Introduction: Quit Victoria partnered with Monash University and key stakeholders in health promotion and education to develop an anti-vaping education resource for use in Victorian schools: Seeing Through the Haze. The resource was first rolled out in January 2024. An evaluation of the resource is underway that focuses on its implementation across the year 7-10 cohort. Evaluation questions focus on understanding barriers and facilitators to uptake and adoption of the resource.

Methods: Both quantitative (e.g., surveys) and qualitative (e.g., in-depth interviews) data sources are being used to investigate the evaluation questions. Cohorts involved in data collection include Victorian school staff and community health promotion workforces. The focus of this presentation is on preliminary findings gleaned through a survey and interviews with community health promotion workforces. Survey respondents (n=16) were recruited through a community health promotion mailing list and discussion forum membership list. Three interviewees who completed the survey also took part in a follow-up interview.

Results: Health promotion workers support schools to deliver anti-vaping education to students and welcomed the resource. However, some reported barriers in their ability to support schools in taking up the resource. Barriers identified included schools often lacking space to include anti-vaping education within their lesson plans; some school staff struggled to understand the subject matter and how to use the resource; some health promotion workers did not feel adequately equipped to address these gaps.

Conclusions: These preliminary findings provide some initial insight into the experiences of the health promotion workforce as it relates to implementation of the Seeing Through the Haze resource. Insights from the health promotion workforce will be considered alongside insights from other data sources to address the Seeing Through the Haze resource uptake and adoption and will inform recommendations for continuous improvement.

Keywords: anti-vaping, school curriculum resource, health promotion, health education

Background: The landscape of e-cigarette use and policy response has rapidly evolved over the last decade. This study aimed to monitor long-term trends of current e-cigarette and tobacco use, and the emerging trend of quit attempts among e-cigarette users corresponding with increased prevalence over time.

Method: Serial cross-sectional annual population surveys of people aged 15+ years were conducted either face-to-face or by telephone in South Australia from 2014 to 2023 (N=29,814). Prevalence trends over time were documented and tests of association (chi-square; logistic regression) were conducted to explore current e-cigarette and tobacco use, past use and e-cigarette quit attempts, by demographic characteristics including age, gender, socio-economic disadvantage, mental health status and smoking status.

Findings: E-cigarette use was relatively stable between 2014 (1.4%) and 2020 (2.0%) but had increased markedly by 2023 (6.2%). The recent rise was most pronounced for 15-29 year olds, with the prevalence of e-cigarette use (19.4%) double that of tobacco use (9.8%) in 2023. Almost all (91%) past year e-cigarette users aged 15-29 years reported that the products they used contained nicotine. E-cigarette use was strongly associated with current smoking and was more likely among males and among those living with a mental illness. Attempts to quit e-cigarettes increased from 35.8% in 2021 to 52.7% in 2023. The majority (70.5%) of current e-cigarette users did not know of any e-cigarette cessation support services or programs.

Discussion: A decade of monitoring has shown that the rapid rise in nicotine-containing e-cigarettes started around 2021. By the end of 2023, over half of e-cigarette users had attempted to quit, indicating that there is a large cohort of people who may benefit from e-cigarette cessation support programs and services. Continued monitoring of e-cigarette and tobacco use trends is warranted given the recent legislative changes to curb e-cigarette supply.

One quarter of young West Australian adults aged 18-24 currently vape. Younger Australians, including those in Western Australia, find accessing vapes easy; however in 2024, Federal regulations were passed restricting access of vapes to pharmaceutical supply. From 1 October 2024, in Australia, vapes could be purchased from a pharmacy without the need for a prescription, for the purposes of smoking cessation. Following this, Tasmania, Queensland and then Western Australia passed regulation requiring a prescription for the purchase of a vape. Lobby groups expressed dissatisfaction with the pharmaceutical model and questioned its effectiveness in supplying vapes to those who required them for smoking cessation purchases.
Our study sought to provide evidence for the effectiveness of the pharmaceutical model in restricting youth access to vapes while maintaining access for those using these devices for the purposes of smoking cessation. A list of 689 Western Australian pharmacies was obtained from the Pharmaceutical Board of Western Australia and contacted via telephone to ask if they sold vapes, both prior to and following the implementation of Federal legislation.
Prior to 1 October 2024, 41% of pharmacies reported they would sell e-cigarettes to customers. Following the Federal legislation, and after the implementation of the Western Australian regulations, this proportion appears to have risen, suggesting that pharmacies have had time to familiarize themselves with the regulatory framework and make informed decisions about their business’ position in regards the sale of e-cigarette products. This research adds to the evidence for the success of the prescription model in maintaining access to e-cigarettes for those who wish to use them for smoking cessation support, while at the same time restricting access to young people.

Problem: Adolescent e-cigarette use has emerged as a pressing public health challenge in Australia, necessitating responses that extend beyond individual behavior change. Recent data indicates that 19.8% of Australians aged over 14 years have tried e-cigarettes, highlighting the need for local approaches that address the social and environmental factors contributing to this trend. Our project applied a whole-of-community approach within Western Sydney schools to create supportive environments for e-cigarette prevention and cessation.

What you did: We initiated a multi-phased project informed by the needs of the school community to address adolescent e-cigarette use, supported by partnerships between the Department of Health and Education. In phase 1, we conducted a needs assessment of vaping in the school community and established Special Interest Groups in e-cigarette prevention and cessation. In phase 2, we listened to students, school staff, parents, and health professionals to understand their perceptions of adolescent vaping and preferred prevention strategies. In phase 3, we developed a suite of student-led initiatives to prevent vaping, including the Breathe Easy All Together (BEAT) peer-leadership program. In phase 4, we collaborated with local health services to deliver workshops for wellbeing school staff, upskilling them to support e-cigarette cessation among students.

