A Heart & Stroke study of youth and young adult vaping behaviour and preferences reveals that young people across Canada who vape do so most days of the week, many times a day. The research highlights the reasons why young people start vaping and why they continue – and that many have moved on to smoking cigarettes.
“The survey results are both horrifying and illuminating,” says Dr Andrew Pipe, board chair of Heart & Stroke, which funded the study conducted by the Lung Association of Nova Scotia and Smoke-Free Nova Scotia.
“Young people are starting to vape before they turn 16; they are vaping six days a week, 30 times a day, and they are addicted: the majority (59%) have tried to quit vaping multiple times without success and many have begun smoking after vaping.
“We are throwing decades of successful tobacco control out the window by creating a whole new generation dependent on nicotine.”
Other findings from the survey point to the factors that influence vaping behaviour:
Flavours entice young people to start vaping and keep vaping
- The survey revealed nine in ten (92%) young people cite flavours as an important reason why they started vaping and the same number (90%) say it is an important factor for continuing to do so.
- Their most preferred flavours are berry, confectionary, mango and mint/menthol.
Young people use vapes high in nicotine
- Nine in ten (92%) of the young vapers surveyed use e-juice that contains nicotine and of these almost all (98%) are aware of the nicotine concentration in their devices.
- Two-thirds (66%) of young people who use vapes use the highest concentrations of nicotine available; between 50–60mg/mL. The nicotine concentration limit in the European Union is 20mg/mL.
- The amount of nicotine consumed each week by young people who vape regularly is equivalent to the amount of nicotine in six packs of cigarettes. Nicotine is highly addictive and damaging to developing brains.
Vaping is affordable for young people
- According to the survey young regular vapers spend on average just under $15.00 per week on vaping products, which is about an hour of minimum wage work and less than a single pack of cigarettes in most Canadian regions. Cigarettes are taxed at a much higher rate than vaping products: cigarette taxes range from 60% to 76% of the purchase price across provinces, while vaping product taxes range from 5% to 38%.
Young people share vapes
- Virtually all young vapers (99%) have been offered someone else’s vape to use and almost the same amount (93%) have offered to share their own. This is worrisome given the current pandemic.
Disturbingly, the survey also found that many young vapers are now young smokers. Over one-quarter of young people say they began smoking cigarettes after they started vaping and over one-third know someone who began smoking after they started vaping.
Only 17% report using vapes as a way to try to quit smoking. Those who both vape and smoke have an increased risk for stroke and heart attack.
“The time to act is now. Although there are varying protections in place across the country, a number of policy measures need to be implemented nationwide to strongly address the youth vaping crisis,” says Dr Mohammed Al-Hamdani, Director of Health Initiatives at the Lung Association of Nova Scotia and lead researcher for the study.
“This includes the federal government implementation of a robust set of policies including a comprehensive flavour ban, excise tax, and capping nicotine levels. Provinces should also utilise taxation and raise the minimum purchase age to 21 (for both smoking and vaping).”
According to other recent Canadian research, vaping among youth skyrocketed by 112% from 2017 to 2019. Vaping is linked to lung injury and increased blood pressure.
Protecting youth will not stop adult smokers who want to quit from accessing e-cigarettes which may have the potential to help them quit smoking, said the study authors.
The 2020 Youth and Young Adult Vaping Project
Heart & Stroke Canada. Published on 11 September 2020
Al-Hamdani, M, Hopkins, DB and Davidson, M.
E-cigarette use (“vaping”) has been on the rise. The 2020 Youth and Young Adult Vaping Project, conducted by The Lung Association of Nova Scotia and Smoke-Free Nova Scotia with funding from Heart & Stroke, aimed to examine the vaping behaviours, experiences, and product preferences of youth and young adult e-cigarette users in Canada.
Using an online survey, 1871 regular e-cigarette users (used an e-cigarette at least once a week for the past three months) between the ages of 16 and 24 and residing in one of six Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Nova Scotia, and Saskatchewan) were asked about their vaping behaviours (e.g., days vaped per week, number of episodes per vaped day, and number of puffs per vaping episode), experiences (e.g., co-use of other substances), and product preferences (e.g., nicotine concentration).
This report details average responses across all regions and further segments findings by age, gender, and region. Results: On average, respondents began vaping at the age of 15.74 years. More than half (59.0%) of all respondents reported having tried to quit vaping, with many making several attempts. The average e-cigarette user engaged in vaping behaviour six days per week and almost 30 vaping episodes per day, with approximately 6 puffs per episode.
Since learning about the COVID-19 pandemic, respondents reported vaping less vaping days per week (5 days) and a marked decrease to 19 vaping episodes per day, but puffs per episode were nearly unchanged.
On average, respondents spent between $12 and $16.47 per week on e-cigarettes. The overwhelming majority of respondents indicated that they have both used someone else’s e- cigarette (98.6%) and shared their e-cigarette with others (93.0%). For those that have shared their e-cigarette, the average number of people the e-cigarette was shared with was almost 23.
Around half (50.3%) of all respondents had experienced a negative side-effect related to vaping. The majority of respondents reported exposure to vaping-related advertisements on social media platforms (74.0%). Users of pod-based devices constituted the largest proportion of respondents (62.0%).
Almost all users used a flavoured vape juice at initiation (91.9%) and presently (90.4%). In most provinces, berry, mango, and mint/menthol were the most commonly reported flavours used at initiation and at present. Most users used vape juice containing the highest possible concentration of nicotine (50-60 mg/mL)1 (66.2%).
With respect to tobacco use, 64.3% of respondents were former users and 12.6% were current users. Current smokers used 11 cigarettes per week on average. A notable proportion of respondents (35.3%) indicated that they knew someone who started smoking after vaping. In the past 30 days, cannabis use (12 days of use) was more common than alcohol use (6 days of use).
Analysis of the total sample reveals concerning vaping behaviours among youth and young adults. Regular e-cigarette users report similar vaping behaviour and experiences across regions, though a number of notable differences at the individual- and regional-level emerged from our findings.
In this report, we discuss our findings in the context of viable policy options to restrict the appeal and use of e-cigarettes among youth and young adults across Canada. These include a comprehensive flavour ban, limiting permitted nicotine concentrations to 20 mg/mL, increasing taxation on vaping products, and increasing the minimum age of purchase to 21.
Heart & Stroke Foundation – Youth are vaping early and vaping often
The 2020 Youth and Young Adult Vaping Project