Vaping – Youth perceptions and attitudes: evidence briefing

Key findings

The meta-ethnographies, systematic reviews and primary studies examined for this briefing highlight that perceptions among young people are varied (e.g. depending on user status – current, ever or non-vaper), dynamic and sometimes contradictory. Findings have been grouped into three overarching themes.

Attractiveness – The research indicates that young people find vaping attractive due to:

• design of vaping products (e.g. small size and possibility to customise them, for example by choosing a variety of flavours and nicotine contents) and lack of unpleasant smell compared to conventional cigarettes, which make them easy to conceal from disapproving authoritative figures such as parents or teachers;
• the availability of a variety of flavours, cited as the second most common reason (after curiosity) for increased willingness to try/continue vaping;
• brightly coloured packaging and appealing names; and
• easy accessibility in terms of cost and purchasing options (i.e. from multiple illegal sources, including physical stores, online or through proxies).

Risk perception – Evidence around youth considerations on vaping health harms are mixed, often due to what is perceived as a lack of research and a lack of consensus within public health. Young people:

• are concerned about the unknown long-term risks of vaping and second-hand vapour/aerosol (SHV/A);
• believe that flavoured vaping products are less harmful than unflavoured or tobacco-flavoured ones;
• think that vaping is safer compared to tobacco smoking (although the evidence suggests the proportion of those who do is gradually decreasing);
• believe that vaping is less addictive than smoking, although the majority of young vapers consider themselves addicted or describe their urge to smoke as moderate to strong (with research showing this might be due, in part, to the lack of natural “end point” of vaping products compared to conventional cigarettes which burn to their end); and
• are influenced by the nature of the packaging, with a systematic review concluding that warning labels are associated with increased harm perception, but more recent primary studies suggesting these do not have an impact; and one experimental study suggesting that plain packaging might be associated with higher risk perception, hence might diminish the appeal of vaping.

A cceptability – The research indicates that young people find vaping socially acceptable. This is because young people:

• experience an increased exposure to vaping due to a lack of restrictions and have a perception of high vaping prevalence, which contribute towards a normalisation of vaping and indirect peer pressure to partake in vaping;
• are influenced by family and peers in their behaviours and beliefs of vaping, namely are more likely to vape if the people around them have positive attitudes towards vaping;
• tend to see vaping as a social activity if current/ever vapers, but consider vaping as just a trend if never vapers;
• generally approve of vaping products when used socially or for cessation purposes, but disapprove of regular use;
• recognise the environmental impact of plastic/batteries contained in vaping products, although they believe SHV/A is better for the environment than tobacco smoke; and
• consider vaping as a coping mechanism to control stress or anxiety.