Reflect

Vapes; those brightly coloured pieces of plastic, often seen littering streets, countryside and beaches, and potentially polluting waterways. Little devices which heat a mixture of chemicals, including nicotine, to create flavoured vapour, for inhalation through a mouthpiece. Vapes; recommended by the NHS as a “less harmful” and effective aid for adults to help them stop smoking traditional cigarettes, but increasingly taken up by people who have never smoked.

In the UK, vapes have hit the headlines numerous times in recent weeks. First, there’s the huge environmental impact. Shockingly, data published at the end of 2023 showed that five million disposable vapes were thrown away every week in the UK last year, four times as many as in 2022. Research by Material Focus, an organisation campaigning to increase recycling rates, found that only 17% of vapers correctly recycle these products, despite the fact that they contain valuable materials. In fact, it’s estimated that the vapes disposed of in the UK last year contained enough lithium to provide batteries for 5000 electric cars.

Cut to more big news. Whilst the sale of non-disposable vapes to adults will remain legal, on 29th January, UK Prime Minister, Rishi Sunak, announced plans to ban the sale and supply of disposable vapes in England, Scotland and Wales, a move welcomed by the Royal College of Paediatrics and Child Health. This proposed legislation wasn’t only devised because of the startling ecological effects. Actually, its main driver is the increasing popularity of these products amongst the young. The government’s press release states that, “The number of children using vapes has tripled in the last three years and there is strong evidence to suggest that cheap and easy-to-use disposable vapes are partly to blame. Our research shows that in 2023, around 69% of vapers aged 11 to 17 in Great Britain were using disposable vapes, up from 7.7% in 2021”. Alongside the ban, the government is also proposing to strengthen the regulation of vape flavours and packaging in order to make it less appealing to the young, further regulate how they are displayed in shops and crack down on underage sales.

In the UK, teenage vaping should be a non-issue, given that it has been illegal to sell e-cigarettes or e-liquids to under 18s since 2015. But a chat with any teen will likely tell you that it’s not! A survey of 6,500 young people carried out by drugs education charity the DSM Foundation in 2023 found that 95% of respondents aged 15-18 said that vaping is the main substance used by their peers, just ahead of alcohol.

In the UK, the vast majority of young people do not vape, particularly if they have never smoked, but a concerning minority do. The most recent biennial NHS Digital survey into secondary school pupils’ smoking, drinking and drug use, published in 2022, found that 88% of pupils know what e-cigarettes are and that 22% have tried vaping. We also know that the likelihood of vaping increases with age. Data from the annual ASH Smokefree GB survey of 11-18 year olds showed that children under the age of 16 are less likely to try e-cigarettes than those over 16. It found that 15% of 11-15 year olds have tried vaping, compared to 34% of 16-17 year olds and 38% of 18 year olds.

Sadly, there are a significant number of retailers who sell to under 18s – both in person and online. These places also seem more likely to stock unregulated vapes, which contain unknown levels of nicotine, may harbour harmful chemicals (unsafe levels of lead and nickel have been found in some samples confiscated from school children) and are untested in terms of device safety. A whopping 4.5 million illegal vapes, weighing almost 10 tonnes, were seized at UK borders over the last year. A recent BBC news story on illegal vapes quoted a senior London Trading Standards officer as saying: “You just don’t know what’s in them.”

Motivate

A 2022 report commissioned by the Office for Health Improvement and Disparities in the Department of Health and Social Care has found that vaping is not risk-free, particularly for people who have never smoked, and it’s been linked to many health problems, the majority affecting the heart and lungs.

For young people, a huge source of concern is the nicotine that is contained in most vapes. Nicotine is an addictive, psychoactive substance that initially gives users an adrenaline surge – causing blood pressure, heart and breathing rate to rise – followed by a sense of relaxation. The body gets used to nicotine very quickly, meaning users soon need more in order to feel the same effects, setting up cycles of dependence, which can lead to long-term addiction. Their developing brains make teens particularly vulnerable to these challenging patterns of behaviour. The nicotine content of some disposable vapes is especially concerning when you learn that it can be equivalent to 48 cigarettes.

The reasons why young people might choose to vape are varied. Studies have found that it includes the flavour (with fruity, sweet flavours preferred to tobacco or minty ones), accessibility, discreteness (they don’t smell like cigarettes), a desire to experiment, stress relief, to learn ‘tricks’, or because they’ve been encouraged by adverts.

Some social media influencers actively promote vaping. Asha Fowells from drugs education charity the DSM Foundation notes that, “The UK regulations surrounding vape advertising and promotion are quite tight, and there is an expectation that anything that is permitted – for example, an outdoor poster – is done in a way that is socially responsible and isn’t targeted at children, instead focusing on factual information. However, there are loopholes that are exploited: the ASH report found that a significant number of 11-17 year olds had seen vaping promoted online, most frequently through social media platforms, with TikTok the most common." This is difficult to monitor and regulate, whether it is a video showing vaping “tricks” or an influencer talking about a product that has been sent to them free of charge. The individual may even simply be using the device while talking about or doing something completely unrelated, but the mere presence of the vape normalises it for the potentially huge number of followers who view the content.

