Nowadays, vaping is more common among young adults than traditional cigarette consumption. Researchers are observing startling increases in the number of young people who regularly use e-cigarettes—so much so that, for the first time, more young people are starting to use nicotine through vaping rather than through cigarettes—after years of success in the public health domain in reducing the number of cigarette users.
According to Benjamin Toll, Ph.D., head of the MUSC Health Tobacco Treatment Programme and researcher at the MUSC Hollings Cancer Centre, there is a current trend in the population where more “never smokers” than regular smokers vape. That represents a significant change in the tobacco industry. These so-called “never smokers” are more likely to vape and continue vaping than to start smoking combustible cigarettes. And these individuals, who range in age from 18 to 24, will predict the usage of e-cigarettes in the future.”
It’s a mixed bag of a forecast. The fact that the percentage of young individuals who report smoking is at an all-time low is very positive. Toll and other tobacco researchers at Hollings agree that e-cigarettes may be a less harmful option for smokers who have tried but failed to give up, but they also stress that vaping is not a risk-free alternative, which is why it depresses them to see young adults who have never smoked start to vape.
This month, Toll and associates from the Medical University of South Carolina present their latest research results in a research letter published in JAMA Internal Medicine. The National Institutes of Health provided funding for the study.
The research letter’s co-first authors are associate professor Naomi Brownstein, Ph.D., and postdoctoral fellow Brandon Sanford, Ph.D., both of the Department of Public Health Sciences.
We wish to assist persons who smoke and have smoked combustible tobacco cigarettes for a few decades in quitting since they are at an extremely high risk of developing cancer. Although we ultimately want to assist people in giving up tobacco completely, moving to e-cigarettes is at least a partial victory if they’re not ready for that, according to Brownstein.
“Now, if you are an 18-year-old and your friends are like, ‘Hey, let’s vape some banana bread nicotine,’ and you’ve never smoked, those are the people for whom we think starting vaping is a problem.”
The National Institutes of Health and the U.S. Food and Drug Administration collaborated to conduct the nationally representative longitudinal survey known as the Population Assessment of Tobacco and Health (PATH) Study, from which the study team derived its data. Since the survey’s inception in 2013, six waves of data have been collected.
The survey responses from 2021 comprised the sixth wave, which was not publicly accessible when the researchers finished their investigation. Through the University of Michigan’s National Addiction & HIV Data Archive Programme, they were able to view the restricted data before it was made public.
The Wave 6 data revealed a persistent upward trend in vaping and revealed that 56% of young adults who vape frequently have never smoked cigarettes on a regular basis.
The PATH Study found that 14.5% of adults between the ages of 18 and 24 reported using e-cigarettes on a regular basis, which is higher than the 11% indicated in an earlier report from the Centres for Disease Control and Prevention. Toll anticipates an even bigger increase in the upcoming phase of PATH Study data, which is expected to be released in the autumn of 2024.
For all types of marketers, the 18–24 age bracket is a valuable one. “It’s a time that you’ve just graduated high school; you are transitioning to either college or to work, and you’re changing many things, starting your life, and, importantly, it’s when brand loyalty starts,” Toll stated. Cigarette producers targeted this population, as evidenced by confidential industry documents that were later uncovered in lawsuits. This was true for cigarettes as much as for any other product.
While cigarette advertising has drastically decreased, e-cigarette advertising has skyrocketed. Toll links to a company’s website that features vibrant, computer-animated emojis and asks users to subscribe to their Discord channel, which is a community-based social media platform.
“We don’t know yet what the long-term health consequences are, but I’m very uncomfortable that there are so many flavoured and disposable e-cigarettes that are clearly marketed to young people,” Toll stated.
It is required of e-cigarette manufacturers to apply to the FDA in order to be allowed to market their goods. However, a lot of them don’t, and their goods are widely accessible. Only e-cigarettes with tobacco flavours have received marketing authorization from the FDA thus far.
Young people are drawn to fruity, sweet flavours because they mask the taste of tobacco. Certain firms even capitalise on the craze for toys, drinks, and cartoons that have nothing to do with vaping. In August, the FDA sent warning letters to internet sellers who were offering e-cigarettes that were made to resemble Starbucks or Dunkin coffee mugs. Toll reported that he was recently informed by a patient that he uses a vape pen that tastes like Capri Sun.
Apart from the general rise in vaping, the survey data also demonstrated the rise in vaping’s popularity among young women.
“At the beginning of the survey data, young men were vaping more than young women,” Brownstein stated. “And they still were at the end, but young women had a slightly steeper increase, so they were starting to catch up a bit.”
According to Sanford, the group’s findings highlight unanswered questions in the field of public health.
“We know if combustible tobacco use is becoming less prevalent than e-cigarette use, there are a lot of public health implications about where our efforts need to be in terms of cessation counselling and treatment development,” he stated.
Currently, there aren’t many recognised vaping therapies available. Many studies are being conducted, although they are still in their infancy, to determine whether the strategies we have employed to help people quit smoking traditional tobacco would also be effective for people who vape.”
He went on, “A lot of vapers do want to stop.” “Even if the health problems associated with vaping aren’t as extreme as smoking, it’s still an uncomfortable addiction for a lot of folks.”
According to Toll, there is a lack of standardisation and quality control in the unapproved vaping goods, and his patients have observed that the quality might differ greatly even within the same brand.
“We need authorization and standardisation of these new vapes,” he stated.
“There’s clear marketing to youth and to adults who never smoked cigarettes,” he continued. The fact that kids and “never smokers” are now vaping makes me unhappy.”
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