by Lindsay Robertson and Janet Hoek, The Conversation

Credit: Unsplash/CC0 Public Domain

The number of young New Zealanders aged 15 to 17 who vape every day has tripled in two years, from 2% in 2018–19 to 6% in 2020–21, according to the most recent New Zealand Health Survey. For young adults, aged 18 to 24, daily vaping increased from 5% to 15%.

Another national survey focused on Year 10 school students shows these increases are especially high for Māori girls. Around one in five Māori girls aged 14 to 15 reported vaping daily in 2021.

Increases in regular vaping (defined as vaping at least monthly) are also large, particularly for Māori boys (19% in 2019 to 31% in 2021) and girls (19% to 41%).

While manufacturers claim vapes are lower risk alternatives for people who smoke cigarettes, many people who vape have never smoked.

If only smokers took up vaping, we would expect to see increases in vaping to be offset by equivalent decreases in smoking. Instead, the growth in daily vaping exceeds the decline in daily smoking.

Had vapes never been introduced, many young non-smokers may not have started using any nicotine products. Our new research helps explain why non-smokers start vaping.

Five factors that lead young non-smokers to vaping

The manufacturers and promoters of vapes have been criticized for youth-centric promotions using social media influencers and music event sponsorship. Some retailers have also circumvented recent laws aimed at preventing youth from being exposed to enticing vape products and e-liquid flavors.

A review on the health effects of vaping reflects what public health advocates have feared—escalating use of e-cigarettes in school-aged children, early warning signs of increased smoking rates in youth, and direct health harms of vaping in all ages https://t.co/coO5agYfgC.

— AsthmaFndation (@AsthmaFndation) April 8, 2022

Regulating industry activities to prevent youth vaping should remain an important focus of policy, research and monitoring. But the personal reasons why young non-smokers start vaping could provide additional insights and ways to reduce the problem.

Our research, published in the journal PLOS One, is based on in-depth face-to-face interviews with 16 young adults, aged 18 to 25, who self-identified as regular vapers (from daily to at least a couple of times each month). Using a qualitative approach, we identified five factors that helped explain what had led these young non-smokers to vaping.

Two of these factors—connection and belonging, and balancing social status and stigma—were psycho-social in nature. Vaping is a highly social activity, taking place predominantly in shared flat settings or at parties. Being part of a peer group where a vape was circling helped reinforce relationships through a collective experience.

The communal nature of vaping also helped provide an entry to social groups where participants had previously felt on the periphery. For instance, one participant enjoyed how his vape piqued others' interest and acted as a conversation starter, while another explained how vaping helped him "fit in" at parties.

The second theme, balancing social status and stigma, reflects the way vapes can become a personal fashion statement. One participant described her vape as "sleek and […] just my kind of style." For others, vaping offered an opportunity to impress with "skills and tricks" they mastered when exhaling aerosol.

These attributes fostered social cachet and helped offset the perceived stigma many participants felt as non-smokers who vaped. That stigma, they believed, did not apply to people who had switched from smoking to vaping, as one participant explained: "If you make the effort to get off smoking and get onto vaping, you get a lot more respect for it […] compared to people who just do it for the sake of it."

The allure of vaping

Apart from psycho-social factors, vapes attracted non-smokers by providing stimulation and engagement. Unsurprisingly, the wide variety of vape liquids that mimic confectionery or soft drink flavors attracted and maintained young adults' interest. Participants also experienced blowing clouds as whimsical, and many expressed an almost child-like fascination with the aerosol they exhaled.

Several participants vaped as a means of self-management, to relieve stress or boredom, anxiety or awkwardness. A minority began vaping intentionally to manage their weight, using sweet-flavored vape liquids as a replacement for "stress eating." The effectiveness of this approach is not clear.

Lastly, participants used rationalizations about vapes' costs and benefits relative to smoking to justify their vaping. They believed vapes offered multiple benefits, such as pleasure, connections and social cachet, without the "costs" they associated with smoking cigarettes, including financial and long-term health harms as well as unpleasant odor and nausea.

As one participant explained, vaping "doesn't seem anywhere near as bad as cigarettes […] I feel less guilty about using it."

Study limitations and implications

One limitation of our work is that data collection took place before higher-strength "pod" devices such as JUUL and Vuse and disposable vapes such as Fruitia and SOLO entered the market.

Pods and disposables are popular with young people and allow high nicotine concentrations in e-liquids, up to 60mg/ml, without causing a harsh sensation in the mouth and throat. Evidence suggests the majority (at least 80%) of youth and young adults who vape currently use nicotine, whereas a 2019 study suggested only around a quarter of vaping school students used nicotine.

This limitation means our study may not have fully captured the role of nicotine addiction in maintaining vaping.

While recent regulations have restricted the widespread, aggressive marketing of vaping products, social media promotion nonetheless continues. Vaping products are available at numerous outlets and there are no restrictions on manufacturers or retailers making "reduced-harm" marketing claims.

Easy access and "lower-risk" marketing messages likely normalize vaping and the belief that vaping is a safe activity. Educational efforts aimed at youth, such as the Asthma Foundation's Don't Get Sucked In campaign, may help counter ideas that vaping is low-risk.

However, educational campaigns will have a limited impact if products remain widely available and appealing, and social marketing is not a substitute for effective policy. In light of rapidly increasing youth vaping, it is time to reconsider the widespread availability of vaping products in convenience stores and supermarkets and the use of eye-catching packaging and flavors that appeal to young people.

Journal information: PLoS ONE 

Provided by The Conversation 

This article is republished from The Conversation under a Creative Commons license. Read the original article.