Two recent stories – Dutch teens “flooding” hospitals after vaping and Belgian kids supposedly being “hooked” on hidden opioids in vapes – sound terrifying.
They also risk seriously misleading the public about what’s really going on with youth nicotine and drugs. Let’s pull them apart, using the best available evidence.
1. Dutch teen hospitalisations: scary headlines, tiny numbers
The Dutch story says hospitalisations of children “linked to vaping” more than doubled, from 14 in 2024 to 31 in 2025. That sounds dramatic. But here’s the context you don’t get in the headlines:
- In 2023 (the most recent full year of national data), there were 2.95 million hospital admissions in the Netherlands overall.
- There are hundreds of thousands of adolescents in the 12 to 17 age bracket.
- Against that backdrop, 31 cases in a year is a very small absolute number, and we’re not told how many were brief observations versus serious, long stays.
The article also presents extreme cases, like a teen allegedly draining a “turbo vape” (around 15,000 puffs) in four days, said to be equivalent to 15 to 20 packs of cigarettes and “four to five packs per day”. Those are not typical youth use patterns; they are outliers.
Dutch national data on youth vaping and smoking
According to the National Youth Monitor data from Statistics Netherlands, 7.6 per cent of Dutch children aged 12 to 18 reported having used a vape in the last year, up slightly from about six per cent previously.
This is a much lower prevalence than the extreme picture implied by the hospitalisation headlines.
School-based research confirms the real patterns
School survey data breaks things down in more detail:
- Of 978 students surveyed, 457 reported ever using nicotine, and 90 per cent of those reported past-year use.
- But in the full school-wide sample, only 28 per cent reported past-year nicotine use, and 35 per cent reported ever using nicotine.
The authors emphasise that these five schools are not nationally representative, but their figures sit in the same ballpark as broader Dutch data.
For comparison, the most recent nationally representative Trimbos figures show that among 12 to 16-year-olds, 25 per cent had ever used vapes and 16 per cent had ever smoked cigarettes, with four per cent and two per cent reporting daily use respectively.
So while nicotine use among teens is a real issue, the data shows:
- 28 to 35 per cent of students in this sample had ever tried any nicotine product,
- about 7.6 per cent report current vaping nationally,
- and a smaller minority vape daily.
2. “Vaping is not safer than smoking”: that’s simply not what the evidence says
The Dutch piece quotes a pulmonologist saying vaping is “not safer than smoking”, highlighting metals, flavourings and nicotine while putting cigarettes and vapes on the same moral and health footing.
That clashes with a large body of toxicology and biomarker evidence:
- Public Health England’s expert review concluded that, while not risk-free, vaping is “around 95 per cent less harmful than smoking”, based on the chemicals generated and biomarkers of exposure.
- A major review of biomarkers in people switching from smoking to exclusive vaping found substantial reductions in cancer-related and toxin-related markers compared with continued smoking. Public Health England also notes that for some biomarkers, levels in vapers are similar to those seen in non-smokers.
Telling the public “vaping is not safer than smoking” contradicts the best current evidence and risks pushing adult smokers away from a much less harmful alternative.
For teens, the school study again shows the real issue: most adolescent vapers in Dutch schools aren’t choosing between “clean lungs” and “a harmless vape” – they’re choosing both vapes and cigarettes, often at high frequency and even at night.
3. Belgian “opioid vapes”: real problem, wrong target
The Belgian story is even more alarming: the drug commissioner says more than 80 per cent of illegal refill capsules for vapes seized in Belgium contain synthetic opioids.
A few crucial details get lost:
- The 80 per cent figure applies only to illegal refill capsules that customs already suspected and seized, not to vapes on sale in registered shops, and not to the total number of vape products in circulation.
- Synthetic opioids like nitazenes have been found in a handful of illicit vape liquids in Australia, enough to justify strong enforcement, but nowhere near evidence of a widespread “opioid vape” epidemic.
- Across the EU, overdose deaths are overwhelmingly driven by traditional routes (pills, powders, injected drugs), not nicotine vapes. Opioids are implicated in about 69 per cent of drug-induced deaths, but public reports do not identify vaping as a major route of exposure.
So there is a serious issue: criminal networks will exploit any device that can deliver drugs, including refillable vapes. That demands targeted measures against the illicit trade such as better customs screening, cracking down on unregistered online sellers, and good forensic testing of seized liquids.
What it doesn’t show is that ordinary nicotine vapes bought in regulated shops are quietly dosing children with opioids. Blurring that line between vapes in general and illegal drug refills is exactly how disinformation takes hold.
4. What good policy looks like once you strip out the hype
If we ignore the nuance, these stories push three unhelpful ideas:
- Any hospital case involving a teen and a vape proves vapes are uniquely dangerous.
- Vapes are as bad as, or worse than, cigarettes.
- All vapes are potential opioid delivery devices.
The evidence says something different:
- For adult smokers, switching completely to regulated nicotine vapes massively cuts exposure to the toxins that kill smokers, although long-term risks are not zero.
- For teens, the main danger is addiction and dual use, not an epidemic of immediate life-threatening poisonings.
- For opioids, the threat comes from the illegal drug market using any available gadget, including vapes, not from standard nicotine products on regulated shelves.
So instead of moral panic, evidence-based responses look like this:
- Tight enforcement against unregistered, illegal and “super-strength” devices and refills.
- Serious school-based cessation help for nicotine-dependent teens, plus honest education about nicotine and smoking.
- Clear separation in policy and media between regulated nicotine vapes and illicit drug products that just happen to use the same hardware.
- Maintaining safer options for adult smokers, rather than pretending vaping is no safer than cigarettes.
Scary stories travel fast. But if we want to protect young people and help smokers move away from the product that still causes most tobacco-related deaths, we can’t afford to build policy on fear instead of facts.
