It is estimated 13 per cent of people who vape but have never smoked before, transition to tobacco cigarettes.

To understand the financial impact of this transition, QIMR Berghofer researcher Professor Louisa Gordon has conducted the nation’s first economic analysis of the cost of smoking vapes or e-cigarettes on the Australian healthcare system.

The findings, published in Australian Health Review, conservatively estimate at least $180 million annually will be needed to treat increased numbers of people with respiratory diseases, cardiovascular disease and cancer.

This is in addition to the current healthcare costs of 25 smoking-related conditions estimated to be $2.6 billion each year.

“In a short space of time we’ve seen a huge increase in the number of people vaping in this country. It is estimated that more than one million people use e-cigarettes,” Gordon says.

“There’s a risk that the nation’s already strained health system could weaken even further, with an increased number of people experiencing smoking-induced disease and addiction following a transition from vaping to cigarettes.

The latest data suggests about one in seven 14- to 17-year-olds and roughly one in five 18- to 24-year-olds vape.

In response, the Government has begun implementing a raft of vaping reforms this year.

The importation of disposable single-use vapes has been banned, while a new access scheme will allow doctors and nurses to prescribe therapeutic vapes where appropriate.

From next month it will be illegal to import or supply any vape that does not comply with the Therapeutic Goods Administration’s standards.

Any importers will need to obtain a licence and permit from the drug regulator.

Later in the year, the Government is also expected to limit vape flavours, regulate nicotine concentration and mandate pharmaceutical packaging for vape and e-cigarette products.

“The Federal Government is absolutely on the right path, banning the importation of disposable vapes and making therapeutic vapes only accessible through medical prescription,” Gordon says.

“However, further Australian reforms and community-wide education campaigns are urgently needed to support people addicted to e-cigarettes and to prevent the uptake of tobacco cigarettes which are still widely available.”

Late last year the Australian Medical Association (AMA) also congratulated the Federal Government for tackling what it calls a “critical public health issue”.



In November, AMA President Professor Steve Robson said the phased reforms will help prevent a new generation of people becoming addicted to nicotine.

“The AMA has advocated for years for the introduction of stronger, strictly-enforced regulation of vapes, and we applaud the measures announced by Minister [Mark] Butler,” Robson said.

He said there was now a clear trend of people who started out vaping and moved on to cigarettes with the number of young smokers growing for the first time in decades.

“Australia has been a world leader in reducing smoking rates and the subsequent health harms, so the government’s decisive action to stop vaping in its tracks and prevent further harm is very welcome.”

The QIMR Berghofer research focused on the cost of vape users transitioning to tobacco smoking.

Lung Foundation Australia general manager of policy, advocacy and prevention, Paige Preston, who collaborated on the research, says evidence continues to support government action to prevent and reduce use of vapes.

“The commendable action taken by government to get vapes out of school yards and corner stores, alongside other strategies, will likely result in significant healthcare savings, and importantly protect the lung health of so many Australians,” Preston says.

“We need to see the reforms implemented and enforced as a priority for all jurisdictions, as well as enhancing education efforts and leading with empathy as we help people overcome vape and nicotine addiction without stigma.”

Gordon says the many damaging impacts of e-cigarette use include addiction, poisoning, acute nicotine toxicity, seizures, burns, lung injury, and increased uptake of cigarette smoking.

“However, as a relatively new product, the harmful effects of e-cigarette use are not fully understood, and limited evidence exists for chronic health conditions arising from vaping,” she says.

“More research is needed to assess the true burden of e-cigarette use on people’s health and the resulting impact on the Australian healthcare sector and the nation’s economy.”

Vaping involves inhaling a large mix of chemicals, including listed poisons, heavy metals such as nickel and chromium, and chemical by-products produced during heating such as formaldehyde, nitrosamines, acetone, and acrolein.

Acrolein, aldehydes, and polycyclic hydrocarbons are ‘probably carcinogenic’ according to the International Agency for Research on Cancer, while nicotine derivatives (nitrosonornicotine and nitrosamine ketone) are known potent carcinogens in humans.


The study on vaping prevalence, risk of smoking-related disease, and disease-related health system expenditure can be viewed here.