Vaping – Youth perceptions and attitudes: evidence briefing

Footnotes

1. Health Behaviour in School-aged Children (HBSC) Scotland 2022; Use of e-cigarettes among young people in Great Britain - ASH.

2. Findings on the appeal of fruit and sweet flavours are supported by the following more recent primary studies: Use of vapes among young people in Great Britain; Vaping Flavors and Flavor Representation: A Test of Youth Risk Perceptions, Novelty Perceptions, and Susceptibility; Youth’s engagement and perceptions of disposable e-cigarettes: a UK focus group study.

3. See: A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type; Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review; E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General; A Review of the Use and Appeal of Flavored Electronic Cigarettes.

4. See: Youth who use e-cigarettes regularly: A qualitative study of behavior, attitudes, and familial norms; Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study ; “If Someone Has It, I’m Gonna Hit It”: Lessons Learned From Minnesota Teens About Vaping; Young people's use of e-cigarettes in Wales, England and Scotland before and after introduction of EU Tobacco Products Directive regulations: a mixed-method natural experimental evaluation; "That's the whole thing about vaping, it's custom tasty goodness": a meta-ethnography of young adults' perceptions and experiences of e-cigarette use; The emerging norms of e-cigarette use among adolescents: A meta-ethnography of qualitative evidence; Youth’s engagement and perceptions of disposable e-cigarettes: a UK focus group study; Adolescent Use and Perceptions of JUUL and Other Pod-Style e-Cigarettes: A Qualitative Study to Inform Prevention; E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.

5. A more recent Scottish focus group study (2023) supports these findings, highlighting concerns in participants about product ingredients and effects on health.

6. Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review; Adolescents’ Health Perceptions of E-Cigarettes: A Systematic Review; A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type; Associations between public e-cigarette use and tobacco-related social norms among youth; A Review of the Use and Appeal of Flavored Electronic Cigarettes; Do JUUL and e-cigarette flavours change risk perceptions of adolescents? Evidence from a national survey. To note, a more recent US primary study on vaping flavours and youth risk perceptions (2023) found no differences in youth risk perceptions between tobacco and fruit flavours. The researchers speculated this was due to an overall high risk perception of vaping products, possibly due to increased public health education or to the EVALI outbreak in the US in 2019-20. EVALI stands for e-cigarette or vaping products use-associated lung injury.

7. See also E-cigarette Use Among Youth and Young Adults. A report of the Surgeon General and Association between Harmful and Addictive Perceptions of E-Cigarettes and E-Cigarette Use among Adolescents and Youth. A Systematic Review and Meta-Analysis.

8. See also Associations between public e-cigarette use and tobacco-related social norms among youth and Harm perceptions of secondhand e-cigarette aerosol among youth in the United States.

9. E-cigarette Use Among Youth and Young Adults. A report of the Surgeon General; Adolescents' Health Perceptions of E-Cigarettes: A Systematic Review; Association between Harmful and Addictive Perceptions of E-Cigarettes and E-Cigarette Use among Adolescents and Youth. A Systematic Review and Meta-Analysis.

10. A qualitative study of e-cigarette emergence and the potential for renormalisation of smoking in UK youth ; Youth’s engagement and perceptions of disposable e-cigarettes: a UK focus group study; Adolescent Use and Perceptions of JUUL and Other Pod-Style e-Cigarettes: A Qualitative Study to Inform Prevention.

11. Adolescent participants in a Scottish focus group study (2023) also considered disposable vapes as distinct from e-cigarettes, with several participants easily recognising disposable e-cigarettes, but not other models.

12. The emerging norms of e-cigarette use among adolescents: A meta-ethnography of qualitative evidence; "That's the whole thing about vaping, it's custom tasty goodness": a meta-ethnography of young adults' perceptions and experiences of e-cigarette use; A Review of the Use and Appeal of Flavored Electronic Cigarettes; Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study; “If Someone Has It, I’m Gonna Hit It”: Lessons Learned From Minnesota Teens About Vaping.

13. Adolescents Who Vape Nicotine and Their Experiences Vaping: A Qualitative Study; “If Someone Has It, I’m Gonna Hit It”: Lessons Learned From Minnesota Teens About Vaping; Factors that influence decision-making among youth who vape and youth who don’t vape; Adolescent Use and Perceptions of JUUL and Other Pod-Style e-Cigarettes: A Qualitative Study to Inform Prevention.