Associations of Socioeconomic Status, Parental Smoking and Parental E-Cigarette Use with 10–11-Year-Old Children’s Perceptions of Tobacco Cigarettes and E-Cigarettes: Cross Sectional Analysis of the CHETS Wales 3 Survey

Abstract

Background: This study examines primary schoolchildren’s perceptions of e-cigarettes and tobacco cigarettes, and associations with parental smoking, vaping and socioeconomic status. Methods: Survey of 2218 10–11-year-old children in 73 schools in Wales. Results: Overall, 36% reported that a parent figure smoked compared to 21% for vaping, with parental smoking lower in affluent families (OR = 0.72; 95% CI = 0.68 to 0.76). Overall, 1% had tried a cigarette, while 5% had tried an e-cigarette. Most said they would not smoke or vape in 2 years’ time; susceptibility to vaping (20%) was higher than smoking (12%). Exposure to and perceptions of tobacco cigarettes were more positive for children of smokers. Having a parent who vaped was associated with exposure to and positive perceptions of e-cigarettes, but not smoking. Most children perceived e-cigarettes as used by adults to stop smoking (64%). Susceptibility to smoking (OR = 0.57; 95% CI = 0.41 to 0.79) and vaping (OR = 0.78; 95% CI = 0.62 to 0.99) were lower among children who perceived e-cigarettes as cessation aids. Conclusions: Parental smoking continues to be concentrated in poorer families. This study provides no evidence that parental vaping in the absence of smoking is associated with more positive perceptions of tobacco cigarettes. Communicating to children the role of e-cigarettes as cessation devices for smokers may help to limit their appeal to young people.

Ecological Exploration of Knowledge and Attitudes Towards Tobacco and E-Cigarettes Among Primary School Children, Teachers, and Parents in Wales: A Qualitative Study

“…Research is also recommended to explore the impact of school communication which stresses e-cigarettes as a product for adult smokers and unsuitable for non-smokers. Analysis of our survey data collected shortly after qualitative interviews and published elsewhere 14 found that children who reported perceiving that e-cigarettes as cessation aids were less likely to report that they might smoke or vape themselves in the near future. Such messaging, which stressed the relationship of e-cigarettes to smoking, may act to build on the strong disapproval of smoking evident in children at this age while acknowledging current ambiguity about health harms and avoiding the risk of loss of credible content.…”

“…At the level of family influence, evidence suggests that trying e-cigarettes is more common among children whose parents use either e-cigarettes or tobacco, 14 raising concerns that the observation of a 'smoking-like' act may normalise smoking. 15 The development of positive attitudes towards e-cigarette use by family may act to stimulate experimentation among youth 16 and increase risks of nicotine exposure through ready availability of the product.…”

Trends in electronic cigarette use and conventional smoking: quantifying a possible ‘diversion’ effect among US adolescents

“…In contrast to a direct catalyst effect, ECs may also indirectly increase cigarette smoking via 'renormalization', i.e. making smoking become more socially acceptable, although supporting evidence is weak [17,18].…”

“…The model is calibrated to historical data from US adolescents during 2000 to 2010 (pre-ECs). Simulated nicotine use trends are projected under the assumptions of (a) a null model (neither catalyst nor diversion), (b) the catalyst hypothesis (as opposed to renormalization, for which evidence is weak) [17,18] and (c) the diversion hypothesis, projected for 2011 to 2019 (post-ECs). Simulated behavior is compared to observed data to evaluate the consistency of each hypothesis with actual observed data.…”

Changes in childhood experimentation with, and exposure to, tobacco and e-cigarettes and perceived smoking norms: a repeated cross-sectional study of 10–11 year olds’ in Wales

“…However, causality remains contested, with residual confounding remaining a likely partial explanation for these trends ( 32 ). Youth smoking rates and attitudes in favour of smoking continued to decline during the emergence of e-cigarettes ( 11 ), while our analyses of survey data and qualitative data on primary school pupils in Wales from the present study indicate that parental vaping is associated with perceived smoking norms only where it occurs alongside smoking ( 33 , 34 ). Indeed, children whose parents used e-cigarettes were more likely to perceive these as devices adults used to stop smoking, with perceiving e-cigarettes as a means of giving up smoking associated with lower reported susceptibility to smoking ( 33 , 34 ).…”