Already a big problem in local high schools, electronic cigarettes (aka e-cigarettes or vapes) are now officially hazardous, with an Australian-first study proving that most vapes contain nicotine, even if it’s not on the label.

Over the past four years, University of Wollongong senior lecturer and toxicology expert Dr Jody Morgan has leant her expertise to the analysis of e-cigarettes and cannabis use in Australia. Working as a research fellow for a clinical toxicologist in 2019, she first tested e-cigarettes to determine whether they covertly contained prohibited substances. The results – both then and now – are startling.

“This actually started back in 2019, and that was back when e-cigarettes hadn't really taken off, particularly amongst the young population in Australia, but we were seeing them being used a lot overseas,” Jody said.

“What actually led us into this research field originally was seeing if e-cigarettes were being used as a means to deliver other illicit drugs.

“Turns out they were, and still are.”

In a 12-month Australian-first research project, done on behalf of NSW Health, the team from the UOW’s School of Chemistry and Molecular Biosciences tested 750 vapes, including 428 seized from retailers and 322 surrendered by New South Wales high schools.

Releasing the findings from their most recent study late last month, it came of little surprise to researchers that 97.5 per cent of the devices analysed contained nicotine despite most not having it listed as an active ingredient, with an average concentration of 40 milligrams per mil.

This included e-cigarettes labelled as ‘nicotine-free’, skirting legislation that requires a prescription for e-liquid containing nicotine.

“Obviously the biggest issue with the e-cigarettes currently for sale in Australia is that, with the way the regulation works, nicotine-containing e-cigarettes and nicotine-free e-cigarettes are under separate regulation, so because of that, what we found is that a lot of the nicotine-containing devices have simply removed the word nicotine from the packaging,” Jody said.

“About 97.5 per cent of the samples that were confiscated from children in schools contained nicotine, and that contradicts what a lot of those students believe, because a lot of them, when they're surveyed, state that their e-cigarette doesn't have nicotine in it, but obviously in reality that's actually not the case. It's not surprising that they're mistaken because there's no label that says nicotine on the packaging.

“[Another] important finding was that about 4 per cent of these e-cigarettes across the whole cohort that we analysed… contained one of the chemicals that are banned under the current Australian regulation.”

Jody says one of the most alarming findings was the presence of ethylene glycol – the main ingredient in antifreeze – in four of the samples. It’s the first time the researcher has detected the toxic component in Australian samples in her research.

“Ethylene glycol is something that we actually have, in the past, corrected people who have said that there's antifreeze in e-cigarettes, because it's actually something that we don't usually see in these samples,” she said.

“It was a real surprise to find that, and it was present in relatively high concentrations. In the samples with NSW Health, it was up to about 11.1 milligrams per mil, so these are not being detected at minuscule concentrations; this was actually a substantial amount of that compound present in that product.

“Honestly, we don't know a lot about the inhalation of it. Ingestion of it can be really toxic [and] can lead to significant poisoning and death, but from an inhalation perspective, we don't have a lot of information on what might happen if someone inhales these compounds.”

Another cause for concern unearthed by the research was the discovery that students are tampering with their single-use vapes, potentially leading them to inhale metal compounds.

“Something else that we did make note of in this study was that a number of the e-cigarettes that were being used by school students had previously been opened by the student, so there's some evidence that they're tampering with these devices; either opening them in order to refill them or opening them in order to recharge them and extending these disposables beyond the lifespan that they were intended for,” Jody said.

“There's a risk there that the coil that does the heating and cooling cycles is going to degrade more than it's intended to, and then there's a risk of inhaling some heavy metals as well, so that's obviously an additional concern amongst this cohort.

“If young people are opening these devices and refilling them and extending the lifespan of these, we don't have a lot of information at the moment to what happens to these heating coils over time, so that's sort of the next step for our research. We'd like to look at what happens when you extend the life of these devices; are you inhaling the same content on the first puff and the 6000th puff?”

Following the release of the study’s findings, the state government has allocated $6.8 million to combatting illegal e-cigarette sales and establishing specialised support for young people addicted to vaping.

Dr Jody Morgan backs a move proposed by the Therapeutic Goods Administration to see all e-cigarettes – including nicotine-free, vitamin and aromatherapy vapes – require a doctor’s prescription, but believes it will also lead to an increase in the black market presence of e-cigarettes.

“At the moment we have a proposal put forward by the Therapeutic Goods Administration and that is going to realign the regulation of all e-cigarettes together, so nicotine-containing and nicotine-free e-cigarettes will all be brought under the one regulatory umbrella, which is a good thing because obviously at the moment it is that kind of loophole that's allowing a lot of these products to be sold over the counter,” Jody said.

“In addition to that, all disposables will be completely banned, so what is likely to happen is that a lot of these devices will undoubtedly still come into the country [and] it'll push things further into a black market.

“Realistically, what I would expect to see is lots of devices appearing on the Australian market that don't look like e-cigarettes, and I think we'll get a real push back into devices that are designed to be very stealthy – they'll look like pens, they'll look like USB sticks, they'll look like something else – so that people in Australia can still import them into the country.”