2020-21 Youth & Young Adult Vaping Survey

The 2020-2021 Youth and Young Adult Vaping Project:

Key Findings and Recommendations from the Prince Edward Island Data

 

Background

E-cigarette use (“vaping”) among youth and young adults is an epidemic. Between 2017 and 2018, vaping among Canadians aged 16 to 19 increased by 74% and continues to increase [1,2]. 20% of Canadian students in grades 7 to 12 are current e-cigarette users, and 40% of those are daily/almost daily users [3]. Recently, research has been conducted on the subjective experiences [4], perceptions [5], and expectancies [6] of e-cigarette use. To extend this past research, the 2019 Youth and Young Adult Vaping Survey was conducted to better understand vaping behaviour among 16 to 24-year-olds in Nova Scotia [7-8], and this was replicated in all other provinces between April 2020 and January 2021.

 

Aim

The 2020-21 Youth and Young Adult Vaping Project was conducted by The Lung Association of Nova Scotia, made possible through funding by Heart & Stroke and other partners, to better understand vaping behaviour, experiences, and product preferences among regular e-cigarette users aged 16 to 24 across Canada. The initial results of the national survey were reported in September 2020 where the previously collected Nova Scotia data and data from five other provinces, from which data was collected in April and May 2020, was included. Data collection for the remaining provinces, including Prince Edward Island (PEI), was conducted between November 2020 and January 2021. A final report of all Canadian provinces was completed in March 2021.

This brief consists of some findings from the PEI data and can be used for the purpose of advocacy in non-media avenues. This work was completed by staff at the Lung Association of Nova Scotia.

 

Methods

In PEI, a single, cross-sectional survey, offered in English, was advertised online using paid Facebook and Instagram ads. To participate, participants had to be between the ages of 16 and 24, to have vaped at least once a week over the past three months, and to have resided in PEI at the time of the survey. The entire data for PEI was collected between November and December 2020 and consisted of a sample of 273 participants. The survey included demographic questions, questions about the participants’ vaping behaviour, product preferences, experiences, a personality questionnaire, and a substance use motives questionnaire. On average, the survey took approximately 20 minutes to complete. Participants who completed the survey in its entirety were offered a $10 electronic gift card as renumeration. Further, all participants were invited to share their email address to be entered to win one of five $100 gift cards from a prize draw, regardless as to whether they completed the survey.

 

Summary of demographics and vaping characteristics

Demographics

  • 34.4% of the sample identified as male and 65.6% identified as female. No participants identified as “other.”  
  • 51.3% of participants were youth (16-18 years old) and 48.7% were young adults (19-24).
  • 58.2% of the sample was employed.
  • 67.6% of participants reported living in urban regions.

 

Vaping characteristics

  • The average age of vaping onset (first time vaping) was 15.75 years old.
  • Participants reported vaping, on average, 6 days per week, 33.26 times (episodes) per day, and took 5.93 puffs per vaping episode.
  • Since the onset of the COVID-19 pandemic, participants reported less vaping behaviour compared to pre-pandemic: 5.58 days per week, 29.40 times (episodes) per day, and 5.55 puffs per vaping episode.
  • Of youth participants, 62.6% reported that their parents were aware of their vaping behaviour.
  • 42.2% of participants reported negative experiences (e.g., health effects) from vaping.

 

Summary of key findings, supporting evidence from other studies, and recommendations for policy action

Given the findings from the survey, the following are 4 recommendations to combat youth and young adult vaping with reference to supporting evidence from other research.

  1. Implementing a comprehensive flavour ban. Reducing access to flavoured products will lessen the appeal of vaping to youth and young adults.

 

Survey evidence

  • 88.6% of participants currently prefer using flavoured vape juices, and 90.1% began vaping using a flavoured vape juice.
  • Berry, Menthol, and Mango were the most commonly reported flavours used by participants, whereas Tobacco was the least common.
  • 38.1% of the 226 participants who prefer flavoured vape juices reported they would not continue to vape if they could not purchase flavoured juices.

 

Supporting evidence

  • Non-tobacco flavoured products are more appealing to youth than tobacco flavoured products [9,10].
  1. Limiting permitted nicotine concentrations to 20 mg/mL. Youth and young adults that are vaping are using high concentrations of nicotine which facilitates nicotine dependence.

 

Survey evidence

  • Although only 81.0% of participants reported using vape juice containing nicotine at vaping onset (first time vaping), 93.0% reported currently using vape juice containing nicotine.
  • 75.0% of participants that used nicotine products used the highest permitted nicotine concentrations (50-60 mg/mL).
  • Of participants that reported attempting to quit vaping (56.8%), the average number of serious quit attempts was 3.77.
  • Of participants that reported former or current tobacco use, 24.2% reported using tobacco for the first time after trying vaping.

