The health risks of vaping for young people, with Dr Sandro Demaio, and how to recharge your personal batteries, with Meg Durham

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Natalie Moutafis: 

Hi, everyone, and welcome back to isPodcast, ISV's show for schools and the wider community. I'm Natalie Moutafis. 

On today's episode, Shane Green talks with well-being expert and educator, Meg Durham, about the five things students, parents and teachers who are feeling run down can do to keep their personal batteries charged. But first, Mike Broadstock talks with VicHealth CEO, Dr. Sandro Demaio, about the health risks of e-cigarettes or vapes, especially for young people and how they are introducing a new generation to nicotine. 

Michael Broadstock: 

The proportion of secondary school students who smoke has declined significantly since the 20th century, down from around 17 per cent in the '80s to only 2 per cent a few years ago. Now, e-cigarettes appear to be introducing a whole new generation to nicotine. I spoke with VicHealth CEO, Dr. Sandro DeMaio, about e-cigarettes or vapes and why they're not safe either, especially for kids. 

Hi, Sandro, and welcome to isPodcast. 

Sandro Demaio: 

Thank you for having me. 

Michael Broadstock: 

Young people seem to have gotten the message about the dangers of smoking, so why are they taking up vaping? 

Sandro Demaio: 

Well, I suppose there are two parts to that question. The first part is absolutely, we've seen some really fantastic and important declines in smoking as we've put things in place to protect young people, but really all people across society from a product that we know if used exactly as it's intended and designed will kill one in two, to two in three, of its long-term users. 

Things like plain packaging, eliminating advertising, taking it out of the sites in supermarkets and retail environments of the consumer, and of course, really important public health campaigns and investing in programs like Quit, which helps people to get off these harmful and addictive products. 

All of that over the last three decades has been hard work by many across the public health and policy communities, but really got incredible benefits and results. 

Concerningly, the second part of the question is, why are we seeing an uptick in e-cigarettes? Well, in part because these products are flooding our markets and they're designed to appeal to young people. 

It's really the playbook all over again. It's history repeating itself on the disastrous and dangerous behaviour that big tobacco played in the last century, but with a whole new mode of delivering the same addictive substance, nicotine. 

We know that these are designed to appeal to young people. They have sweet flavours such as chocolate milk or Froot Loops or strawberry kisses and colourful packaging. Some are even shaped to look like highlighter pens and makeup products, and e-cigarettes we know contain harmful chemicals including nicotine, a highly-addictive drug. Young people can access these in a very short period of time and at very low cost, usually through social media. 

We've seen the promotion of these products, really an explosion of promotion of these products on social media like TikTok and YouTube, which are often used, often sponsored in fact by tobacco and e-cigarette companies. They're designed to reach young people through what we call dark marketing, so marketing but really only they can see, not even their parent or teacher sitting next to them sees the same adverts on their digital platform and get them addicted early and keep them addicted early and keep them addicted. 

Michael Broadstock: 

I saw a TED Talk recently – a behavioural scientist from Yale, Suchitra Krishnan-Sarin – She said that e-cigarettes are like technology on a stick, a perfect fit for the smartphone generation. They're small, rechargeable, refillable, instantly attracted to young kids, I guess. 

Sandro Demaio: 

Well, and I think a few really concerning elements that I would add to that. First of all, they come in bright colours. They come in bright packaging that looks like products that young people would like, whether it's makeup or highlighter pens or USB drives, and you can't smell the product after you've used it. It doesn't linger in your clothes, so it's becoming much more socially acceptable and it's really flying under the radar of, I think, policy leaders, the public health community, and I would guess probably many in education and even many families. It's incredibly insidious. 

Michael Broadstock: 

Advocates for vaping say that it gives smokers a way for them to transition away from cigarettes, but you've said that people who vape are three times more likely to go on to smoke. What are the dangers, especially for young people? 

