Led by researchers from the Australian National University Centre for Epidemiology and Population Health, the Government-commissioned review looked at evidence from 189 studies to draw conclusions on the effects of vapes.
It found “conclusive evidence” that e-cigarettes cause immediate toxicity through inhalation and acute lung injury, largely linked to e-liquids containing THC and vitamin E acetate.
Lead author Professor Emily Banks warned the global data shows vapes risk hooking a new generation onto smoking.
"The evidence shows e-cigarettes carry significant harms. Nicotine is a key ingredient and one of the most addictive substances known. Vaping is causing addiction in a new generation of users.
"Young non-smokers who vape are around three times as likely to take up smoking than non-vapers. Nicotine use in children and adolescents can lead to lifelong addiction issues as well as difficulties in concentration and learning. Vaping is also illegal if it isn't on prescription."
The report found a number of early red flags on key cardiovascular health markers, including blood pressure, heart rate, and lung functioning.
"The evidence is there for some of the risks but for most major health outcomes, like cancer, cardiovascular disease and mental illness, we don't know what the impacts of e-cigarettes are. Their safety for these outcomes hasn't been established," Banks said.
"There are myths targeting young people; the false ideas that vapes wouldn't be widely available if they were dangerous and 'it's just water vapour'.
"Vapes deliver hundreds of chemicals - some of them known to be toxic and many others with unknown effects."
Over two million people in Australia have used e-cigarettes, Banks added, and their use was more common among young people, particularly young males. The majority of those who vape are not doing so in order to quit smoking, she said.
"Our young people have been through a lot and they deserve the best future possible.
"The evidence is in that avoiding e-cigarettes should be part of that,” Banks said.
Last year Mark Brooke, CEO of Lung Foundation Australia, told EducationHQ that Australia was facing a “tsunami” of young people whose health would fall victim to the vape industry, unless the dangers of e-cigarettes are exposed and swift industry reform was actioned.
“Our real bugbear in this is chemical e-liquids, because they sound really sexy and they're marketed at young people. So pina colada and chocolate and things called ‘sex on the beach’ and you name it; they've got truckloads of different flavours…,” Brooke warned.
A 2021 paper published in Respiratory Research called for stricter regulation around the composition of e-liquids in vapes.
“…they can be easily bought online and many incidences of mislabelling have been detected, which can seriously affect consumers’ health,” researchers noted.
“Beyond their unknown long-term effects on human health, the extended list of appealing flavours available seems to attract new “never-smokers”, which is especially worrying among young users.”
Brooke said prevailing mistruths around the safety of vaping needed to be squashed if young people were going to be empowered to make sensible choices about their health.
“The simplest way to describe it is, the only thing you should be inhaling into your lungs is clean air. Now, whether it's tobacco smoke, vaping, e-liquids, poor air quality, bushfire smoke, it all does accumulative damage to the linings and the way in which your lung works.”
Cancer Council's Public Health Committee Chair, Anita Dessaix, said the ANU report sends an ‘urgent message’ to Australian governments.
"Every week we're hearing growing community concern about e-cigarettes in schools, the health harms and the risks of smoking uptake among young people," Dessaix said.
"Now we have the world's most authoritative independent scientific analysis showing us exactly why we're seeing those problems.
"A public health crisis is rapidly unfolding before our eyes.
"This thorough, rigorous, independent report, from one of the world's leading public health research centres, should put an end to the misinformation being spread by people trying to make money from e-cigarettes.
"These findings send a clear message to all governments: act now. Do more to protect the community, especially young people, from the harms of e-cigarettes."