Journal of Adolescent Health

Report
Young People and the
Use of
E-cigarettes
An overview of the
Literature
Dr Rosanne Palmer, ASH Wales
Towards a Tobacco Free Wales
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Starting points
• Confusion
• And fear
– Uncertainty, especially over the
long-term implications
– Young people
• What’s our starting point?
What do we know so far?
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Prevalence: who is using
them?
• We know increasing numbers
of young people are using
electronic cigarettes
• Predominantly smokers and
ex-smokers
• Association with other risk
behaviours
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Some data from Wales
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Some data from Wales
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And why?
• Most current data focuses on
prevalence rates, not on
intentions or motivations for use
• “Have you ever used an ecigarette?” (Dautzenberg et al,
2013: p22)
• “Have you ever bought or tried
an e-cigarette?” (Hughes et al,
2014: p4)
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Perception and image
• Pepper et al, 2012: Smokers
more willing to try any ecigarette than non-smokers
• Participants willing to try ecigarettes had less negative
beliefs about the typical
smoker
• Association between positive
beliefs about the devices and
likelihood of trying them
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Advertising and marketing
• CAP/BCAP consultation
• Market should be current
smokers; not appealing to
young people
• Hardcastle et al (2014)
suggested young people
lack awareness around
advertising and marketing
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The nature of the device
• Before being banned by the
FDA flavoured tobacco
cigarettes popular among
young people
Tobacco Free Flor
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Education and awareness
• Survey of college students in
North Carolina – half of
respondents reported that they
did not know when asked how
harmful e-cigarettes are
compared with regular
cigarettes
• Hardcastle et al identified
information that young people
would like on e-cigarettes
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The million-pound question
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The million-pound question
•
•
•
“Use of e-cigarettes does not discourage,
and may encourage, conventional
cigarette use among US adolescents”
(Dutra and Glantz, 2014: pE1)
“Compared with nonsmokers (never and
former smokers), current cigarette
smokers were significantly more likely to
have used e-cigarettes (P<0.1) and to be
current e-cigarette users (P<0.1).” (ibid:
pE4)
“This is a cross-sectional study, which
only allows us to identify associations, not
causal relationships. (ibid: pE7)
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Meanwhile, in France…
• 8.1% of respondents
reported having had an
experience with e-cigarettes
• One question; no proof of
uptake
• Main conclusion not directly
supported by available data
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Meanwhile, in France…
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Elsewhere
• Goniewicz and Zielinska-Dach:
Survey acknowledged that
unable to examine patterns on
never smokers e-cigarette use or
whether they had later initiated
tobacco use
• Pepper et al (2012) did not ask
whether e-cigarette use began
prior to initiating smoking regular
cigarettes
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The round-up
• Use among young people is
increasing
• Strongly associated with
ever smoking
• Link to other risky substance
behaviours
• Role of surroundings:
partners, parents
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The round-up (2)
•
•
•
•
•
Intentions of use?
Uptake of e-cigarettes?
‘gateway’ effect?
Long-term consequences?
Exposure to vapour?
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The round-up (3)
• (Re)normalising smoking?
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Where do we go from here?
• “One point of consensus,
however, is that protections
must be put in place to
ensure that young people
who are at risk for smoking
initiation do not use ecigarettes.” (Pepper, McRae
& Gilkey, 2013: p1)
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Where do we go from here?
(2)
• make a list of possible
interventions around ecigarettes and young people
• discuss your group’s priorities –
which intervention/issue is top
of your list?
• justify the intervention chosen
in terms of its actual impact on
improving public health
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References
de Andrade, M; Hastings, G; Angus, K; Dixon, D & Purves, R (2013): The
Marketing of Electronic Cigarettes in the UK. A report commissioned by CRUK
http:[email protected]/
@pol/documents/generalcontent/cr_115991.pdf
ASH Wales (2014): Young people and electronic cigarettes in Wales
http://www.ashwales.org.uk/creo_files/upload/downloads/young_people_an
d_e-cigarettes_in_wales_final_march_2014.pdf
Bauld, L; Angus, K & de Andrade, M (2014): E-cigarette uptake and marketing.
A report commissioned by Public Health England
Britton, J & Bogdanovica, I (2014): Electronic Cigarettes. A Report
commissioned by Public Health England
Cho, JH; Shin, E & Moon, S-S (2011): Electronic-Cigarette Smoking Experience
Among Adolescents Journal of Adolescent Health, 49: 542-546
Choi, K & Forster, JL (2014): Beliefs and Experimentation with Electronic
Cigarettes: a prospective analysis among young adults American Journal of
Preventive Medicine, 46(2): 175-178
Towards a Tobacco Free Wales
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References
Dautzenberg, B; Birkui, P; Noël, M; Dorsett, J; Osman, M & Dautzenberg,
M-D (2013): “E-cigarette: A New Tobacco Product for Schoolchildren in
Paris”
Open Journal of Respiratory Diseases, 3: 21-24
Durmowicz, EL (2014): “The impact of electronic cigarettes on the
paediatric population”
Tobacco Control, 23: ii41-ii46
Dutra, LM & Glantz, SA (2014): “Electronic Cigarettes and Conventional
Cigarette Use among US adolescents. A Cross-sectional Study”
JAMA Pediatrics: E1-E8
Goniewicz, ML & Zielinska-Dach, W (2012): “Electronic Cigarette Use
among Teenagers and Young Adults in Poland”
Pediatrics, 130: e879-e885
Grana, RA (2013): “Electronic Cigarettes: A New Nicotine Gateway “
Journal of Adolescent Health, 52: 135-136
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References
Hardcastle, K; Hughes, K; Worsley, J; Bennett, A; Ireland, R &
Sweeney, S (2014):"Most people I know have got one":
Young people's perceptions and experiences of electronic
cigarettes “
Centre for Public Health, Liverpool John Moores University
Hughes, K; Hardcastle, K; Bennett, A; Ireland, R; Sweeney, S
& Pike, K (2014):“E-cigarette access among young people in
Cheshire and Merseyside. Findings from the 2013 North
West Trading Standards Survey “
Centre for Public Health, Liverpool John Moores University
Lee, S; Grana, RA & Glantz, SA (2013): “Electronic Cigarette
Use among Korean Adolescents: A Cross-Sectional Study of
Market Penetration, Dual Use and Relationship to Quit
Attempts and Former Smoking“
Journal of Adolescent Health, xxx: 1-7
Towards a Tobacco Free Wales
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References
Morbidity and Mortality Weekly Report (Sept 6 2013): Notes from the
Field: Electronic Cigarette Use among Middle and High School Students United States, 2011-2012 62(35); 729-730
Pepper, JK; McRee A-L & Gilkey MB (2013): “Healthcare Providers' Beliefs
and Attitudes about Electronic Cigarettes and Preventive Counselling for
Adolescent Patients”
Journal of Adolescent Health, xxx: 1-6
Pepper, JK; Reiterate, PL; McRee. A-L; Cameron, LD; Gilkey, MB & Brewer,
NT (2013):“Adolescent Males' Awareness of and Willingness to Try
Electronic Cigarettes”
Journal of Adolescent Health, 52: 144-150
Sutfin, EL; McCoy, TP; Morrell, HER; Hoeppner, BB & Wolfson, M (2013):
“lectronic cigarette use by college students “
Drug and Alcohol Dependence, 131: 214-221
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