Sandro Demaio: 

Well, look, I think we have to talk about two really clear groups here. The first group is people who are currently addicted to cigarettes, have tried, have been to their GP and as per the Royal Australian College of General Practitioners Smoking Cessation guidelines, they've tried other first line therapies like gums and patches to get off cigarettes and haven't been successful. So, they're looking for e-cigarettes as a possible second line therapy, with a prescription, to get themselves off cigarettes. 

This is a tiny number of people, and there's really no reason why these products then should be brightly packaged and with a flavour of Froot Loops and milk because really, they're a therapeutic drug and highly regulated, as it should be, because they're highly addictive, and they're used in a very small proportion of population by a trained doctor. 

What we're talking about here is actually very different, and what we are seeing across society is a very different picture. The single biggest users of e-cigarettes are under 24 years of age. We're seeing an enormous increase in the utilisation and uptake of these products of e-cigarettes in young people. These are not young people who were smoking. They're not young people who were smoking traditional cigarettes, have been to their GP and are getting access to e-cigarettes as a smoking cessation tool. Not at all. 

That's the argument that big tobacco will use to try and confuse the public and conflate two quite distinct issues. 

What we're talking about here is really an explosion of e-cigarettes among young people who have never smoked. It's getting a whole new generation addicted to nicotine, and this is in people whose brains are still developing. 

We know the brain continues to develop until the mid-20s. So, if we've got young people, teenagers and young adults addicted to nicotine, not only are their brains more vulnerable, but the long-term impacts on their development, on their memory and on their concentration could be enormous. 

Michael Broadstock: 

While nicotine's bad enough as it is, there are all sorts of chemicals in vapes aren't there, including chemicals in the vapes themselves? 

Sandro Demaio: 

That's right. In fact, there are no quality or safety standards for e-cigarettes nor nicotine-free liquids, so their manufacturing contents and labelling is completely unregulated. We know that nicotine harms the adolescent brain development impacting on memory and concentration, but we know that e-cigarettes contain far more than nicotine. 

I would first of all say, though, nicotine itself is a huge concern and that we know in a recent raid in Western Australia, two-thirds of e-cigarette products that were being sold as not containing nicotine on the market illegally did, in fact, contain nicotine. First of all, many of the products, even most of the products that are being sold as not containing nicotine, are not declaring nicotine but actually do contain it in very high quantities. In fact, some of these products contain as much nicotine as 1200 cigarettes...

Michael Broadstock: 

Wow. 

Sandro Demaio: 

... in a single disposable product that you can buy, young people can buy easily through social media and have it delivered out the back of a sedan in under half-an-hour. 

But these products also contain things like propylene glycol or glycerine and flavourings. Other substances found in cigarettes include formaldehyde, acetaldehyde and acrolein, which are known to cause cancer, and some we know damage the developing brain, as I've already mentioned. 

Michael Broadstock: 

You talk about them getting sold out the back of a truck. How are kids getting access to vapes, including flavours with nicotine, because it's against the law to sell them to young people? 

Sandro Demaio: 

It is against the law to sell any e-cigarettes or vaping products to young people, and it's illegal to sell these products if they contain nicotine without a prescription, and yet, quite frankly, there is a thriving black market as per the recent Four Corners episode. 

This is really fueled by rising demand and a failure to police the regulation and legislative controls we do have, although, we would argue that they too, are too weak. 

In Victoria, we're the only state that doesn't either have or in process of a retail licencing scheme, and we really need that. What that would allow is basically for the sale of these products to be better controlled. 

We would understand who is selling them and where, and we would be able to test at the point of sale more easily and more consistently to make sure that we're not selling thousands of these products every day that say that they don't contain nicotine, when in fact, they do, as we recently saw in Western Australia, and there's no reason it wouldn't be the same here in Victoria. 

The first thing that we'd really like to see is a retail licencing scheme with proper enforcement officers, because at the moment, this is falling on police to do this in addition to everything else they do. I really don't think police need this on their plate along with everything else we're asking of them, particularly at this difficult and busy time. 