 

Supporting evidence

  • Use of higher nicotine concentrations among youth may facilitate more excessive smoking and vaping [11].
  • Youth e-cigarette use is associated with later smoking initiation [12–14].

 

  1. Increasing taxation on vaping products. Vaping is affordable relative to smoking cigarettes and increasing the cost of these products can deter young users.

 

Survey evidence

  • Participants spent on average $21.50 CAD per week on vaping products, which is substantially less than what a regular smoker would spend on cigarettes per week ($100+). Thus, we would expect a regular smoker who uses a half-pack of cigarettes per day to spend at least three times more than that per week.

 

Supporting evidence

  • Young people are more sensitive to price increases on tobacco products (and thus less likely to purchase these products) than adults [15,16].

 

  1. Increasing the minimum age of purchase to 21 years. Underage youth can access vaping products and increasing the minimum age will permit fewer opportunities for youth to access vaping products through social sources of legal age.

 

Survey evidence

  • 86.1% of participants reported offering their e-cigarette to someone else to use. Of these participants, the average number of people who have used their e-cigarette is 17.18.
  • 31.5% of participants reported purchasing their vaping device from a friend, and 31.9% reported purchasing their vape juice from a friend.

Supporting evidence

  • Social sources are a common way that underage youth access vaping products [7,17,18].

 

References

 

[1]      Hammond D, Reid JL, Rynard VL, et al. Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys. BMJ 2019;365.

[2]      Hammond D, Rynard VL, Reid JL. Changes in Prevalence of Vaping among Youths in the United States, Canada, and England from 2017 to 2019. JAMA Pediatr 2020;4:2018–21.

[3]      Health Canada. Canadian Student Tobacco, Alcohol and Drugs Survey. Available at: https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey.html.

[4]      McDonald EA, Ling PM. One of several ‘toys’ for smoking: young adult experiences with electronic cigarettes in New York City. Tob Control 2015;24:588-593.

[5]      Pokhrel P. Fagan P, Kehl L, et al. Receptivity to E-cigarette Marketing, Harm Perceptions, and E-cigarette Use. Am J Health Behav 2015;39(1):121-131.

[6]      Pineiro B, Correa JB, Simmons VN, et al. Gender differences in use and expectancies of e-cigarettes: Online survey results. Addict Behav 2016;52:91-97.

[7]      Al-Hamdani M, Hopkins DB, Hardardottir A, et al. Perceptions and Experiences of Vaping Among Youth and Young Adult E-Cigarette Users: Considering Age, Gender, and Tobacco Use. J Adolesc Health 2020.

[8]      Davidson M, Al-Hamdani M, Hopkins DB. Differences in motives by personality risk profiles: Examining regular youth and young adult e-cigarette users. Pers Individ Differ 2021;168:110352.

[9]      Shang C, Huang J, Chaloupka FJ, et al. The impact of flavour, device type and warning messages on youth preferences for electronic nicotine delivery systems: Evidence from an online discrete choice experiment. Tob Control 2018.

[10]    Meernik C, Baker HM, Kowitt SD, et al. Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review. BMJ Open 2019;9(10): e031598.

[11]    Goldenson NI, Leventhal AM, Stone MD, et al. Associations of Electronic Cigarette Nicotine Concentration With Subsequent Cigarette Smoking and Vaping Levels in Adolescents. JAMA Pediatr 2017;171:1192–9.

12]     Hammond D, Reid JL, Cole AG, et al. Electronic cigarette use and smoking initiation among youth: A longitudinal cohort study. CMAJ 2017.

[13]    Berry KM, Fetterman JL, Benjamin EJ, et al. Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths. JAMA Netw Open 2019.

[14]    Chan GCK, Stjepanovic D, Lim C, et al. Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation. Addiction 2020.

[15]    van Hasselt M, Kruger J, Han B, et al. The relation between tobacco taxes and youth and young adult smoking: What happened following the 2009 U.S. federal tax increase on cigarettes? Addict Behav 2015;45:104–9.

[16]    Liang L, Chaloupka F, Nichter M, et al. Prices, policies and youth smoking, May 2001. Addiction 2003.

[17]    McKeganey N, Russell C, Katsampouris E, et al. Sources of youth access to JUUL vaping products in the United States. Addict Behav Reports 2019;10:100232.

[18]    Tanski S, Emond J, Stanton C, et al. Youth Access to Tobacco Products in the United States: Findings from Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2019.

 

 

Page Last Updated: 31/05/2021