENDS), electronic non-nicotine delivery systems (ENNDS), alternative
nicotine delivery systems (ANDS), personal vaporisers, e-hookahs, mods, vape
pens, vapes and juuls (pronounced ‘jewels’).
Using e-cigarettes is often called ‘vaping’. It is sometimes
referred to as ‘juuling’.
What do e-cigarettes look like?
E-cigarette devices come in many different shapes and sizes.
They can look like traditional cigarettes, cigars or pipes. Some look like everyday
items commonly used by young people, such as pens or memory sticks (USBs). Some
are even disguised as medical devices or concealed within clothing.
What are the health risks of e-cigarettes?
Most e-cigarettes contain nicotine, which is highly
addictive especially for teens. E-cigarettes and e-cigarette liquid may contain
nicotine, even if they have been labelled ‘nicotine free’. One e-liquid pod can
contain as much nicotine as a packet of cigarettes.
Nicotine exposure during the teenage years can harm brain
development, which continues until about age 25. It can impact learning, memory
and attention, and increase risk for future addiction to other drugs. Young
people who use e-cigarettes may be more likely to go on to use regular
cigarettes.
E-liquids can poison children and adults through swallowing
or skin contact. Symptoms of nicotine poisoning include sweating, dizziness,
vomiting and increased heart rate.
E-liquids can also be a danger to young children if inhaled,
swallowed, or spilled on the skin. A young child can die from very small amounts
of nicotine. The effects of nicotine poisoning can come on very quickly. If you
think your child may have been exposed to nicotine, you should seek medical
attention or call an ambulance immediately.
While
scientists are still learning about the short and long-term health effects of
using e-cigarettes, a recent outbreak of lung disease and deaths related to
e-cigarette use in the United States demonstrates that e-cigarette aerosol can
be harmful to the lungs. In the short term, using e-cigarettes may cause breathing difficulties and coughing. Many e-cigarettes contain known-carcinogens and inhaling cancer causing chemicals increases the risk of cancers. In the longer term, e-cigarette use also increases the risk of heart disease. E-cigarettes can also be modified to deliver marijuana and other harmful substances that have been linked to lung disease.
Defective e-cigarette batteries have caused some fires and explosions, which exposes the user to the risk of serious injury and burns.
Nicotine addiction
Young people who use
e-cigarettes containing nicotine can become addicted. The more frequently someone uses e-cigarettes,
the more their brain and body gets used to having nicotine, and the harder it
is to go without it. When someone stops using, the nicotine level in their body
drops, which may cause unpleasant physical symptoms, and a strong urge to vape.
This is nicotine addiction.
How do you know if you are addicted to nicotine?
If you answer yes to any of these questions below, you may be addicted to nicotine:
- have you ever tried to quit vaping but couldn't?
- do you vape now because it is really hard to quit?
- have you ever felt like you were addicted to vaping?
- do you ever have strong cravings to vape?
- have you ever felt like you really needed to vape?
- is it hard to keep from vaping in places where you are not supposed to?
When you haven't used e-cigarettes for a while do you:
- find it hard to concentrate?
- feel more irritable?
- feel a strong need or urge to vape?
- feel nervous, restless or anxious?
Nicotine withdrawal
Nicotine withdrawal occurs when someone stops using e-cigarettes and the body and brain must adjust to going without nicotine. The withdrawal symptoms can come on quickly, may be uncomfortable and trigger cravings for nicotine. Common nicotine withdrawal symptoms include:
- feeling irritable or restless
- having headaches
- feeling anxious or depressed.
- difficulty concentrating
- having trouble sleeping
- having intense cravings for e-cigarettes
Are e-cigarettes and e-liquids safe?
The Australian Therapeutic Goods Administration (TGA) has
not safety tested e-cigarettes or e-liquids, so they should not be considered a
safe product. These products are not regulated in Australia and are often
purchased online, meaning they can be made anywhere, by anyone and contain
anything.
When to see a doctor
If you’re worried about your child, or if your child needs support to quit vaping, it’s a good idea to see your GP.
Young people can also call Quitline to receive multisession, individually tailored behavioural support provided by skilled cessation counsellors. Quitline referrals can be made online at the Quit Centre or by phone from anywhere in Australia on 13 QUIT (13 78 48).
Too much nicotine from e-cigarettes can cause nicotine poisoning. If you are concerned about your child, please call the Victorian Poisons Information Line on 13 11 26.
The Victorian Poisons Information Centre (VPIC) has information on what to do when someone has been poisoned, overdosed or made a mistake with their medication. When you call the VPIC, trained staff will give you first aid information, and tell you if you need to call an ambulance or refer you to a doctor for treatment.
Recommendations for parents
As a parent and caregiver, you have an important role in protecting children from e-cigarettes.
The best way to protect your children is to never smoke or vape in the house, car or other places where there may be children nearby. Passive exposure to e-cigarette vapour can be damaging for children and young people.
In most Australian states and territories, it is illegal to use e-cigarettes in cars with children under the age of 16 present.
Parents should learn about e-cigarettes. It’s important to talk to your teen about the health risks of e-cigarettes. Many teenagers are under the misconception that e-cigarettes are safe. It is helpful to know what the different devices look like and the different words young people may use to describe using e-cigarettes. This will help you to talk about e-cigarettes with your teen.
Finally, if you are an e-cigarette user, always keep e-cigarettes and e-liquids locked away and out of reach of children.
How to talk to teens about the health risks of using e-cigarettes?
Talking with teens about risky behaviours is an important way for parents to help keep them safe. Parents are already good at talking to their teens about alcohol, smoking and drugs. E-cigarettes should be included in the conversation.
The earlier and more often you speak with young people about e-cigarettes, the more likely they are to listen. It’s important for parents to educate themselves, so they know the facts and what to say when the topic comes up.
Finally, young people are more likely to use smoking products if others around them do. Parents can lead by example by not using e-cigarettes at all, especially when children are around.
Key points to remember
- e-cigarettes and vaping devices heat e-liquids into an aerosol that users breathe in
- e-liquids may contain nicotine, flavourings and a range of harmful and toxic chemicals
- e-cigarettes are also known as vapes, mods, e-hookahs and juuls
- using e-cigarettes is sometimes called ‘vaping’ or ‘juuling’
- e-cigarettes and e-liquids have not been safety tested by the TGA in Australia, and should not be considered safe
For more information
Common questions our doctors are asked
Do e-cigarettes contain nicotine?
Yes, most e-cigarettes contain nicotine. E-cigarette liquid may contain nicotine, even if it has been labelled ‘nicotine free’.
Are e-cigarettes and e-liquids safe?
No. The Australian Therapeutic Goods Administration (TGA) has not safety tested e-cigarettes or e-liquids, so they should not be considered a safe product. In some countries, people have died due to lung injury caused by using e-cigarettes.
Developed by The Royal Children’s Hospital National Child Health Poll, Respiratory and Adolescent Medicine Departments. We acknowledge the input of RCH consumers and carers.
Reviewed May 2023
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.