The other thing that we really need, though, are tighter regulations around the imports. We know that these products are coming in enormous numbers across our borders. They're highly profitable, and so they're coming in and simply just not declaring as they import them that they contain nicotine when in actual fact, they do. Nicotine is a Schedule 4 medicine, and so thus, e-cigarettes containing nicotine or electronic nicotine delivery systems, should only be imported or sold domestically by pharmacies with a valid prescription. This is certainly not the case. 

Michael Broadstock: 

What can parents and schools do to help stem the tide of e-cigarettes? 

Sandro Demaio: 

Yeah, well look, it is a tough one, and I think the first thing to say is that I'm not assigning any blame to young people, to teachers or to parents. I think when it comes to talking to kids about these products, whether you're a parent or a teacher, approaching the conversation calmly and asking questions, trying not to judge, but look, it's difficult. It's really difficult. 

We know these products are addictive and dangerous. We all want the best for our young people and we probably feel a sense of frustration as I do that greater supports aren't in place for parents and for teachers and for young people to protect themselves against these products. 

I think parents are already very good at talking to their teens about alcohol, smoking and other drugs, and e-cigarettes should be part of those same conversations. The earlier and more often that we speak to young people about e-cigarettes, the more likely they are to listen, so it's important for parents to upskill themselves. I wasn't aware of just how dangerous and addictive these products were when I first came into contact with them a few years ago. 

The Department of Education and Quit Victoria have a really great range of resources available for schools, including fact sheets, sample newsletter texts, and even a suite of teaching and learning activities for teachers to use in the classroom. 

Michael Broadstock: 

We've been educating kids and families for a long time about the dangers of smoking and alcohol and so on. Is it partly that they see vaping as a less dangerous alternative? 

Sandro Demaio: 

The thing is, people would say that they don't contain nicotine or that there's only a handful of ingredients. The problem is that actually a lot of them do contain nicotine and the ingredients in these products while they may be safer, to eat them, you certainly don't want to be breathing them as a viscous plume deep into your lungs. 

We don't know the long-term health consequences of e-cigarettes and the chemicals that are contained in them are implicated in serious health concerns and poor health outcomes, including damage to the developing brain and increased risk of cancer. 

We need to do better, I think, as a public health community, and I think government needs to do better and really step up in terms of providing greater tools and education, but most importantly, protections for parents, for teachers, and first and foremost, for our young people. 

Michael Broadstock: 

What can young people do if they have been vaping and they want to stop? 

Sandro Demaio: 

Well, look, I really encourage anyone who's struggling with e-cigarette addiction to have a conversation with their GP to better understand the risks. Even if they're only using them infrequently or don't see it as a problem themselves, really encourage them to be open and honest with their GP and have a conversation and properly understand the significant risks of any use. 

Quit Victoria, which we are proud to fund and support, the Royal Children's Hospital and the Raising Children Network also have a great range of resources available online to assist young people to better understand these risks. Resources are available at quit.org.au/articles/teenvaping. 

Finally, look, Quitline is an invaluable resource. It's free, it's confidential advice from trained counsellors and they can really answer any questions that you might have about e-cigarettes and help you think of ways either to approach the conversation with a loved one or indeed to consider quitting these products yourself. Quitline is 13 78 48. 

Michael Broadstock: 

We'll put links to all of that in the show description. Sandro, thanks very much for joining us on isPodcast. We hope that all this information's really useful to our school communities. 

Sandro Demaio: 

Thank you. 

Natalie Moutafis: 

Feeling overwhelmed by the demands of a busy life? Well-being expert and educator, Meg Durham, says we should be checking our energy levels and taking steps to recharge our personal batteries. She talks with Shane Green about the strategies teachers, parents, and students can use to manage their energy levels. 

Shane Green: 

Meg, welcome to isPodcast. 

Meg Durham: 

Shane, thanks so much for having me. 

Shane Green: 

If you were to ask the question today of most people, are you feeling busy? What do you think the answer would be? 

Meg Durham: 

Yes. An overriding sense of yes, absolutely. I can feel it in my bones. We are feeling tired, exhausted, and overwhelmed with the somewhat relentless demands of life. 

Shane Green: 

Now let's delve into the reasons for that. You've identified key areas or elements when it comes to energy management. 

