Nicotine is a morish drug and given to an adolescent, the addictive process will be accelerated.
We experience good sensations from drugs unconsciously in our brains, ahead of our consciousness, and memories are formed.
Teenagers' frontal lobe connections are not fully developed and are more likely to signal highly positive feelings from risky experiences than those of us who have lived a bit.
In my view, if you want to optimise selling nicotine for profit you target adolescents, because they will become customers for life.
What harm will vaping do to an adult? Compared with smoking tobacco, relatively little.
In 2015, an independent evidence review from Public Health England estimated that e-cigarettes are 95 per cent less harmful than smoking.
Nicotine is not toxic in small doses and is hardly carcinogenic, but tobacco containing up to 7000 harmful additives is as cancerous as alcohol and treacherous for the heart, lungs and brain.
A non-smoking adult risks addiction, and any toxicity related to vaping additives.
Australia's ban on vaping was associated with an increase in tobacco smoking and unregulated ENDS on the black market, so regulated vaping should be here to stay.
It is beneficial that addicted smokers can choose to take their drug of choice without the associated risks of tobacco.
It is useful to think of the regular use of nicotine as like using coffee, with a more significant but functional addiction.
It's all about the level of harm, and vaping causes lower levels of harm to adult smokers. Vapers can also wean off nicotine using gradually reducing doses.
A teenager using heated nicotine may fare differently because the drug is unhealthy for the developing brain, and addiction begins in adolescence.
Dependency on nicotine can have negative psychological effects on people and is expensive, although vaping is 10 times cheaper than smoking.
Nicotine is harmful in pregnancy, although less so if not smoked with tobacco.
Some public health researchers are not so chuffed, saying e-cigarettes do have some harm and may expose some of the adolescent population who would otherwise not smoke to becoming hooked on nicotine and possibly harmed by additives in vaping.
Long-term data on this is not yet available, making regulation and high product standards paramount until more is known.
Before you say popcorn lung, check out the excellent Ministry of Health website's "vaping facts".
Is vaping a gateway to smoking in adolescents?
This is very complex to study, but vaping in non-smoking youth is associated with an increased risk of subsequent tobacco use.
This does not necessarily mean vaping causes smoking.
Kiwi teenagers are preferring e-cigarettes over smoked tobacco, and while there has been a sharp rise in vaping, smoking rates have remained almost static.
More than a third have tried vaping nicotine, but only a small percentage are using it weekly or more frequently, according to a survey published last year in the Australian and New Zealand Journal of Public Health.
The Asthma and Respiratory Foundation survey found even higher rates of regular or even daily vaping.
Study design and population sampling are important here, as some populations are more likely to vape, and therefore figures can be over-represented.
Given these concerns, we must be vigilant.
I think the devil is in the retail.
I believe there was a regulatory vacuum after the Ministry of Health lost a court case in 2018.
This decision enabled the sale of vaping products in New Zealand, and in my opinion the promotion of vaping as a lifestyle burgeoned.
Nicotine products were promoted on websites and social media with easily breached or no age restriction barriers.
Offers included free samples with an array of flavours often attractive to youth.
In my opinion, that looks like some vape sellers wanted lifelong customers.
It is pleasing that vape companies are contributing to the recycling of the significant e-waste produced by the proliferation of devices.
A commercially addictive product contributing to climate change is perilous.
The Smokefree Environments and Regulated Products Act 1990 was then amended in 2020.
It requires smokefree indoor workplaces, restaurants, bars and schools to be vape/smoke-free, with purchases restricted to people over 18, amongst other restrictions.
But social media marketing remains unregulated.
We must get the balance right.
Vaping should be available for adult smokers, with limited access for young people.
We don't want public health gains to be evaporated by the heat of market forces.
Tony Farrell has been a general practitioner for 30 years. He is a Mount Medical Centre director and a Fellow of the Royal New Zealand College of General Practitioners. Tony has a special interest in mental health and addiction and is a trustee of Hanmer Clinic and chair of Alcohol Action NZ
