How illegal vapes end up in teenage hands, and the dilemma for pharmacists

Published Nov 19, 2024, 6:01 PM

Health officials have warned us of the potential health risks of vaping for a while now. But, a joint investigation by The Sydney Morning Herald, The Age and 60 Minutes has uncovered an even bigger problem. Organised criminals, infuriated pharmacists and a government struggling to crack down on vaping, particularly among young Australians, are at war.

Today, investigative journalist Eryk Bagshaw, on whether this perfect storm is creating a new generation of nicotine addicts. And undoing decades of work by health officials, who have, until now, caused cigarette usage to plummet.

From the newsrooms of the Sydney Morning Herald and The Age. This is the morning edition. I'm Samantha Salinger Morris. It's Wednesday, November 20th. Health officials have warned us of the potential health risks of vaping for a while now, but a joint investigation by The Sydney Morning Herald, The Age and 60 minutes has uncovered an even bigger problem organised criminals infuriated pharmacists and a government struggling to crack down on vaping, particularly among young Australians, are at war. Today, investigative journalist Eric Bagshaw on whether this perfect storm is creating a new generation of nicotine addicts and undoing decades of work by health officials who have until now caused cigarette usage to plummet. So, Eric, you have uncovered some quite shocking stories about the vaping crisis in Australia right now. But first, I want to ask you about the government's attempt to crack down on vapes. So when did that actually begin and how is it playing out?

Well, this has been a huge issue, I think, for both the coalition and Labor governments over the past 4 or 5 years. You know, we've we've seen vaping become what was once a pretty niche trend, probably about 2013 over 14 to exploding to becoming the most dominant form of nicotine consumption, particularly amongst young Australians. It is, you know, an absolute torrent of these devices coming into the country. We went down with Australian Border Force. We went to a seizure of vapes. It is pallet after pallet of vapes and most of them, you know, are barely concealed. So how many vapes are in this box?

Close to about 200. We can see sometimes up to thousands. Tens of thousands. You know, you can fill a container with well over 100,000 vapes.

You know, in schools across Australia. Teachers are having to be rostered on inside the toilets at recess and lunch time to stop people, kids from vaping while they're in the cubicles. The black market is absolutely flourishing and we've now seen certainly in Victoria, it's a very big issue. You know, there's firebombings there's threats and intimidation, bad.

Guys, firebombs and billions of dollars at stake. They're the ingredients fuelling an illegal tobacco war that's spreading across the country and becoming, you know.

Federal Health Minister Mark Butler has called it the number one public health menace facing young Australians.

This is a product that is deliberately and cynically marketed to them. You'll see in the vape stores, you'll see in convenience stores, vapes that have pink unicorns on them that are flavoured.

And what we've seen with these laws that were introduced at the beginning of this year is an attempt to try and get on top of the situation, but I think, as we have revealed, really, it's an imperfect solution to what is a very complicated issue.

And so can you just briefly take us through what are these new laws that the government has put into place?

So since January, disposable vapes, which are brands like Ijet or HCD, they are colorful, bright, um flavored vapes and watermelon, grape ice, those sorts of things. The vapes that you will see on the street, people puffing. Most of them are those disposable vapes. Now, since January, they've actually been banned. You can't. You're not meant to import them. Um, they are highly addictive. They are targeted at teenagers. Uh, but as if you step onto any street in Australia, um, you're likely to still see them in use.

And then in July, there was another legislation that came in. So tell me about that one.

Yeah. So since then, vapers have been allowed to get vapes from the pharmacy without a prescription. Now, that change is designed to allow ease of access for smokers and for them to be able to stop smoking by taking up vapes, they should have tried every other form of nicotine replacement therapy gum, you know, patches, spray, and if they can't, they can go into a pharmacy and pick up a vape. Those vapes are not disposable, and they're only meant to be in three flavours menthol, mint, and tobacco. And they're meant to be supplied by reputable providers who can self-declare their devices to get onto this, what's called a notified list. And then they can be supplied in pharmacies. They are completely different operations from what we see in the disposable market.

And just to, I guess, underlie the point that you made earlier about the potential harms on our young people specifically, you actually spoke to a health advocate, Lily Ford, who has a really troubled history with vaping. So what did she tell you?

Yeah. So, Lily, I think her story mirrors that of many young Australians in that introduced to vaping at school where there's now, you know, vape dealers running around the schoolyard, other teenagers providing vapes. And that's actually where she started vaping because she thought it was the social thing to do.