Meg Durham: 

When it comes to energy management, I see that there are five elements that we need to focus on daily. As bighearted humans, we often don't think about it or don't take the time to just notice how is our energy, so it's a check-in with our battery. 

The five questions that I love to ask is: 

• In the last 24 hours, have you had enough sleep for your body? 
• In the last 24 hours, have you moved your body? 
• In the last 24 hours, have you had some nourishing foods and drinks? 
• In the last 24 hours, have you had some rest or dare I say, pleasure or fun? 
• In the last 24 hours, have you had some quality connection? 

Depending on the answers to these questions, that'll give us a good indication of how people are feeling, functioning and relating to others. Because when our battery is charged, when we have energy, we can make really good choices, we can think clearly, and we can move towards discomfort and get the tasks done that we need to get done. 

But when our battery is flat, when we're exhausted and depleted, it's really hard to think straight. It's hard to make decisions, and we start to really avoid tasks that need to be done. 

Shane Green: 

Going through those questions, Meg, I think the answers would be quite confronting for many people. 

Meg Durham: 

Very confronting, and it's interesting you say that, Shane, because I have asked these five questions over a decade now, and the reason why the battery first appeared and I first created it was when I was in a classroom, in a Year 9 classroom, and I noticed there was a particular class that always seemed really tired, and I wanted to create a way to check in with them each lesson that gave them an invitation to think about the choices they were making. 

That's how the battery came about. I quickly realised that this is a big thing. So many students are coming to school each day with a flat battery. Then when I started to work with teachers and parents, I would ask these five questions. Overall, in the last 10 years – and it hasn't changed since the pandemic – the average answer is two out of five when it comes to adults and children. 

Shane Green: 

Looking at the three groups you have just mentioned, teachers, students and parents, everyone seems to be experiencing a similar feeling, a feeling of busyness. 

Meg Durham: 

Yeah, everyone is feeling busy. Modern life is exhausting because of the pace. There is so much going on, and there is so much that we could be doing it feels like life could be 24 hours a day, day seven days a week if we let it be. Because of this fast-paced nature, because of all the connectivity with technologies, with all the demands, think about the financial pressures going on as well, we are forgetting that we are humans with human needs. So, each element of the battery is getting pushed to the side. 

Shane Green: 

Let's look at each of those groups specifically. What are the demands being placed on teachers that are leading to that? 

Meg Durham: 

When it comes to teachers, there are external demands, so the compliance, the assessment, the reporting, the incident reports. I remember even looking at a Band-Aid thinking, 'Oh no, I've got to write another report about that Band-Aid, about that left knee, where I've got to put it,' there is so much demands as far as that compliance, and also the emotional demands for educators. 

As educators, big-hearted humans, they really want to provide for their students, and so with that, they take on this emotional labour, this emotional load. When you are a secondary teacher, you could be teaching up to 200 students a week or a fortnight, and that is a big load to take on. 

So, we've got much higher demands as far as expectations externally. We've got this emotional labour. 

The next thing that teachers are really struggling with at the moment is student engagement. Because there is so many incredible technologies, there are so many short clips – lots of bells, lots of whistles – it can be so hard to keep students engaged and to keep them engaged when they're really struggling to work out a task. 

So, they don't get into that avoidance cycle where they just say, 'I don't want to do it anymore'. They're feeling like they're constantly trying to keep on top of all of the documentation, keep on top of all the emotional needs of their students and also create engaging content, and that is a big load. 

Shane Green: 

Talking about students, there are unique pressures there, but they are related. 

Meg Durham: 

Absolutely it's related, because students are in these environments where they're used to lots of information, lots of quick, short bits of information. With the remote learning of the last two years, they've missed a vital window of this social development, of being in rooms with other people to have to wait to talk and express your opinions. 

You can't just go on mute or turn your camera off or when things are getting a bit tricky, you can't just walk to the fridge and have another Milo or do those things. Students are really trying to catch up for a two-year period where they've missed all of this social dynamic. 

