Get 'em off the stinkies: Is vaping really that bad?

Left unregulated for almost two years, the vaping industry has been described as the Wild West. Young people are on the receiving end of aggressive recruiting to the habit through flashy parties, catchy jingles on hit music stations and marketing by popular influencers. Everyone agrees - there needs to be rules but the Government is struggling to find the right balance between attracting smokers to switch without encouraging teens to pick up the habit. But there could be an upside to the vaping revolution, Amelia Wade investigates.

From his converted ambulance which he rolls around Taranaki, Graham Peters is trying to convert as many smokers he can.

"I want to get 'em off the stinkies."

Once a heavy smoker who'd got hooked at 14, Peters transitioned to vaping about eight years ago after buying a device online.

His first e-juice contained a heavy 24mg of nicotine but the 61-year-old gradually reduced that and has now been nicotine-free for four years.

"But yeah, I still vape because it's yummy. It's about the pleasure I used to get from smoking."

Back when he first switched, Peters said all that was available was "teeny bottles of Chinese juice" with flavours which weren't spectacular.

"I'm a bit of a custard square fan myself and I'd heard about all of these custard vapes and thought, 'S***, I've got to try that'. Imagine vaping custard, that'd be yummy."

So he had a go at making his own.

He now sells more than 100 flavours, including peanut butter cups, kiwifruit on a New York cheesecake, Anzac biscuits, banana lollies, cinnamon doughnuts, buttery kettle corn and his own take on a red velvet ice cream.

"But my speciality is the custard ones."

Peters makes all the flavours himself in a clean room out of propylene glycol, vegetable glycerin, nicotine and food-grade flavouring and sells them on his website and through his mobile converted ambulance.

He prides himself in doing it responsibly. If he gets an order for anything more than 12mg of nicotine, he'll call the customer and check that's really what they need.

Peters really wants to get every smoker to quit, he says

But last year when the Government signalled flavours might be off the table he figured that could put his whole business in jeopardy.

He's still waiting to find out if he'll be forced to hang up the ambulance keys.

It's the Wild West

Catchy radio jingles, ads on dating apps, popular Instagram influencers, music festivals and brightly-coloured billboards are all tools the vaping industry has employed to flog their sleek devices and tasty flavours.

And this is exactly how you market to young people, said Professor Janet Hoek, a public health expert and New Zealand's leading expert on tobacco advertising.

"It's currently the 'Wild West' and the lack of regulation is really problematic. I don't think that anybody would disagree with that."

Hoek called the marketing of vape products "aggressive" and said they were being marketed in "exactly the same way" that tobacco products once were.

Of the five Big Tobacco corporations, British American Tobacco, Philip Morris, Imperial Brands and Japan Tobacco have launched e-cigarettes and their annual reports all promise that vaping is the golden egg to a sustainable future.

Their devices are sleek and smooth to the touch while the marketing campaigns are intense.

A type of vaping device. Photo / Bevan Conley

Hoek studied the launch of British American Tobacco's e-cigarette brand Vype in late 2018 and found familiar promotional tactics to old cigarette marketing.

Vype used social media to access young adults, partnered with cool brands like Remix and Vice by sponsoring their Christmas parties and called on influencers to promote their ePen.

Hoek is so concerned, she's called on the Ministry of Health to investigate and prosecute.

"Vaping is seen as cool, it's sophisticated, it's rebellious, it's for young people to make them appear more mature.

"That's a real risk and we really need policymakers to do something about it."

Not all vape sellers are the same

The local vaping lobby wants to make it very clear their approach is different.

Vaping Trade Association of New Zealand spokesman Jonathan Devery described the British American Tobacco's launch Vype launch "just outrageous".

"They just would have been spending a fortune and we're not in the position to do that. Local businesses don't have that kind of cash."

Vype's new campaign with "cool kids" vaping, spray painting and a DJ is clearly marketed at young people which Devery said the local industry didn't agree with.

"These are the kinds of people teenagers look up to these days and they're the new faces of the brand. They're not targeting smokers at all."

Devery also took issue with some online stores, which don't have R18 courier drivers which check ID upon delivery which most of their retailers use.

"We are desperate for regulation, this will legitimise the industry and help convert current smokers to a much less harmful, more cost-effective alternative.

"We want world-class product standards to give consumers confidence in the industry, and we want clear legislation that we can all implement to prevent youth access."

VTANZ wants products to be able to be displayed to convert as many smokers as possible, and responsible advertising guidelines, Devery said.

Alt. New Zealand's advertising campaign for their vaping products.

A spokesperson for British American Tobacco said it has demonstrated commitment to preventing youth access to vaping products.

It did this through appropriate health warnings and disclaimers on its products, R18 age-gated social media platforms, educational materials targeted at adults-only in store and verified ID checks on the Vype website.

"[We] urge the Government to bring forward its proposed vaping product regulations and ensure that stringent youth access prevention measures are incorporated into any such regulations."

Japan Tobacco said it strongly agreed minors shouldn't use or have access to vaping products and that it "always communicated responsibly" about its products.

Philip Morris said it didn't comment on other companies' marketing while Imperial Brands did not respond to the Weekend Herald's requests.

