Australia's success in reducing smoking rates is the envy of the world - their smoking rates have more than halved in the past 30 years - but the growing popularity of e-cigarettes, especially among young people, makes this a major achievement at risk. The federal government must redouble its efforts to crack down on vaping before it becomes popular among our young people and induces them to smoke tobacco.

As The Herald Sun reported today, new import restrictions on vaping products containing nicotine appear to be doing little to curb the commodity's burgeoning black market. Teens also have easy access to vaping products and use them in schools, although the sale of e-cigarettes to children is illegal in Australia. Some schools have had to take steps to discourage students from vaping, such as installing CCTV or vaping detectors, or locking bathrooms during recess.

Decades of government interventions to stop people from smoking - advertising bans, plain packaging, massive tobacco excise taxes and public health campaigns - clearly have an impact in Australia. Today, only 11 per cent of Australians aged 14 or over smoke daily, up from 24 per cent in 1991. But those gains are under threat.

E-cigarettes are growing in popularity, especially among young people, and many of these products appear to be marketed against them. From 2016 to 2019, the proportion of Australians aged 18-24 who had tried e-cigarettes jumped from about 19 per cent to 26 per cent, and experts fear e-cigarettes could become a way for some e-cigarette users to smoke. A 2020 Australian National University study found that teens who use e-cigarettes are three to five times more likely to start smoking tobacco cigarettes - a finding that has been replicated in overseas research.

Smoking is known to cause significant harm not only to the health of smokers, but also to communities who have to pay for smokers' medical bills and miss out on the contribution of sick smokers to society. The net cost of smoking in Australia was estimated at $136.9 billion in 2015-16.

As Curtin University health policy professor Mike Daube said in the Senate's 2020 inquiry into vaping, Australia's efforts to curb smoking, especially among young people, are remarkable. Any attempt to renormalize smoking would be disastrous.

The adverse health effects of smoking also take decades to become apparent, and public health experts worry that the ingredients users inhale when vaping, even if the products do not contain nicotine, could cause significant harm in the long run. They urge caution in public policy about vaping until there is more evidence of how the practice affects users, which will take 20 to 30 years to sort out.

The government's import ban on nicotine vaping products has been delayed due to liberal concerns among some members of parliament. Individual liberty is important, but when it comes to public health, it must always be weighed against broader societal issues. These include the social cost of providing care for related health problems and the responsibility to protect more vulnerable Australians such as children and young people.

There is also insufficient evidence that e-cigarettes can help smokers quit, and physicians are advised to encourage patients to use other treatments to quit smoking rather than e-cigarettes.

Doctors are right to call for a tougher crackdown on all vaping products. Scientists don't yet know how dangerous vaping is, and evidence suggests it's a gateway to smoking, risking Australia's hard-earned gains in controlling smoking rates. Continuing to use e-cigarettes without stricter regulation is a risk Australia cannot take.

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