The social dynamic is so important when it comes to learning because if we're really focused on this social piece because we're not settled in the classroom, it's really difficult to learn. 

So, students are trying to learn, they're trying to get through their content, but they're also really struggling with this social piece, and that can lead to increased behavioural issues. That's what lots of students and school leaders are reporting at the moment that there are so many difficult behavioural issues because of the fallout of the last few years. 

Shane Green: 

That's a pretty common experience. The past two years have had a profound impact on what's happening now we're back in the classroom. 

Meg Durham: 

Yes, and it's had a profound impact in really different and nuanced ways in different schools. So, you may have one school that tells me that their students are just so passive, they're just expecting everything to be spoon-fed to them and they're not as willing to express their opinion. They just want to know what they need to do to get through the exams or to get through that assignment. 

But then another school, they're really struggling with attendance to try and get students to school regularly because they just don't have that endurance or that interest now, so every school's got their own version of difficult situations when it comes to students, and also, some students who absolutely loved remote learning. They loved being away from the social context, and so they're really struggling to get back in the classroom. 

Shane Green: 

Now, let's not forget parents. Where do you think parents are after these two years? 

Meg Durham: 

Parents are feeling that pull of exhaustion, feeling like they haven't done enough. There is always more to do. They are juggling work. They're juggling the commitments of their children. They're juggling the catch up of the last few years. They're trying to juggle their own self-care in the mix, and we know that family structures have changed so much in the last 10 years that it's very common that you have two working parents. 

So, you've got two working parents who are desperately trying to keep things afloat with this financial pressure, with the increase in cost of living, there is so much going on, so they're really under strain as well. 

Shane Green: 

As you say, Meg, there's a lot going on. This is where your five pillars of energy management really come into play. 

Meg Durham: 

Yes, I believe energy management is the most crucial skill that we can all develop, whether we're a student in the classroom, we're a principal at a school or a parent trying to juggle the demands of parenting, because when we have energy, we make better decisions. 

When we're making better decisions, we feel much more confident in our decisions, and we're more confident to draw boundaries to say that, 'I can't do this, this is not the right time for me.' We make decisions that are better for us in the long term. 

But when we're exhausted, when we're depleted and our battery is flat, we make decisions based on just getting through the day, they're survival decisions. 

So, it's about avoiding discomfort in the moment because you just don't have the energy, so that means watching one more episode, that means having that extra glass of wine that you know is going to make your sleep a bit disrupted. That means continuing to check your emails when you really don't need to check your emails, because when we're exhausted, we start to engage in activities that are really unhelpful for us in the long term, but when we're energised, we engage in activities that are helpful for us in the long term. 

Shane Green: 

What are the strategies that people can use to help them with those situations you've mentioned? 

Meg Durham: 

Real strategies is check in with your battery every day. 

You'll be surprised that once you start to notice how your battery is, how that influences the way that you are functioning. Because if you are feeling a bit tired and you notice, 'Oh, I'm feeling tired, that will motivate you to get to bed in the evening.' Just by simply noticing how charged is my battery, then you're going to take deliberate action. 

Most people know that when they move, they feel so much better. So, something that I love to say to people is something is better than nothing. You may not have 45 minutes a day or an hour a day, but you have five or 10 minutes. Every time we move our body, we are changing our physiology so we can think better. We never finish a walk thinking, 'Oh, I wish I didn't do that'. We finish a walk feeling much better about ourselves, much better about our situation, and we can think much, much clearer. 

The same thing when it comes to food and our intake is, what are you eating? How are you eating? If you are really busy and you've got lots going on, what's some convenience options that are healthier for you instead of doing the reach for food in the evening, just whatever you can get your hands on? 

When I talk to people about what are some key signs that you're in that survival, you're really depleted, they talk about how they reach for the Uber Eats. They reach for things that are really simple and easy, and I encourage people to start thinking about simple, easy, but also, healthy options. 

It could be as simple as having a little bit more water. As humans, we all need at least 500mls of water per 15 kilos of body weight for basic functioning. The average person that I work with is not drinking enough water, so really getting back to basics. As humans, what do we need to feel good? 