Platforms such as Instagram and Facebook banned branded product endorsements related to vaping in 2019, but a quick search reveals that content can easily be found using hashtags including #vape, #vapelife, #vapesale and #ejuice. Recent UK research found that young people who reported seeing adverts for e-cigarettes online, most commonly saw them on TikTok.

The UK government is currently planning to create a ‘smoke free generation’ by ending cigarette sales to those born on or after 1 January 2009 (a proposed law change that aims to phase out smoking by 2040). Are we walking into another cycle of addiction to nicotine through a product which seems to have explicit marketing appeal to the young?

Support

Significant evidence shows that a strong connection with our children and effective conversations focused on boundaries, risks, potential consequences, and the importance of decision making can make a positive difference. Pre-emptive conversations about vaping, and about evaluating risk more generally, are likely to make our children at least think twice before giving it a go.

At Tooled Up, we’ve worked with the DSM Foundation to get their advice on dealing with the tricky topic of vaping at home. They note that whilst pre-teens can often seem more receptive than teenagers to conversations on tricky topics such as vaping, it is never too late to start and, if it all feels like it’s going wrong when you do, don’t give up! They suggest we revisit the topic another time.

With younger children, the DSM Foundation suggests we talk about making healthy choices in a general sense. Chat about practices that introduce concepts of risk and harm, such as smoking or the consumption of caffeine. As children become aware of other substances, give them up to date, relevant, factual information, make them aware of the risks, allow space for questions and reflections, and make sure that you agree on clear and consistent boundaries.

Avoid being overly formal and instead seize natural opportunities to chat where they arise. Perhaps someone vapes on a TV show that you are watching together? Maybe you spot a news story or see an advert on your own social media? Maybe you walk past a vape shop or you get a letter home from school on the subject?

Asking open ended questions is likely to be the most fruitful strategy; “Why do you think some teens might want to try vaping?” “How do you feel about it?” “Is vaping popular at school?” “Have you ever seen adverts for vaping on social media? What do you think about them?” Dialogue is key here. We want to hear what they think and know, as well as impart our knowledge. If you know (or suspect) that your teen is vaping, exploratory chats to find out their motivation is important.

We know that simply telling teens to say ‘No’, attempting to frighten them with shocking images or stories, or just giving them facts without context or guidance, are not effective strategies in preventing them from doing something risky. When talking about vaping, try to avoid lecturing or focusing on threats or punishment. Vaping may hold some appeal to our children and it’s important not to dismiss this. Our job is to help them weigh up the risks against what they might perceive to be the benefits. Provide honest and fact-based responses to any questions they have, and if you aren’t sure of the answer, research it together.

It is also important to challenge young people’s perceptions of what their friends might be getting up to. We know from numerous research studies that teens tend to overestimate their peers’ propensity to engage in risky behaviours, including smoking, drinking, sex and drugs, and that the belief that ‘everyone’ is doing these things is linked to stronger intentions of engaging in these behaviours themselves. Emphasising social norms might just help to combat any FOMO (Fear Of Missing Out) they may be experiencing. Whilst there is a lot of awareness among teens about vaping, it’s still the case that most haven’t tried it and only a tiny fraction vape regularly.

Many teens will be offered the chance to try vaping by friends and they may feel pressure to do so. Role playing potential scenarios can be a useful way of helping them to build confidence in evaluating risk and saying no, as can thinking about possible stalling or avoidance tactics that they can call upon when needed. Simply practising saying ‘no thanks’ confidently can help them to feel more prepared. It’s worth regularly checking in with your child about how things are with their friends and at school, asking them if anyone has said anything that has made them feel uncomfortable, or even ‘just a bit weird’.

Despite measures taken by some social media companies to ban adverts for vaping, we know that young people often still see vaping online. Promote an open culture at home, where your children feel comfortable talking to you if they view things online that concern or worry them, or that they simply want to know more about. Ask them about what they see on social media and how they respond to things they don’t like. We know that some teens do choose to vape as a way of dealing with stress. It’s important to ensure that your child has access to other things that make them feel good, fit in and which help them to cope with any challenges.

If you are looking for further support, the DSM Foundation has a number of resources to support parents and carers in their conversations with young people about vaping including an information sheet, a resource pack for use in schools with children aged 13-18 and a Quick Guide to Vaping, produced in conjunction with us at Tooled Up. The website also contains tips on having tricky conversations with your child. ASH has published resources on vaping in young people, and a short animated film produced by Sheffield City Council outlines the risks and can work well as a discussion starter. Talk to Frank has useful information on vaping and nicotine, and US website Smokefree has more detail on nicotine withdrawal and advice for teenagers wanting to quit vaping.