Trendy and cool. But isn't it just as dangerous as smoking? Young people who vejpar and smoke regularly have many conflicting views about e-cigarettes, smoking and their own nicotine use.
"Young people are in a media frenzy and are naturally influenced by a discussion about vejping that is mostly based on exaggerated risks or horror stories. At the same time, they get very little information about the much more dangerous smoking" says Caitlyn Notley, Professor of Addiction Science who presented new research at the E-cigarette Summit UK 2023.
"Doing qualitative interviews and listening to what young people really say about vejping and e-cigarettes is very important to understand how to deal with it in the best way"
So says Caitlyn Notley, Professor of Addiction Studies at the University of East Anglia.
With many more young people using e-cigarettes on a daily basis, she is bringing young people together to find out what the buzz is about. The aim is to get a picture of how today's young people relate to everything from flavors, risks of harm, stories in the media and how they would react to different bans.
Smoking is decreasing - but vejping is increasing more
Youth smoking has increased dramatically in recent years. This is true not only in Sweden and the rest of the EU, but also in England. Sporadic use (in the last 30 days) has gone from 10% in 2021 to 20% in 2022. However, Caitlyn Notley focuses mainly on the more regular, daily use. There, the statistics show an increase from 3% to 7% over the same period. The figures are for children and young people aged 11-17.
"Smoking, by all means, has continued to decline steadily over the same period for the group and is close to 3% today. But smoking has not declined at the same rate as e-cigarette use has increased." notes Caitlyn Notley when presenting her latest research at the E-cigarette Summit UK 2023.
Disposable vejps in the spotlight
The large increase can be linked to a particular variant of e-cigarettes, disposable models, while the use of other variants of e-cigarettes has decreased significantly. Today, disposable e-cigarettes account for almost 70% of the products circulating among young people.
"It's very clear that this mill is tied to a particular product category in the market," says Caitlyn Notley.
Interviews with young people
But what do young people really think about their own use? Caitlyn Notley specializes in qualitative studies and has spent the last 10 years focusing on users' own stories about e-cigarettes and vejpning. Her research team therefore gathered around 30 young people, aged 16 to 20, gave them discussion questions and let them talk in groups. The conversations were recorded, without a researcher being present. The aim was to create as natural a discussion as possible.
"Over half of the participants came from socially disadvantaged groups, and a third reported having some form of support at school. 70% vejp daily, but interestingly, almost half of the people in the group smoked while vejping" explains Caitlyn Notley.
Most smoked first
The researchers also found that the vast majority of people started smoking before they started vejpa.
"The average age of smoking initiation was 14, while it was 15 for those who started with e-cigarettes first. A common story was that they used to meet their friends and smoke together, but someone brought an e-cig and they tried it too." says Caitlyn Notley.
Interchangeable behaviors
According to Caitlyn Notley, there are clear signs of "interchangeable behaviors" among young people. They use e-cigs and cigarettes in the same way, in the same context and for the same reasons.
"To fit in and to socialize with friends were common explanations. But many people also said they were vejping to deal with emotions such as stress, anxiety, sadness. At the same time, it was about enjoyment, including taste sensations, and playing with the vapor" says Caitlyn Notley.
Young people told us that vejping is a habit driven by availability. Something you do if and when the opportunity arises.
"Someone said it's like having a cell phone in your pocket. You pick it up all the time, but only if it's there. If you don't have a vejp in your pocket, you don't think much about it, either," says Caitlyn Notley.
Think e-cigs are worse than cigarettes
Caitlyn Notley says that the use of e-cigarettes among young people is not really that remarkable. They are trendy products that are seen as a bit 'cool', just like smoking. What caught her attention was young people's perception of the relative risks between smoking and vejpa and the ease with which they switch between products.
"A majority of the interviewees felt that it is just as dangerous to vejpa as it is to smoke. That you "know what's in cigarettes", that you get cancer from smoking, but that it "can be cured, sort of". However, an equally common opinion about e-cigs was that there are "dangerous chemicals" in a vejp that can lead to "popcorn lung and corrosion". And that it's even worse than smoking" says Caitlyn Notley
Gross exaggerations in media affect
Caitlyn Notley says that these particular perceptions of e-cigarettes can be linked to a number of high-profile media articles. Many have been gross exaggerations - popcorn lung, for example, has long been dismissed as something that can be linked to vejpning - or headlines that rarely reflect what any research actually shows.
"It is both worrying and sad that misleading information so easily affects young people. But it's clear that this is part of their world." says Caitlyn Notley.
"Nobody talks about smoking anymore"
At the same time, a large proportion of young people said that they rarely read or heard anything about the risks of smoking any more. However, vaping was always in the news.
"One of the participants said this: 'Nobody talks about the dangers of smoking any more. Most people know that smoking is dangerous, but we are constantly told that it is a total disaster if we vejpar. And that it's as bad as smoking really"
Perceiving smoking as cheaper
Caitlyn Notley also notes that young people's perceptions of risk influence other factors. Price was an important part of the choice between vejpa and smoking.
"A majority of those who both smoked and vejpade talked about the costs. A common argument was that it is actually cheaper to smoke than to buy e-cigs." A single e-cig lasts a day while a few packs of cigarettes can last a month" said one participant,"
Buying illegal products easily
The young people also revealed that they were happy to buy e-cigs that are not actually legal to sell. These are products with a much higher liquid capacity than the two milliliters allowed in both the UK and the EU. Here too, young people were thinking economically.
"Someone explained it like this: "If I buy a vejp with 600 puffs for £6, it will last me half a day. But if I buy one with 9,000 puffs for £15, it will last me two weeks" It was clear that getting this type of e-cigarette was not a problem" says Caitlyn Notley
Prohibition matters less
At present, some countries want to ban the sale of disposable models. British politicians have also opened up this possibility. The young people in the study were therefore asked what they would do if disposables were banned. "The answers were very clear," says Caitlyn Notley.
"They would do what they do today: get them illegally. Some would switch to just smoking instead. Some would try a fillable system. It was clear that many felt that a ban would not affect them to any great extent," says Caitlyn Notley.
Youth voices at the center
Caitlyn Notley's study is funded by the National Institute for Health Research and is now going through the final stages before publication. She is asked if it is really possible to draw any overall conclusions about what is behind the recent increase in young people taking vejpar, by talking to just 30 people. Caitlyn Notley
"This type of qualitative study cannot in any way be considered to show causal relationships or draw overall conclusions about what influences young people like vejpar to do what they do. However, we need different types of studies to see the links, both quantitative and qualitative. Qualitative studies on a topic can fill important gaps in our knowledge and provide explanations that would not have been possible otherwise. We need to put young people's voices at the center of our discussions and thinking on this issue," says Caitlyn Notley.