The failed court case

The Ministry of Health tried to shut down the sale of vaping products by taking Philip Morris to court in 2018.

The decision didn't go in their favour.

The Wellington District Court found the e-cigarette Heets wasn't caught within the Smoke-free Environment Act because there's no combustion and it isn't as harmful or potentially harmful as smoking.

This had the consequence of giving the vaping industry clarity in what was previously a grey area.

It effectively legalised the sale of nicotine vapes and e-cigarettes and led to the situation we have today, said Hoek.

The Advertising Standards Authority (ASA) has some power to rein in overzealous marketing with codes requiring ads to have a social responsibility towards children, to not make unwarranted therapeutic claims and to not be misleading,

Last year, the authority got five complaints about ads for smokeless tobacco and vaping products - two were upheld, another was upheld in part, one was settled and the last was not upheld.

ASA chief executive Hilary Souter said it also had jurisdiction over influencers peddling products on social media. The ASA had yet to receive a complaint of this nature about vaping.

The authority doesn't have any power over companies sponsoring events - that would need to be regulated by the Government.

Shosha in Napier, a specialist vaping and hookah retailer. Photo / Duncan Brown

As the court ruling against the Ministry ruled out bringing vaping under the Smoke-free Act, the Government has to make an amendment in order to regulate it.

Associate Minister Jenny Salesa promised to do this by the end of last year but she's now extended that deadline to bring it in before the election on September 19.

The difficulty is finding the balance between encouraging smokers to transition while making it unappealing to young people and regulating something which hasn't definitively proven to be harmful.

"It's important that we get this legislation right. While it has taken longer than I'd like, regulating the vaping industry remains a priority for me," Salesa told the Weekend Herald.

"Whilst I have never smoked nor have I tried vaping myself, I appreciate that it is an important quit tool for many New Zealanders.

"I congratulate everyone who has successfully given up smoking, including those who use vaping to quit.

"I have also been listening to the concerns raised by parents, teachers and principals about the interest teenagers have been showing in vaping products – and that is why it is important that the legislation gets the balance right."

Meanwhile the kids keep vaping

At every interval Glendowie College principal Richard Dykes confiscates vapes.

It's illegal to sell minors vaping products, with or without nicotine, but a University of Otago study last year found many dairies didn't realise this and did it anyway.

This week the Weekend Herald took a 14-year-old to 15 dairies and vape shops around Auckland but all asked him for identification and none sold him e-juice without it.

The teenager told us lots of kids at his school vaped because it was cool and cheaper and more accessible than smoking.

Most bought it online.

Vapers go up in a cloud of fumes at a Queen St pedestrian crossing. Photo / Michael Craig

Teenagers often don't realise it's not just water vapour they're sucking into their lungs, and that it's not completely harmless, said Dykes.

"They think it's completely safe."

He was grateful for the Don't Get Sucked In campaign launched this month by the Asthma and Respiratory Foundation NZ to educate young people about the potential risks.

And Dyke's sick of arguing whether there's a youth vaping crisis. He just wants legislation to stop his young students from being both marketed to and able to buy it.

"We're incredibly disappointed. [This delay] has given Big Tobacco and vaping companies a free-for-all."

In January, the authors of the annual survey which measures smoking rates and attitudes of teen students said the latest results didn't "support the notion of a so-called vaping epidemic".

Action on Smoking and Health (ASH) found 0.8 per cent of students aged 14 and 15 who'd never smoked, vaped daily and just over a third (37.3 per cent) had tried vaping, compared to 19.6 per cent who'd tried traditional cigarettes.

One of the criticisms of the ASH survey is that it surveys teens too young because researchers know the risk-taking behaviour that leads to experimentation starts later on, Hoek said.

Ideally she'd like a more comprehensive study which is nationally representative that monitors uptake over time to get a better picture of the trends.

"It's concerning that the perspective of people on the ground and what they're reporting seems to be so different.

"I think we all hope that it's not a problem, but it's a premature conclusion to draw at this stage."

A type of vaping device. Photo / Bevan Conley

But any way you smoke it, nicotine is addictive.

Nicotine is as addictive as heroin or cocaine and Salesa said the Government knows this.

"Nicotine is an addictive, toxic substance, and most vaping products contain nicotine.

"While small quantities of nicotine are associated with few risks, high-levels and exposure to children is of concern."

Flavours falling out of favour

One of the ways the Government is looking to curb vaping's appeal to young people is flavours, which is somewhat controversial as many experts say this is what helps keeps smokers vaping.

In a Cabinet paper, Salesa proposed including a power in her Bill to enable the Government, be it present or future, to prohibit "flavours and colours that attract children and young people".

Many of the participants in one of Hoek's studies about transitioning smokers found initially they wanted to find a flavour similar to their preferred cigarette to ease the switch.

But they soon moved to a sweeter flavour and grew to dislike the tobacco taste.

"Other people wanted to move completely away from smoking - so they wanted to create an entirely new behaviour.

"So for them the look, feel and taste of smoking was much less important," Hoek said.