And you'd smoke it. It didn't smell bad. It didn't taste bad. It was strong enough to give you a head spin. And it was like this secret new world of fun flavours and socialisation and beauty. And that's what made it so attractive.

And she didn't really have any idea that they had nicotine in them. She didn't realise how addictive they could become by, you know, her final year of school. It was a full blown addiction.

I describe it as this loop. I'd feel anxious. I would reach for the vape. I'd smoke the vape, put the vape down, feel relaxed for almost ten 15 seconds, straight back to feeling anxious again, picking up the vape, smoking it. And it was just a repetitive cycle.

I think for her, you know, that sort of reached a kind of a crisis point.

I had never done anything along the lines of running before, and I think I did two kilometres. I was coughing up banana, banana, vape liquid and blood. It was gory.

And that situation is one that's common across many schools across Australia. There's many thousands of teenagers going through that. And I think Lily, you know, was scared about that. She's scared about the future health impacts. And I think many in her generation are scared about that, but they don't quite have the wherewithal yet to understand those implications, especially when the marketing of vapes was so pervasive, so effective, so colourful that it made it look like, you know, no more harmful than a soft drink. How important is that for younger people now to hear your story?

I just want to help the person that can resonate with my story from slipping down the same path that I slipped down.

And then the other side of the coin, of course, is that health authorities are really struggling to get the message out right to young Australians that vaping can be really dangerous. I mean, because one expert that you spoke to, this was the Department of Health's chief medical officer, Tony Lawler. He told you something that literally stopped me in my tracks. So tell me what he told you.

Well, he's, you know, really worried about the health impacts that that that this vaping has become so normalised and so regular that, you know, at one stage he caught someone vaping inside a hospital ward, just that this was just a regular thing to do. And the guy who he caught vaping inside the hospital ward couldn't understand what he had done wrong. You know, as far as he was concerned, this wasn't doing anything to anyone else. And that was the moment that shocked Doctor Lawler. You know, that he realised that this really has become a full on public health crisis, because we're now seeing something that we would never have seen the smoking for decades.

And I believe there was a health authority expert that spoke to you that said, you know, really the risk here is that we could be seeing the undoing of all of the health messaging about how bad tobacco is and how harmful it is, really those decades of of strides forward, they could be undone by this. Is that right?

Well that's right. Doctors are now monitoring issues like popcorn lung potentially damaging the airways in the lung through excessive vaping. You know, all the chemicals that are in vapes to produce the actual vapor and not to mention nicotine, which which can potentially lead to, you know, things like anxiety to mental stress to all of these other issues because you are ultimately becoming addicted to a chemical substance.

We'll be right back. Okay. So, Eric, I really want to turn to how the pharmacies play into this because I find this just absolutely puzzling because under current laws, pharmacies can sell nicotine vapes. But many pharmacists across the country are actually up in arms at the position they've been put in. Right?

Yeah. They're furious. Really. The Pharmacy Guild of Australia, which represents about 70% of pharmacists, really have no interest in stocking vapes in their pharmacies. And that's for two reasons. One is because they've seen the the tobacco wars and the, you know, the vape disputes play out, particularly in Victoria and in other parts of the country. And they are now scared that they could become targets of organised crime for selling a product that eats into the market share of the illegal black market operators. That's the one hand. The second is they don't really want to sell a product that they believe has limited evidence for its safety and efficacy. And I think the government, through the notified list, which is effectively the mechanism by which vapes can go into pharmacies, It's a list of 1800 devices and accessories that can be sold within pharmacies. Now, the problem is because the devices are so numerous and the TGA, for whatever reason, doesn't want to approve each one of these devices, the producers have been allowed to self-declare that their devices and their vape accessories are safe. And I think that's really got the pharmacists off guard, because everything else they sell apart from, let's say, chewing gum and other other sort of knickknacks in a pharmacy, every medical, most medical device they sell has to be approved by the TGA. These are not they are just notified and self-declared by the companies who are providing the devices. And on that list is big tobacco.

I mean, this just seems crazy to me. And I was reading your investigation and I was thinking what I imagine a lot of listeners will think or might have been thinking, which is why are pharmacies even stocking vapes? I mean, if they're highly addictive, as many would say, and many contain nicotine, isn't this sort of nuts? Because pharmacies are meant to be places that help people combat addiction or aid their health, but not aid addiction and harm their health?

