Vaping is most prevalent in Canada among 15- to 24-year-olds, and has significantly increased since e-cigarettes with nicotine were legalized in 2018. Ensuring that young people understand the health risks involved may help encourage them to steer clear of vaping.
Recent data from Statistics Canada show that more than one-third of teenagers between the ages of 15 and 19 have tried vaping, and 15 per cent report having done so within the last 30 days. Of those who reported vaping in last 30 days, approximately 80 per cent had vaped nicotine.
Unfortunately, teens may underestimate the amount of nicotine in the vaping products they use, while one in 10 users reported having tried vaping without knowing whether it contained nicotine.
There is evidence that vaping among young people may be a “gateway behaviour” to cigarette use — another smoking behaviour that contains nicotine. By extension, we may be seeing a new generation of tobacco smokers who will likely have serious health problems.
Health risks
Vaping is not without health risks. Some studies suggest that it could lead to lung damage or even pneumonia. Many vaping products in Canada and the United States have also been made with fruit-flavoured aerosols, leading to concern from some advocates about how these products are marketed and their potential appeal to young people.
In response, Health Canada and advocates have called for more measures beyond warning labels on e-cigarette products, including ways to make them less accessible to youths, particularly when it comes to online sales which can be difficult to regulate for teens.
Working in the area of behavioural medicine with expertise in health behaviour change, our research suggests ways to help university students steer away from vaping. Providing health risk information about vaping through expert advice and personal testimonies is an effective strategy. This is important because it tells us how information can be presented to have a strong impact on how young adults think about the consequences of vaping.
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In January 2021, we conducted a 45-day study on undergraduate students from six provinces, all of whom consistently vaped e-cigarettes. Most vaped at least five to 15 times a month.
Our goal was to investigate whether young adults can refrain from vaping using an informational video about the potential health risks of vaping told by health experts and other e-cigarette users. Participants were randomized into two groups: one watched the vaping information video, and a control group watched a more general nutrition and healthy lifestyle video that did not offer in-depth information on the health effects of vaping.
Health risk information and vaping
Over the course of 45 days, we followed the students to see how their feelings about vaping changed. We found that those who viewed the informational video were more likely to express intentions to stop or reduce their vaping habits.
Those feelings remained strong over the study period, including three follow-up sessions when participants were asked to report how they felt about the perceived severity of the threats posed by vaping and their vulnerability to them.
The study showed vaping intentions — and, to a lesser degree, vaping behaviour itself — can be reduced after learning about the potential consequences in this way. The students’ intentions were significantly altered after learning about possible health effects, but those intentions to reduce vaping were not seen in the control group. The emphasis on intention formation is crucial because it drives the necessary actions (such as goal setting and motivation) towards achieving the desired change.
Overall, vaping use in both groups dropped over the study, however this drop was more pronounced in the intervention group, specifically towards the end of the study. This intervention does underline a successful strategy to reach young people engaged in harmful behaviours.
What’s next?
Curbing vaping remains the ultimate goal. While health risk information can lead regular vapers in university to form intentions to vape less, more research is needed on how to convert those intentions into convincing behaviour change. For now, to reduce harmful habits like vaping, we encourage others to educate themselves on the potential harms of these behaviours.
Evidence of health risks associated with the use of e-cigarettes continues to grow. However, there is limited evidence to illustrate health benefits of stopping vaping. Research is needed to address this knowledge gap.
Similar to tobacco and cigarettes in the past, a full understanding of the harm from using vaping products, and how reducing their use affects one’s health, may take several decades. Current evidence suggests e-cigarette use may follow the trend of tobacco cigarettes: multiple long-term health risks with continued use.
As the literature on the short-term health consequences of vaping behaviour continues to mount, and as the vaping market continues to grow, research identifying effective health behaviour change strategies to curb intentions to vape and vaping use are paramount.
We envision provincial and federal health agencies will implement evidence-based interventions like our study in settings like schools, clinics and community centres to help clear the “smoke” around the true health effects and harms of vaping to motivate them to steer away.
Babac Salmani does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Harry Prapavessis receives funding from the Canadian Foundation for Innovation (CFI); Canadian Cancer Society (CCS); Canadian Institutes of Health Research (CIHR); Social Sciences and Humanities Research Council (SSHRC).