Shane Green: 

Getting exercise, drinking enough water, common sense, simple things that we so often ignore. 

Meg Durham: 

It is so interesting, Shane, because it is common sense and yet we resist it violently. As bighearted humans that are so care focused, we find it very difficult to care for ourselves. For a lot of people, the act of going for a walk or the act of finishing work or saying no to their children makes them feel so uncomfortable, and yet, once we move through that resistance and we take care of ourselves, we're in such a better head space to be in better relationships with everybody that we live and work with. 

Shane Green: 

Meg, one thing you talk about is 'getting off the dance floor and taking in the view from the balcony'. Can you explain that? 

Meg Durham: 

Yes. This is a really interesting concept. It's from Harvard Uni. There's an incredible researcher there, Ronald Heifetz, talking about adaptive leadership and how he talks about so much of our day we're on the dance floor. 

The dance floor is the doing. That's going to the next meeting, seeing the next appointment, checking the phone. It's the doing of life, it's the dance of life. He really encourages people to get off the dance floor and get up on the balcony and have a look. 

Just notice. Is what you are doing busy work or is it really making a difference? Because when we're tired, we start to do busy work, which is work that's not particularly necessary. It's at 20%, it's not the 80%. 

So, getting up on the balcony is a really powerful strategy to stop and reflect, to think about, 'How is my battery?' And maybe, 'How is my battery considering the last 12 months, is there a common pattern here? And now that I see this pattern, what am I going to do with it?' 

When we are in reflective spaces, it gives us the opportunity to then take deliberate action that's appropriate for our setting and our context. 

Shane Green: 

Meg, I think we all need to get up to the balcony and do exactly that, so many great insights. We'll put a link to your website in the show's notes. Thanks for joining us on isPodcast. 

Meg Durham: 

Thanks so much, Shane. 

Natalie Moutafis: 

That's it for this episode of isPodcast. 

We're going to leave you today with Year 8 Presbyterian Ladies College student, Katherine Lam's step-by-step guide on how to belong. Our student poetry competition judges applauded Katherine's recitation skills and the poem's stunning imagery. 

Katherine Lam: 

How to Belong, A Step-by-Step Guide to Belonging in a Group of People. 

One: Observe. Look at what they do. Look at what they have, look at what they have that you don't. 

Two: Look at you. Look at what you do. Look at what you have. Look at what you are missing. 

Three: Copy what they do, buy what they have. Oh, but you don't have money? Then make up a reason or steal, that works too. 

Four: Talk to them, but make sure that your voice sounds like theirs. Get used to the flow of conversation. Follow it. 

Five: Laugh at their jokes. What if they're not funny? What if now your own laughter grates at the back of your throat? Laugh at them anyway. Laugh until your laugh just slips through you easily as if you've done it for a long, long time. 

Six: Go where they go. Follow them to the park, to the restaurant, to the bar. 

Seven: Do what they do if they play on the playground, if they skateboard on the roads, if they drink beer and wine, if they smoke cigarettes, you don't want to? 

Didn't you want to fit in? Slide into their routines, copy their actions. This is the only way. 

Eight: Is it working? No? You have to stick with it. No matter how little you seem to fit in, keep going. Mould yourself to become like them. Mould yourself to become them. 

Nine: Be them. Embody them. You are them. 

Ten: Don't look back. I can see you looking back. Don't. After all, you worked so hard. After all, you wanted to be here. After all, you wanted to belong with them. 

What did you say? You say that you don't feel like yourself anymore. You say you've lost yourself and become someone else, but of course, that's the price. 

Everyone has to give something to belong, don't they? 

Natalie Moutafis: 

isPodcast is brought to you by Independent Schools Victoria. It's produced by Duncan McLean and presented by Shane Green, Michael Broadstock, and me, Natalie Moutafis. Our podcast things composed by Duncan. There are transcripts of our show with links to what we've discussed at podcast.is education.com.au. Please follow us wherever you get your favourite podcasts. While you're there, we'd love it if you could rate and review the show so more people just like you can find us.