Results: The needs assessment revealed a lack of Australian context-specific resources on adolescent vaping. Extensive community consultation showed a strong preference for a holistic, health-centered approach, emphasising education, student empowerment, and cross-sectoral collaboration. This feedback informed the development of capacity-building initiatives for students and staff, with school staff reporting an increased “sense of control” in addressing vaping within their schools.

Lessons: Addressing adolescent vaping requires more than individual behavior change; it demands community-driven strategies that tackle underlying social determinants and support cross-sector collaboration. Our project illustrates how a supportive environment—engaging youth, school staff, and parents in a shared commitment to health—can proactively mitigate adolescent vaping.

E-cigarettes (commonly known as vapes) contain many hazardous chemicals, and flavourings that have not been tested for inhalation safety. E-cigarettes have been linked to respiratory, cardiovascular and mental health impacts. Despite previously declining tobacco smoking rates in Australia, vaping rates have increased in the past few years. Moreover, recent research suggests that young people who vape are five times more likely to transition to tobacco smoking, and the younger the person when they start vaping, the greater the risk for this transition.
Recent legislation has been enacted to provide stronger supply controls, blocking the import of vape products into Australia. However, young people still report accessing these products through alternate channels. Our national online survey focused on what school staff (n=72) and parents (n=231) think about adolescent vaping. School staff reported high levels of vaping amongst students, with almost half reporting they respond to vaping issues every day in their school. Respondents noted the need for more educational resources covering the harms of vaping, for students, parents and staff. Almost all (90%) school staff reported parents/families should be responsible for educating students about the harms of vaping, with 80% reporting school staff also played a role in this regard. The majority of parent respondents reported parents and family members should be ‘very responsible for educating students about the harms of vaping’ (90%), while 45% reported school staff should be ‘very responsible’. Parents supported additional education strategies for the whole-school community, enforcement of smoke/vape-free policies and attention to social media influence on smoking/vaping.
Since this survey, additional legislative measures have come into effect further restricting youth access to e-cigarettes. A collective response to education and prevention is needed to accompany the supply controls put in place in Australia to curb increasing vaping and tobacco use prevalence among adolescents.

Background/Aims: Support from family and friends could influence an individual’s experience with quitting smoking and/or vaping. This study aimed to establish the size of this “supporter” audience within the adult population. It further examined key supporter characteristics, offering insights into who these supporters are, and their broader patterns of support behaviours.

Methods: In September 2024, a nationally representative sample (n=7,469) of Australians (ages 18+) participated in an omnibus survey using the Social Research Centre’s Life in Australia™ probability-based panel. Respondents reported their current smoking and vaping status, whether they have supported a friend or family in their quitting journey in the past two years, and the age group of the individual who they most recently supported at the time when they first received support.

Results: Around 1 in 5 Australian adults (19%) reported having supported someone in their quitting journey in the past two years. Support behaviours declined with age; young adults (18-24 years) were the most likely (25%), while those aged 55+ were the least likely (15%) to provide support. More than half (62%) of 18–24-year-old supporters provided support to those in their own age group. Among the people supported, most 55+ year olds (95%) were given support to quit smoking (either exclusively or alongside vaping), while 78% of <18-year-olds were given support to quit vaping (either exclusively or alongside smoking). Prior supporter lifetime experience with smoking and/or vaping tended to increase with age, with 37% of 18–24-year-old and 60% of 55+ year supporters having smoked and/or vaped. Females and those who identify as Aboriginal and/or Torres Strait Islander are significantly more likely to provide support to their family or friends to quit smoking and/or vaping.

Conclusions: The current study provides further insight into supporter audiences, highlighting opportunities for exploration in designing future smoking and vaping cessation offerings.

Introduction
E-cigarette use (vaping) is becoming increasingly common among young people in Australia, with recent survey results showing a significant increase in the number of adolescents who report vaping over the last five years. There is also evidence that vaping increases the risk of initiating tobacco smoking – the so-called ‘gateway effect’ – with estimates suggesting that ever-vapers are three to five times more likely to smoke tobacco than never-vapers. We aimed to estimate the future number of cancers and cancer deaths which would arise in the future as a result of this gateway effect among Australian adolescents.
Methods
We used the future excess fraction (FEF) approach to estimate the future number of cancer cases and deaths in a cohort of Australian adolescents (aged 12-17) that could be attributed to tobacco smoking resulting from vaping. The cancers considered were those with the strongest evidence of a relationship with tobacco smoking; namely, cancers of the lung, larynx, pharynx, oral cavity, bladder, and oesophagus.
Results
From a cohort of 1,916,720 adolescents in 2022, it is estimated that 177,560 will develop one of the smoking-related cancers over their lifetime, of which 4.35% (n=7,720) are attributable to the gateway effect between vaping and tobacco smoking. It is further estimated that 5.54% (n=106,100) will die from a smoking-related cancer, with 5.07% (n=5,380) of these deaths attributable to the gateway effect.
Conclusion
It is estimated that thousands of Australians will develop cancer due to the gateway effect between vaping and tobacco smoking. These results demonstrate an urgent need for investment in youth-focused programs to prevent vaping and smoking uptake, and a need for strong enforcement of legislative reforms that protect young people from tobacco, vapes, and other novel products that promote nicotine dependency.