Vaping supplies at Vapo, Karangahape Road. Photo / Michael Craig

Though the Asthma Foundation is worried flavours aren't just appealing to teens but dangerous to someone's health.

Of the flavour additives, 7000 of them are food products.

"The stomach is very different to the lungs.

"There are a raft of studies demonstrating many of them are toxic to lung cells especially chocolate and berry."

The lesser of two evils?

Smoking kills half of its regular users, unfairly affects our society's most deprived members - especially young Māori women - and is the single leading preventable cause of early death in New Zealand.

Yet 550,000 of us smoke daily.

New Zealand also isn't on track to meet our 2025 deadline where less than 5 per cent of our population smokes.

The Ministry of Health said in a business case in June last year that meeting this goal will be "challenging" with a recent model projecting smoking rates would reduce to 8.1 per cent of non-Māori and 20 per cent of Māori by 2025.

Māori weren't projected to reach 5 per cent until 2061 and the Ministry said inequalities were widening among young people.

But vaping could be the disruptor.

While there's no long-term clinical data and studies are still emerging, the Ministry says vaping is "much less harmful than smoking tobacco but not completely harmless".

"A range of toxicants have been found in vapour including some cancer-causing agents but, in general, at levels much lower than found in cigarette smoke or at levels that are unlikely to cause harm.

"Smokers switching to vaping products are highly likely to reduce the risks to their health and those around them."

And the Ministry says vapers feel less dependent on e-cigarettes than they do on traditional cigarettes and often choose to reduce the strength of nicotine they use over time.

Some may eventually stop vaping altogether.

A woman smokes a fake 'Elusion' electronic cigarette. Photo / Janna Dixon

It's also much cheaper, with some e-juice bottles on sale for $5 - a pack-a-day smoker could save almost $15,000 a year.

The Ministry's business case was for a campaign to encourage Māori women, the population group with the greatest smoking rate, to switch to vaping.

In 2015/2016 42.7 per cent of Māori women between the ages of 18 and 24 smoked.

The Ministry worked with a group of young women to establish the best way to transition them off smoking and had one group which switched completely to vaping.

One woman also quit vaping.

The benefits to the women, their whānau and tamariki were significant, the Ministry said.

"They have reduced the direct risks to their health from smoking and to their children from second-hand smoke, are modelling a smokefree lifestyle for their children, wider family whānau, and have more disposable income to spend on other things."

But while the Ministry of Health backs vaping as a means to end smoking, other health authorities are more cautious.

Dr Stuart Jones of the Asthma Foundation said vaping and e-cigarettes "are likely to be harmful to the lungs long-term".

"We cannot think of any other product which is manufactured to be inhaled, that has not been through stringent regulatory controls

"This is vitally important and e-cigarettes should not be given a free ride.

"We have seen the damage caused by letting cigarettes escape regulation and New Zealand can ill afford to make the same mistake again," said Jones.

The Cancer Society is taking a precautionary approach and doesn't fully support the Ministry's recommendations.

A meaty 100-page report on vaping's degrees of harm concludes the current long-term evidence is insufficient to properly inform regulation.

Among the Society's concerns is that vaping is "a recent phenomenon" with a lack of long-term clinical data and limited evidence that vaping was a successful cessation aid.

But it supports a "very targeted" approach to public information, restricting e-cigarette sales being restricted to specialist vape shops and pharmacies where smokers can get information on how to make vaping as successful to them as possible.

There's also a risk that if vaping isn't beholden to designated smokefree areas, there's the addiction could become normalised amongst children and young people, the Society said in its report.

And an idea Hoek tested was the effectiveness of warning statements on products.

Preliminary results of one of her studies found that by simply adding the text warning that nicotine is addictive, it deterred non-smokers but not smokers looking to transition.

Smokers are used to being told about the dangers of their habit.

The Government holding its breath

Principal of John Paul College in Rotorua, Patrick Walsh, said last year he was worried the decades-long fight to eliminate smoking could be undone by the growing popularity of vaping and the delay to control it.

"Vaping is gaining a strong foothold in our school community.

"If things continue as they are for too much longer, it will be almost impossible to manage within the student population.''The Asthma Foundation has previously accused the Government of holding its breath.

Salesa intends to introduce the amendment before the end of term where it will then follow the normal process through parliament but she couldn't say exactly how long it would take to come into effect.

National health spokesman Michael Woodhouse said he offered his support for an amendment bill in September.

"Regulation is needed quickly and the Government is dragging its heels at every turn. But National's offer is still on the table."

Meanwhile, in Taranaki, Peters is still waiting on whether it's a smart idea to invest in a clean room but will continue to try to get smokers "off the stinkies".

What is vaping?

• Electronic cigarettes are generally comprised of a tank with a built-in "atomiser'' - a coil of wire wrapped around a wick - and a battery.

• The tank is filled with "e-liquid'' or "e-juice", which comes in a range of flavours. Some e-liquids contain nicotine.

• This is absorbed into the wick while the wire is heated by the battery. The heat then vaporises the liquid in the tank, which is then inhaled by the user who produces smoke-like vapour when they exhale.

• There are a vast array of vaping devices available, some looking like traditional tobacco cigarettes.