young people and the use of e-cigarettes an overview of the literature dr rosanne palmer, ash wales...

Young People and the Use of E-cigarettes

An overview of the Literature

Dr Rosanne Palmer, ASH Wales

Towards a Tobacco Free WalesTuag at Gymru Ddi Dybaco


Starting points

• Confusion • And fear – Uncertainty, especially over the

long-term implications– Young people

• What’s our starting point? What do we know so far?

Prevalence: who is using them?

• We know increasing numbers of young people are using electronic cigarettes

• Predominantly smokers and ex-smokers

• Association with other risk behaviours


Some data from Wales


And why?

• Most current data focuses on prevalence rates, not on intentions or motivations for use

• “Have you ever used an e-cigarette?” (Dautzenberg et al, 2013: p22)

• “Have you ever bought or tried an e-cigarette?” (Hughes et al, 2014: p4)


Perception and image

• Pepper et al, 2012: Smokers more willing to try any e-cigarette than non-smokers

• Participants willing to try e-cigarettes had less negative beliefs about the typical smoker

• Association between positive beliefs about the devices and likelihood of trying them


Advertising and marketing

• CAP/BCAP consultation• Market should be current

smokers; not appealing to young people

• Hardcastle et al (2014) suggested young people lack awareness around advertising and marketing


The nature of the device

• Before being banned by the FDA flavoured tobacco cigarettes popular among young people


Tobacco Free Flor

Education and awareness

• Survey of college students in North Carolina – half of respondents reported that they did not know when asked how harmful e-cigarettes are compared with regular cigarettes

• Hardcastle et al identified information that young people would like on e-cigarettes


The million-pound question


The million-pound question

• “Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents” (Dutra and Glantz, 2014: pE1)

• “Compared with nonsmokers (never and former smokers), current cigarette smokers were significantly more likely to have used e-cigarettes (P<0.1) and to be current e-cigarette users (P<0.1).” (ibid: pE4)

• “This is a cross-sectional study, which only allows us to identify associations, not causal relationships. (ibid: pE7)


Meanwhile, in France…

• 8.1% of respondents reported having had an experience with e-cigarettes

• One question; no proof of uptake

• Main conclusion not directly supported by available data


Meanwhile, in France…


Elsewhere

• Goniewicz and Zielinska-Dach: Survey acknowledged that unable to examine patterns on never smokers e-cigarette use or whether they had later initiated tobacco use

• Pepper et al (2012) did not ask whether e-cigarette use began prior to initiating smoking regular cigarettes


The round-up

• Use among young people is increasing

• Strongly associated with ever smoking

• Link to other risky substance behaviours

• Role of surroundings: partners, parents


The round-up (2)

• Intentions of use?• Uptake of e-cigarettes?• ‘gateway’ effect?• Long-term consequences?• Exposure to vapour?


The round-up (3)

• (Re)normalising smoking?


Where do we go from here?

• “One point of consensus, however, is that protections must be put in place to ensure that young people who are at risk for smoking initiation do not use e-cigarettes.” (Pepper, McRae & Gilkey, 2013: p1)


Where do we go from here? (2)

• make a list of possible interventions around e-cigarettes and young people

• discuss your group’s priorities – which intervention/issue is top of your list?

• justify the intervention chosen in terms of its actual impact on improving public health


References

de Andrade, M; Hastings, G; Angus, K; Dixon, D & Purves, R (2013): The Marketing of Electronic Cigarettes in the UK. A report commissioned by CRUKhttp://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@pol/documents/generalcontent/cr_115991.pdf

ASH Wales (2014): Young people and electronic cigarettes in Wales http://www.ashwales.org.uk/creo_files/upload/downloads/young_people_and_e-cigarettes_in_wales_final_march_2014.pdf Bauld, L; Angus, K & de Andrade, M (2014): E-cigarette uptake and marketing. A report commissioned by Public Health England Britton, J & Bogdanovica, I (2014): Electronic Cigarettes. A Report commissioned by Public Health England Cho, JH; Shin, E & Moon, S-S (2011): Electronic-Cigarette Smoking Experience Among Adolescents Journal of Adolescent Health, 49: 542-546 Choi, K & Forster, JL (2014): Beliefs and Experimentation with Electronic Cigarettes: a prospective analysis among young adults American Journal of Preventive Medicine, 46(2): 175-178


http://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@pol/documents/generalcontent/cr_115991.pdf

http://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@pol/documents/generalcontent/cr_115991.pdf

http://www.ashwales.org.uk/creo_files/upload/downloads/young_people_and_e-cigarettes_in_wales_final_march_2014.pdf



References

Dautzenberg, B; Birkui, P; Noël, M; Dorsett, J; Osman, M & Dautzenberg, M-D (2013): “E-cigarette: A New Tobacco Product for Schoolchildren in Paris” Open Journal of Respiratory Diseases, 3: 21-24 Durmowicz, EL (2014): “The impact of electronic cigarettes on the paediatric population” Tobacco Control, 23: ii41-ii46 Dutra, LM & Glantz, SA (2014): “Electronic Cigarettes and Conventional Cigarette Use among US adolescents. A Cross-sectional Study” JAMA Pediatrics: E1-E8 Goniewicz, ML & Zielinska-Dach, W (2012): “Electronic Cigarette Use among Teenagers and Young Adults in Poland” Pediatrics, 130: e879-e885 Grana, RA (2013): “Electronic Cigarettes: A New Nicotine Gateway “Journal of Adolescent Health, 52: 135-136


References

Hardcastle, K; Hughes, K; Worsley, J; Bennett, A; Ireland, R & Sweeney, S (2014):"Most people I know have got one": Young people's perceptions and experiences of electronic cigarettes “Centre for Public Health, Liverpool John Moores University Hughes, K; Hardcastle, K; Bennett, A; Ireland, R; Sweeney, S & Pike, K (2014):“E-cigarette access among young people in Cheshire and Merseyside. Findings from the 2013 North West Trading Standards Survey “Centre for Public Health, Liverpool John Moores University Lee, S; Grana, RA & Glantz, SA (2013): “Electronic Cigarette Use among Korean Adolescents: A Cross-Sectional Study of Market Penetration, Dual Use and Relationship to Quit Attempts and Former Smoking“Journal of Adolescent Health, xxx: 1-7


References

Morbidity and Mortality Weekly Report (Sept 6 2013): Notes from the Field: Electronic Cigarette Use among Middle and High School Students - United States, 2011-2012 62(35); 729-730

Pepper, JK; McRee A-L & Gilkey MB (2013): “Healthcare Providers' Beliefs and Attitudes about Electronic Cigarettes and Preventive Counselling for Adolescent Patients”Journal of Adolescent Health, xxx: 1-6 Pepper, JK; Reiterate, PL; McRee. A-L; Cameron, LD; Gilkey, MB & Brewer, NT (2013):“Adolescent Males' Awareness of and Willingness to Try Electronic Cigarettes”Journal of Adolescent Health, 52: 144-150 Sutfin, EL; McCoy, TP; Morrell, HER; Hoeppner, BB & Wolfson, M (2013): “lectronic cigarette use by college students “Drug and Alcohol Dependence, 131: 214-221


young people and the use of e-cigarettes an overview of the literature dr rosanne palmer, ash wales...

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