The latest Australian National Drug Strategy Household Survey showed vape use doubled among 14 to 17-year-olds and quadrupled among 25 to 29-year-olds between 2016 and 2019.

But anecdotal evidence of a more recent surge has been enough to panic parents and principals who fear a new generation will become addicted to nicotine if government interventions don’t come soon enough.

Before COVID-19 lockdowns,disposable wrappers littered streets after nights out,vape carcasses filled up alleyways and school toilets. Now,as kids prepare to eventually go back to school,a dozen Melbourne and Sydney schools including Knox Grammar have installed vape detectors in bathrooms.

“I’ve got an 11-year-old granddaughter,” says Simon Chapman,an emeritus professor of public health at the University of Sydney. “She is in her final year of primary school. I asked her,‘do you know any kids in your class that vape’? She said ‘oh yes’ straightaway. Why do they do it? She said:‘Because you can get lemonade’.”

“It was just an instinctive response,” said Chapman. “Lemonade is something that at her tender age she thinks is still just lovely,and now you can get lemonade-flavoured e-cigarettes.”

Curtin University’s professor Ben Mullins,who has conducted tests on refillable e-cigarettes,said the disposable vapes are now “everywhere in most states of Australia”. “I see them lying around,thrown away,people using them,” he said. “Companies that sell them look like Australian companies,catering to the Australian market,but if you look at the details they’ll be registered or shipped from another country.”

China’s ‘Wolf Warrior’ companies

Ninety per cent of the world’s vapes are from China,and 90 per cent of those are from Shenzhen:the 13-million-strong metropolis next door to Hong Kong. It is a remarkable sales figure for a country where the domestic online sale of vapes is banned.

Two of the most popular vapes in Australia come from Shenzhen Hanqingda Technology Co and Shenzhen Huaxinyu Technology Co. The companies share their research in the city and distribution channels in Australia.

But in convenience stores and schools in Melbourne,Sydney,Perth and Brisbane,they are better known by their distinctive vape names:HQD and IGET. HQD – the larger of the two – is now producing half a million vapes a day.

The company’s largest market is Russia,where it said it sponsors parties on top of snow-peaked mountains and at a racing club. Other important buyers are Ukraine,Kazakhstan,Uzbekistan,South Korea,Britain,Germany and Australia.

“We sell very well in Australia,” said Hou Shoushan,HQD’s general manager. “We have three to four hundred dealers big and small. In that way,we control the price. You can order 500 or hundreds of thousands.”

In May,Liu Sheng,the secretary of the local Chinese Communist Party committee,visited the factory to highlight examples of tech growth in Shenzhen. He said more Chinese companies needed to be like HQD:“to mobilise the streets and actively seek suitable industrial space for enterprises.”

The nation-building ethos extends from Liu to the factory line. HQD’s military drills are modelled on the 2015 Chinese action filmWolf Warrior. The movie has influenced everything from Chinese diplomacy to HR in the private sector,where it is designed to instil a sense of loyalty and “national prosperity” in workers.

“Only such a team can withstand long-term and cruel market competition,” the company tells its workers. Hou said after the team building exercise,“the employees are invigorated”.

They will need to be if they are going to take on the might of big tobacco,which has pivoted towards vapes and heat-not-burn tobacco products since 2014 as their traditional market shrinks.

“We can 100 per cent defeat them,” said Hou.

Tobacco,still dominated by 20th-century giants Philip Morris,British American and Imperial,has high barriers to entry:the physical crop requires land to grow it and workers to clear it.

But vapes,which are effectively mini electric kettles,need only a five-storey factory in one of the world’s most densely populated areas to pump out hundreds of thousands a day.

Hou originally wanted to manufacture medical equipment,but he chose vapes because he saw a gap in the market.

“Medical equipment required a high threshold and long application process for getting a licence. The e-cigarette was a burgeoning industry without a clear definition of legal status,and a little bit chaotic,” he said. “So we decided to make e-cigarettes.”

The company’s deputy general manager,Deng Yang,said HQD’s orders from Australia are booming. “When we first started,the orders were merely a few hundred each. But now sometimes it can be hundreds of thousands,” he said.

“We have written down the not-for-sale-to-minors warning in English on the package and advised our dealers about this issue.”

