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Youth Perspectives on Smoking and Vaping: Implications for Tobacco Control

March 2019

Because most people who smoke cigarettes begin young, public health efforts to prevent tobacco use among youth are a priority.

The increasing popularity of electronic nicotine delivery systems (ENDS) or e-cigarettes, also called personal vaporizers, vape pens, e-cigars, e-hookah, vaping devices, mod systems or pod systems, raises concerns about normalizing cigarette smoking and perpetuating nicotine addiction. This can create dual users who both vape and smoke.

New research lead by the Prevention Research Center of the Pacific Institute for Research and Evaluation features analysis of interviews with 26 young dual users in California. The interviews focused on the meanings young people ascribe to their dual use practices and how those meanings relate to the tobacco control environment that structures their lives.

Results suggest that dual users of ENDS and cigarettes overwhelmingly perceive a utilitarian meaning of dual use - they view vaping as a tool for reducing smoking-related harm in the near term and facilitating quitting smoking in the long term.

Says one 20-year old participant who has been smoking since she was 15:

[Vaping] was a little bit of a conscious decision. I wanted to lower the amount of nicotine I was getting daily. I tried [to quit smoking] cold turkey before. I couldn’t do it. It was just way too hard…So…I tried the e-cigarettes and the vapes. And I was ‘well, this isn’t that bad’. It was more customizable…flavors and you can control the nicotine levels. So ‘okay, I like this’. Yeah, I mean, of course, I still like cigarettes once in a while. But it’s just something about the vape that I keep coming back to... I mostly kind of sort of moved away from the traditional cigarettes. Like I still buy a pack every now and then, but I don’t go through them as fast as I used to…I still get the craving, but I’m more likely to reach for my vape versus a cigarette.

When asked about Tobacco 21 laws in California, which prohibit sales of both ENDS and cigarettes to individuals under 21 years, participants reported concerns about the aspect of the policy that limits access to e-cigarettes since they are less harmful than traditional tobacco products.

Results of this study raise important questions about whether we are working toward further reductions in the prevalence of smoking and tobacco-related diseases. 

Says lead author, Dr. Tamar Antin, “I think we, as public health professionals, need to take a step back to consider whether our approaches to e-cigarettes have been shaped in way that will ultimately benefit the health of all young people.”

Source:  Antin, T.M., Hunt, G., Kaner, E. and Lipperman-Kreda, S., 2019. Youth perspectives on concurrent smoking and vaping: Implications for tobacco control. International Journal of Drug Policy, 66, pp.57-63.

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PIRE is an independent, nonprofit organization merging scientific knowledge and proven practice to create solutions that improve the health, safety and well-being of individuals, communities, and nations around the world.

The Prevention Research Center (PRC) of PIRE is one of 16 centers sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), of the National Institutes of Health, and is the only one that specializes in prevention. PRC's focus is on conducting research to better understand the social and physical environments that influence individual behavior that lead to alcohol and drug misuse.

The Resource Link for Community Action provides information and practical guidance to state and community agencies and organizations, policy makers, and members of the public who are interested in combating alcohol and other drug abuse and misuse.

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