[updated 23 Dec 2020 and 27 Sept, 2021 — see at end]

In July this year the Australian Institute of Health and Welfare published our most recent estimate of how many people use various drugs, alcohol and tobacco. They also looked at vaping. So how many people are vaping in Australia? If you believed the lobby group ATHRA (the 4 board members and zero membership vaping advocacy group) when they published their blog on July 22 “520,000 people were ‘current’ vapers (vaped at least once in the last year).” That equates to about 2.5% of the 14+ population or one in every 40 people.

Just let that number sit a while, and reflect if it bears any resemblance to your experience of seeing people vape in public. Vapers, with their ostentatious imitations of stream trains, seem to love proclaiming “look at me! I’m a vaper!” as they billow their clouds for all to see. But one in 40 vaping …?

The Australian Institute of Health and Welfare describes “current” vaping (in a footnote to Table 2.23) as including people who reported smoking electronic cigarettes daily, weekly, monthly or less than monthly.) So that means it includes people who might have had a toke or two at a party out of curiosity, 16-year-olds passing one around after school at the local skaters’ ramp and those who bought the vaping gear, tried it a few times and then put it in the drawer with other seemed-like-a-good-idea-at-the-time 5 day wonders.

Had I been swept up in the AIHW sample a few years ago, it also would have included me, because I once had a pull on an e-cig to see what it was like.

So are many of these 520,000 people any more meaningfully “current” vapers than I am a current Tesla or Aston Martin driver (because I’ve driven both these cars once), a current Grange hermitage drinker (I shared one with neighbours recently) or a current guest at Australian prime ministers’ houses (because I attended a fundraiser at one’s last year)?

The AIHW’s Table 2.19 shows the denominator for  determining “current” vaping is the 11.3% of Australians aged 14 plus who have ever used  e-cigarettes in their lifetime.

There are 20,900,000 Australians aged 14+ years with 11.3% of them having ever used an e-cigarette, even once. AIHW Table 2.21 below  means there are around 433,000 people who vape at least monthly, a whole 16% less than 520,000.

Frequency of electronic cigarette use by people aged 14 and over who have used an electronic cigarette in their lifetime, 2019 (per cent)

Estimated numbers of e-cigarette users by usage categories

Vaping advocates pitch their most emotional appeals for policy change around profiles of heavy smokers who they say have often tried to quit and failed, but who are now vaping. This profile could only reasonably be applied to daily vapers, not those who smoke every day and vape very occasionally, nor those who are not nicotine dependent and neither smoke not vape every day. So this means we are talking about some 222,000 Australians 14+ who daily are vapers (about 1.1%), a large proportion of whom will be dual users who continue vape and smoke.

For these,  angst-ridden “I will go back to smoking if access to vaping is tightened” threats about health minister Greg Hunt’s proposed vapable nicotine via prescription policy, are nonsense because they have never given up smoking anyway. Longitudinal cohort studies show that dual use is very often far from a transitory phase leading to exclusive vaping. Many vapers keep smoking as the table below illustrates with a 12 month follow-up. With all major transnational tobacco companies now marketing both cigarettes and vapable products, prolonged dual use and deepening nicotine addiction is of course very good business. This is why all tobacco companies selling cigarettes Australia today are lobbying hard to be allowed to sell their vapable products here too.

ATHRA seems to have little compunction in claiming all those who might have had a tentative toke on an ecig just once or twice as true current vapers whose interests they hope to champion. But when it comes to others pointing out concerns about the increase in teenage vaping either in Australia or internationally, they seem to prefer a much narrower definition when attempting to hose these concerns down. Consider these examples from a recent publication with ATHRA board member Colin Mendelsohn as an author:

Note “3 or more days in the last month”, “vaping daily”, “vaping at least weekly” and “≥20 days in the last 30 days”, are all measures of far more serious vaping than any figure that lumps in “less than monthly”.

So in summary, claims that there are more than half a million “current” vapers in Australia are wildly exaggerated. Just 1.1% of the 14+ population who vape daily, with it being very likely that a large proportion of these are people who continue to smoke and so for whom posturing about “returning to smoking” are nonsense because they’ve never stopped smoking.

Tailpiece On 20 December, 2020, Legalise Vaping Australia, fresh from the ruins of their campaign to have the Senate Select Committee on Harm Reduction overturn the government’s plan to require a prescription to access vapable nicotine, flushed all pretense of being an evidence-respecting body down the toilet. It issued this press release claiming that 500,000 Australians who vaped had “quit smoking for good”. This is the same group which has often taunted that smoking prevalence in Australia has plateaued or stopped falling. So with there being 2.3million smokers today, and 500,000 have quit in recent years via vaping, these clowns are saying there has been an 18% fall in recent years in the numbers of Australians who smoke because of vaping. So which is it, boys?

Update 27 Sept, 2021: Colin Mendelsohn is these days claiming there are 600,000 vapers in Australia. Where has he pulled this number from? Meanwhile, the Pharmaceutical Society of Australia suggests 200,000 as the figure. (“PSA National President, A/Prof Chris Freeman, encourages pharmacists to prepare to manage these changes and support more than 200,000 Australians estimated to be using vaporised nicotine.”)