Welsh Primary Schoolchildren’s Perceptions of Electronic Cigarettes: A Mixed Methods Study

Abstract

There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren’s (aged 7–11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children’s perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation.

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

“…However, contrary to previous findings, no notable differences were identified here between pupils by age across years 4 to 6, contrasting with previous findings. 25…”

“…The same study also suggested strong disapproval of smoking or vaping by young people, but greater levels of approval of both behaviours when done by adults. 25 UK schools provide education on smoking harms from a young age through programmes such as SchoolBeat in Wales (https://schoolbeat.cymru/); however, e-cigarettes are not featured in current recommendations and how or whether their use has been incorporated into teaching and school policies and practices is unclear.…”

Impacts of EU Tobacco Products Directive regulations on use of e-cigarettes in adolescents in Great Britain: a natural experiment evaluation

“…61 There is some evidence from the UK that finds that children see tobacco and e-cigarettes as distinct products. 62,63 In one study, for example, young people whose parents used e-cigarettes were most likely to perceive them as things adults use to stop smoking, with this perception of e-cigarettes as cessation aids associated with lower smoking susceptibility. 64 Hence, where perceived as stop smoking aids, others' use of e-cigarettes might be interpreted by young people as a social display of efforts to give up smoking, rather than as an endorsement of a smoking-like behaviour.…”

Sociodemographic, personal, peer, and familial predictors of e-cigarette ever use in ESPAD Ireland: A forward stepwise logistic regression model

“…There are concerns that the growing popularity of e-cigarettes promotes tobacco experimentation, particularly among younger children 12 . A Welsh study of primary schoolchildren found that children as young as 7 years have general awareness of e-cigarettes.…”

“…A Welsh study of primary schoolchildren found that children as young as 7 years have general awareness of e-cigarettes. They perceived vaping to be healthier than smoking, had some recognition that e-cigarettes were used for smoking cessation but showed limited understanding of any health harms 12 .…”