Well, I think hardened smokers would argue that if they've tried everything, including nicotine patches, gum spray, you name it, and nothing can help them quit that. Vaping is probably a safer alternative to smoking. And on the balance of evidence that we have so far, at least anecdotally, vaping is probably better than smoking a pack a day of cigarettes, but we don't know the full picture yet. You know, it took decades for the full picture about smoking to come out. Um, what we have at the moment is that some smokers, yes, it has helped them quit smoking, and it's been the only thing that's helped them quit smoking. And pharmacists who want to stock those products and for that matter, doctors who want to recommend them. Then they see it potentially as as the only path out of that addiction to smoking cigarettes. That's understandable, but it's also understandable that pharmacists who choose not to stock them, um, are taking a much more cautious approach and are more wary of these claims, particularly when all of a sudden on this list you have, um, items for producers including Big Tobacco, Philip Morris international supplying vapes in a pharmacy. And as Anthony Tassone, one of the Pharmacy Guild's national counsel, said to me.

I'm a health professional, not a tobacconist. I promote health care, not big tobacco products. In all my career of over 20 years being a pharmacist, I can't recall another occasion where we had a separate notified list. Something was either approved or not approved.

And it's a real psychological divide that pharmacists have with selling big tobacco products after so many decades of seeing some of the absolutely devastating impacts of smoking, especially.

Since, I mean, as you mentioned, I can understand that argument of, you know, hardened smokers and this is their last resort to try to to break that addiction. But, you know, as you wrote in your piece today, a third of Australian teens have vaped, according to the most recent Australian Secondary Students Alcohol and Drug Survey. So that's a lot of people going for vapes who presumably not all of them are hardened smokers looking to break their addiction.

It's a whole new generation. A third of all Australian teenagers is a massive number.

And so I'm going to play devil's advocate here for a moment. Some people would argue that our government shouldn't be telling them what to do or when to quit vapes. You know, it's a free country. They should have the right to choose and make decisions as an adult. So is an outright ban on commercially sold vapes the only way to actually protect underage vapers?

Well, the government could have gone another way and they could have regulated them like cigarettes. Where you have vapes available in tobacconists and for only for purchase by those over the age of 18. That is one other model, and I think lots of vaping advocates would probably have pushed for that model. Now that model has problems. A it means vapes are much more available and much more present. They're probably quite a bit cheaper. Um, but it also means that the black market for vapes would be significantly undermined because the profit motives of selling a essentially legal product are much smaller. You know, you're not going to see those huge price rises. So it might take out some of the organised crime elements of that market. That's that's one model. The other model would have been what the government first intended, which is prescription only vapes. That would probably have satisfied the pharmacies more, because they then have the protection of providing a vape to someone who is seen a doctor and a doctor who said, yes, you can have a prescription for a vape and therefore you know you're eligible to buy one. And the pharmacist then doesn't feel like they are the ones dispensing a potentially harmful medical product. And I think that's the real bugbear. So they but that was the model that Mark Butler originally proposed. But they had to scrap that because the Greens and some, some of the nationals certainly, um, were strongly opposed to it because they believed it would undermine the access to vapes for for too many people, they want to see more people able to access vapes to help them stop smoking. And they thought getting a prescription for a vape would have been too high a bar for too many people. And so that's why we had this really rushed compromise through the Parliament that ended up with this legislation and this notified list, which, whilst it is an effective political solution, I'm not convinced it's the most effective health care solution. And that's the situation we now have.

Well, we're so lucky that you've put a light on this issue. It seems like it's going to be something that's going to be playing out for a very long time. So thank you so much, Eric, for your time.

Great to be with you, Sam.

Today's episode of The Morning Edition was produced by Julia Carcasole with technical assistance by Taylor Dent. Our head of audio is Tom McKendrick. The Morning Edition is a production of The Age and The Sydney Morning Herald. If you enjoy the show and want more of our journalism, subscribe to our newspapers today. It's the best way to support what we do. Search the age or Smh.com.au forward slash. Subscribe and sign up for our Morning Edition newsletter to receive a comprehensive summary of the day's most important news, analysis and insights in your inbox every day. Links are in the show. Notes. I'm Samantha Selinger. Morris. This is the morning edition. Thanks for listening.