Vaping at Australian schools is increasing and understandably creating great concern for teachers and parents. However, the widespread punitive and coercive strategies such as suspensions, vape detectors, locking toilet doors and toilet raids are not working, according to Dr Colin Mendelsohn, who says these strategies are alienating kids, and schools are sinking under the pressure.
He suggests a fresh evidence-based approach is needed.
Dr Mendelsohn is a member of the expert advisory group that develops the RACGP Australian national smoking cessation guidelines, and founding chairman of the Australian Tobacco Harm Reduction Association, a registered health promotion charity dedicated to raising awareness of low-risk nicotine products as a substitute for smoking for smokers who can’t quit.
He says he has never received from e-cigarette or tobacco companies but believes there are widespread misunderstandings about vaping, which need to be corrected.
‘We must start with the facts,’ says Dr Mendelsohn. ‘Vaping is not risk-free but has only a small fraction of the risk of smoking, estimated to be around 5 per cent of the risk or less by the UK Royal College of Physicians and the UK Government.
‘The panic about youth vaping has grown out of proportion to the harm it causes. Other risky teenage behaviours such as smoking, binge drinking, illicit drug use and drink driving are of much greater concern.
‘In 2019, 63 Australian teenagers died from alcohol. No teen or adult has ever died from vaping nicotine.
‘A recent assessment of youth drug harms ranked vaping as just about the least harmful form of drug use among young people.’
Low risk, comparatively?
Dr Mendelsohn says most vaping by young people who have never smoked is short-term and experimental, and the risk of harm is particularly low with this pattern of vaping, with recent Australian research finding that only 5 per cent of 14-17-year-olds vape on 6 or more days in the last month and half of these had smoked first.
He says there is no evidence that vaping causes kids to take up smoking if they would not have otherwise done so (the so called ‘gateway theory’).
‘In fact, vaping is diverting kids away from smoking and reducing youth smoking rates overall,’ according to Dr Mendelsohn. ‘There is also no evidence that vaping nicotine causes the serious lung disease “E-cigarette or Vaping Associated Lung Injury” (EVALI), “popcorn lung”, seizures or spontaneous pneumothorax (lung collapse).
‘Harms from long-term vaping may emerge over time but are highly likely to be far less than from smoking,’ he said.
Counterproductive approach?
‘The coercive and harsh response currently being used in schools is counterproductive,’ according to Dr Mendelsohn.
‘This is like a red rag to a bull. Punitive approaches such as suspensions are not effective and have potentially harmful consequences such as academic failure, dropouts, violent and anti-social behaviour and smoking, especially for vulnerable students.
‘In this light, schools should educate students and staff about vaping with honest, evidence-based information. Fear campaigns that exaggerate the risks only serve only to alienate children. Kids know when they are being lied to and will lose trust in authorities,’ he said.
‘Vaping should only be used as a quitting aid for adult smokers and is not recommended for anyone who does not already smoke. Children must also understand that vaping is not completely harmless. There are small potential risks, particularly nicotine dependence.’
Dr Mendelsohn says it’s important to explain to kids that black-market vaping products are manufactured without the same oversight and standards as legitimate products, and are more risky.
‘However, even the best education programs have limited success in changing youth behaviour. Teenagers are programmed for “sensation-seeking” and taking risks. Risky behaviours are driven by social and emotional factors, not cognitive factors or knowledge.’
Peer pressure
Dr Mendelsohn says peer pressure can be a powerful driver of teen vaping. ‘It can be helpful to teach kids how to refuse the offer of a vape, for example with role plays.
‘Quitting vaping is generally much easier than quitting smoking as vaping is less addictive,’ he said.
‘However, some students may need advice and support to quit. Some vapers can stop abruptly. Others prefer to gradually reduce the nicotine content of the vape and use it less frequently. Increasing the time between vaping and setting rules for when and where you do and do not vape, can help.’
According to Dr Mendelsohn, ‘We need to recognise that some kids will vape whether we like it or not. Some schools may wish to consider allowing vaping breaks for addicted students and even to have designated vaping areas for those who need them, with parental permission.
‘Most Australian schools do not have a policy or education program for vaping. Schools should develop clear policy guidelines and outline how vaping should be managed. Restrictions are needed, but a pragmatic, supportive and compassionate approach is most likely to be effective and acceptable,’ suggests Dr Mendelsohn.
You can find out more about Dr Colin Mendelsohn and his views about vaping here.
