The e-cigarette industry, while relatively unknown about 10 years ago, has seen a rapid increase in popularity and use, with the Center for Disease Control estimating that there are around 9 million e-cigarette users in the United States.
Early data suggests that teens and young adults are the fastest growing group to elect use of electronic nicotine delivery devices over conventional cigarettes, with the 2015 Surgeon General Report on E-Cigarette Use indicating that more than a quarter of middle and high school students have tried e-cigarettes. Initially marketed as a smoking cessation tool, e-cigarettes do not contain tobacco, which has been linked to significant risk for cancer and other health related diseases in conventional cigarette smoking.
E-cigarettes are marketed as a safer alternative, delivering nicotine (of varying doses that can be tapered over time similar to other smoking cessation tools), flavorings, and other additives in a battery powered device that heats the liquid into an aerosol which can be inhaled by the user. Of concern among the addiction treatment community, is the difficulty in determining whether e-cigarette use works as a safe form of tobacco harm reduction. Specifically the e-cigarette may function as a replacement habit and provides opportunity to continue the rituals and habits associated with smoking instead of finding ways to eliminate smoking related behaviors.
The popularity of e-cigarettes or ‘vaping’, as is often referred to by youth and young adults, indicates that teens are not using these devices as a way to quit, but for a multitude of other reasons. A study published in the 2018 journal Drugs: Education, Prevention and Policy, interviewed 50 youth between the ages of 16 and 26 to identify common views young people have around e-cigarette use, including how they were introduced to vaping, judgements about risk of harm, similarities with traditional cigarette smoking and what they like most and least about vaping.
Consistent with other studies on smoking behavior among adolescents, most young people are introduced to vaping in social settings with friends who had been using e-cigarettes. Youth discussed curiosity and perception of e-cigarettes as being less harmful than traditional tobacco cigarettes as factors in willingness to experiment. Many youths interviewed also mentioned the variety of flavors (ranging from cotton candy to crème brulee), less stigma, increased acceptability to vape in public, the ability to blow large clouds of thick smoke, and the lack of smell as determining factors as reasons to continue using e-cigarettes.
