Young vapers up to 29 times more likely to smoke cigarettes: Study

There has been colloquial evidence and ample discussion over the years about whether young teens who start vaping will end up smoking cigarettes, calling into question whether a product initially designed for cessation can instead be used to lure in a younger market.
 
A study published in the Australian and New Zealand Journal of Public Health has sought to answer that question, in a first-of-its-kind project using survey data from more than 5100 teenagers.
 
It found Australian teenagers aged 12–17 years who vape are five times more likely to start smoking in the future than those who do not, after accounting for other factors that can predispose young people to trying either vapes or tobacco.
 
The association is stronger the younger the cohort is, with 12-year-olds who vape being found 29 times more likely to try smoking than their same age counterparts who do not.
 
University of Sydney study supervisor Associate Professor Becky Freeman thinks these findings reinforce why the new vaping laws introduced earlier this year need strong enforcement.
 
‘Public health experts have warned that teenage vaping uptake has the potential to undo the positive progress Australia has made in reducing smoking,’ she said.
 
‘This latest study shows how real that threat is.
 
‘Recent data has suggested a possible increase in teenage smoking over the same time period that vape use has exploded.’
 
She says that young people view vaping differently to smoking and ‘don’t know that they are more likely to take up smoking if they vape’.
 
New data, also released on Wednesday, revealed 5.2 million vapes and vaping products have been seized so far this year with an estimated street value of more than $155 million.
 
RACGP Specific Interests Addiction Medicine Chair Dr Hester Wilson agrees that even though there has been a crackdown on the retailing of nicotine vapes, there needs to be a lot of effort put in to now enforcing it.
 
‘It just feels like it is a whack-a-mole, you take one down and one pops up elsewhere,’ she told newsGP.
 
‘As the laws get tougher, they’re still going to have to put in a lot of money to actually act on those laws and that’s the tricky thing.
 
‘It’s going to be this ongoing dynamic of just trying to understand what will happen when you’ve got a group of people who are already nicotine dependent that want to access this product, and you’ve got clever people who want to sell it and manufacture it.’
 
Dr Hester said it is hard to pinpoint exactly why teens might transition from vaping to smoking, due to the number of variables.
 
‘There’s a whole heap of unknowns there but once you get a nicotine dependence, your body is kind of primed for it,’ she said.
 
As the country struggles to reign in the vaping rates among adolescents, more data is starting to come in on the contributing causes of uptake.
 
Also published this week, in the American Journal of Preventative Medicine, is research from the University of Queensland that shows social media influencers and celebrities can heavily impact teenage nicotine habits.
 
It found that 28% of respondents showed interest in trying nicotine products after seeing content on their social media feeds.
 
Dr Wilson says this is not surprising.
 
‘It’s an area where young people and all of us are susceptible,’ she said.
 
‘In the past when we had high-impact celebrities in films smoking it looked very cool, very classy, and we know that influenced people to try smoking.
 
‘That advertising has disappeared, but vaping advertising is ubiquitous.’
 
With young patients being bombarded with influences on all sides for nicotine products, what can GPs do to help them and their parents?
 
It can sometimes be a sensitive topic, Dr Wilson says, but GPs need to keep having conversations with the young people they see.
 
‘It is tricky in 12–15-year-olds, as we might be seeing them with their parents, so how do we have those conversations in a way that’s going to support them to rethink their behaviour and support their parents?’ she said.
 
‘The pharmaceutical nicotine replacement therapies like the patches, the gums, the lozenges, the sprays are all safe to use from 12 years up.
 
‘Really, it’s around having evidence-based, non-judgemental conversations around what’s happening.’
 
Dr Hester recommends using the Hooked on Nicotine (HONC) checklist for young patients.
 
‘I quite like using that because you can say to the kid, “This is a measure that other young people have filled in”, so it’s got some validity for them,’ she said.
 
‘Kids are worried about addiction, and so, once again, it’s about getting that evidence-based advice and supporting them to actually change it when they’re ready.’
 
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