A recent paper explored the optimal way to define “e-cigarette use” among youth in a manner pertinent to individual and public health. Commonly, definitions of youth vaping are derived from those used for tobacco cigarette smoking. In fact very frequently vaping is even referred to as tobacco use, despite the fact that vapes do not contain tobacco. Moreover, many definitions tend to not be appropriate for vaping products, given the lower risk profile and different usage patterns.
Terms of use seem to be particularly misleading when referring to youth. Vaping by young people tends to be more transient and experimental rather than frequent and persistent. And while the current literature uses a wide range of definitions, from lifetime use (“even a puff”) to daily use, most of these measures are too broad and group together use patterns which vary greatly.
Naturally, broader measures cast a wider net, capturing more potentially at-risk youth. However, more specific measures, such as daily use, are more relevant to health outcomes. Future research should consider refining definitions to include the intensity (e.g., number of puffs per day) and persistence/duration of use, using either self-report or technology-assisted data capture methods.
Broad terms group together users with varying patterns
A very good example of how terms which are too broad or inaccurate, can lead to misinterpretation, and in some cases unnecessary panic, is youth vaping data from Australia. Unfortunately, in this case, data collection and reporting seems to be designed specifically for that purpose, to exaggerate findings and create fear.
Renowned smoking cessation expert Colin Mendelsohn has recently highlighted that while the case against youth vaping is often driven by “moral panic” and emotional arguments, some of the risks associated with it have been exaggerated.
Are teen vaping rates being exaggerated?
According to the 2022/23 ASSAD survey, 29.9% of Australian youth have tried vaping at least once. However, only 3% vape daily, 4.8% vape regularly, and 15.7% vaped in the last month. These figures, added Mendelsohn, suggest that actually youth vaping is not as widespread as some claim. The majority of vapers in Australia are adults, with young vapers comprising only 5-6% of the vaping population.
Moreover, in line with the arguments presented by the previous paper, the terms “vape daily”, “vape regularly” and most especially “vaped in the last month” are broad and vague. There is a difference between someone who vaped once in the past month, out of curiosity, and someone who vaped every single day.
In fact the ASSAD survey found that most youth vaping is experimental and temporary, with half of those who try it doing so only once or twice. Regular vaping is mainly confined to current or former smokers, who actually benefit from vaping as a harm reduction tool. Mendelsohn reiterated that nicotine itself does not cause cancer, heart, or lung disease. Smokers who quit by age 35 have no permanent reduction in life expectancy, and vaping is 95% less harmful than smoking, suggesting that long-term harm from vaping is minimal.
Meanwhile, the Australian Medical Association (AMA) and other public health organizations have in recent months been relentlessly campaigning against vaping, to pressure local MPs to pass the Vaping Reform Bill, promoting the prescription model for vaping products.
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