HQD also asks online buyers to upload their ID cards before ordering. But Hou concedes that,even with this safeguard,vapes could still be spreading to schools as some students in Australia buy online using a parent’s ID or through convenience stores.

“Smoking among juveniles is a common phenomenon all over the world. Sometimes,I send my daughter to buy me a cigarette,” Hou said.

“First,the e-cigarette is safer than the traditional one. Second,it can refresh your brain,” he claimed. “Third,it’s a fashion. Personally,I don’t think there is a big problem.”

But parents are worried;their kids are turning up at sick bays with nicotine poisoning. And some young adults who’ve taken up the habit say they are vaping more than they’d ever smoked.

Several vape users in their 20s who spoke to theHerald andThe Age on the condition of anonymity said the convenience of purchasing vapes at corner stores or tobacco stores,and the ability to vape easily indoors,meant they have become more frequent users than anticipated.

One woman,27,said she started vaping to replace smoking,but now she “just grabs it all the time”. “With smoking,you have to go outside,get hand cream,spray yourself. Vaping is a quick nicotine hit. So if I’m in my room I can have a puff,” she said.

Another said she and her boyfriend shared an 1800-puff vape that they replaced every three or four days. “I started vaping to help me quit smoking cigarettes,” she said. “Fast-forward a month and I hate smoking cigs and the smell and the whole experience,but my nicotine addiction is worse than ever. The vape is always there,you can do it inside,there’s no sense of ‘I’ll have one’ because it can’t be measured.”

A third woman,also in her 20s,said she used to feel anxious when leaving home without her vape. “Also I definitely vape in bed.”

Sydney designer Ash Fischer said when he moved back to Sydney from Melbourne last year most of his mates “were huffing on them.”

There were so many vapes being discarded that he decided to turn them into ashtrays. The single-use devices are made with either aluminium or plastic casing,and also contain batteries making them difficult to recycle.

“People will[say they] care somewhat about the environment,but I feel nicotine overpowers that,” the 23-year-old said.

“It’s like the modern-day cigarette. It’s insane – all the school kids have nicotine addictions. It’s completely done a U-turn from smoking.”

The disposable vapes carry very high concentrations of nicotine – sometimes up to 6 per cent,which is triple what is allowed legally in Europe for re-useable vapes.

Matthew Peters,the head of Respiratory Medicine at Concord Hospital in Sydney,said he had never seen this level of nicotine exposure in kids. “We’ve not had young people,going back a really long way – maybe ever – exposed in the way they are now to as much nicotine,” he said.

“We know that the higher levels of nicotine exposure create neuropsychological harms in children. It’s clearly addictive and it leads to addictive behaviours in kids.

“It is bad for your lungs,it causes coughs,wheeze,asthma and asthma attacks. These are the immediate effects in adolescence.”

Chapman said the long-term effects would probably not be known for years,despite untested claims by HQD that “compared to traditional cigarettes,the hazard is almost zero”.

“What they’re doing is basically behaving like somebody who was pronouncing in 1919 that cigarette smoking didn’t cause anything.

“Now,it may,of course,turn out that they genuinely are a much-reduced risk. But we don’t know that. We’ve got this huge experiment happening on our kids. They are still developing airways and lungs and are pickling themselves with this stuff.”

Mullins said the short answer was “we don’t know what is in them”. “I haven’t seen any testing of the vape pen-type devices.“

A Therapeutic Goods Association spokesperson said:“There has not been separate research on the health risks of disposable versus refillable nicotine e-cigarettes that we are aware of.”

Because China’s vapes are not legitimately sold by Australian companies,they don’t undergo any local quality checks. Mullins’ guess is that – aside from high nicotine quantities – other health risks come from food-grade flavourings used in vapes,which are often irritants or asthmagens when inhaled,as well as cross-contaminations in laboratories.

For adults,vaping has been marketed as a nicotine replacement therapy to get consumers away from combustible cigarettes.

In Japan,where heat-not-burn e-cigarettes such as IQOS have been legal since 2015,research by the American Cancer Society found that traditional cigarette use had declined by 0.66 cigarettes per person per month by 2019.

“You do find of course people who quit with vaping,but they are far outnumbered by people who vape and don’t quit,or who vape,and then actually go on to start smoking,” said Chapman.

The National Drug and Alcohol Research Centre’s Dr Ryan Courtney,who has spent several years researching smoking cessation,is cautious of the vape debate.

He said vaping products have advanced so they have the potential to deliver nicotine just as well as a cigarette,and more swiftly than other replacement products. They also mimic the same motions as smoking,which can make them a more acceptable option than other nicotine replacement options such as patches and tablets. He believes this could have great outcomes for smokers if they managed to make the switch long-term.

“But if it goes the other way with uptake among non-smokers,we’re going to have a situation we don’t want. The medical device framework versus recreational framework is a very different discussion,” he warns. “It’s a topic that’s really dividing the public health community.”

Peters said you can be “pro-vaping as smoking cessation”,but “kids are turning up to school sickbay vomiting from nicotine poisoning”. “You can’t pretend all these principals are fools.”

School principals’ uphill battle

Dr Tim Hawkes,the former head of The King’s School in Parramatta,is one of those concerned principals. “The urgency lies in the fact there appears to have been an exponential increase in vaping behaviours by young people,” he said.

Hawkes has madetwo free digital courses about vaping through his company Truwell which delivers student wellbeing programs to schools. He said there’s been a huge demand for information from principals around the country.

“[It’s] a relatively young,recent phenomenon in society. This means there is very little research[and] we’re having to deal with a large amount of ignorance in this space,” he said.

School leaders have told Hawkes their students have started vaping primarily because “it’s very much on-trend”. He puts this down to a few key ingredients:first is the list of attractive flavours. HQD,for example,makes vapes in 32 that range from “apple peach” to “energy drink” and “mango ice”.

Second,there’s the popular belief that vaping is a healthier option to smoking through what Hawkes calls “an incredibly effective marketing campaign made by those who stand to profit billions of dollars from advancing the vaping craze”.

Then there’s the age-old teenage desire to rebel and demonstrate independence;the fact vaping is a cheaper way to consume nicotine than cigarette smoking in Australia;and the social bonding that comes from vaping in groups.

“What is happening in state schools,and indeed independent and Catholics is that students generally go to areas of the school at recess and lunchtime,or in free periods,and engage in vaping,” he said.

“The great advantage is you can’t smell it. A student having fags in the toilet block would be immediately picked up by teachers. With vaping,this can be disguised.”

New regulations are coming,but there are fears for a ‘bootleg’ scenario

Both selling and using e-liquid nicotine is illegal in NSW and Victoria,but there is no government body keeping tabs on how many electronic vapes have made their way to Australian shores. It is legal to sell vapes without nicotine in them.

A NSW Health spokeswoman said the ministry seized 50,000 e-cigarettes containing nicotine in the first six months of this year,and 30,000 in the year before – but that hasn’t dented supply when orders to HQD and IGET can number in the hundreds of thousands.

Anational overhaul of e-cigarette restrictions that kicks in next month will change the regulatory landscape by making nicotine a prescription-only medicine and will place some vapes under the remit of the Therapeutic Goods Administration. This will allow users to import a three-month supply with a valid script or purchase some vapes from pharmacies.

But Hawkes said that “the big fear with the October initiative is it could in fact backfire and result in a bootleg situation”.

Disposable vapes that the TGA acknowledges are becoming “increasingly popular in high schools” won’t fall under the prescription remit because they have not been approved as a medical device.

That will leave it up to Border Force and local health authorities to attempt to police illegal imports. To date,only 2 per cent of imports have been checked at the border and,when it comes to illegal sales at convenience stores,just 22 retailers in NSW have been prosecuted since 2015.

“So it’s literally the Wild West,right?” said an industry source who asked not to be identified because their work is commercially sensitive. “The TGA has almost chosen to ignore regulating them and putting any sort of standards in place.”

For retailers,there are reasonable gains to make on the products because they aren’t taxed. One inner-city convenience store said disposable vape sales to young adults had taken about 50 per cent of its typical cigarette sales.

“If you want to make something cool,you should make it illegal,” said the industry source. “It’s growing to prolific levels,and we’re going to have an issue,just like we do with the trade of illicit tobacco,in illicit vaping very soon.”

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