Youth vaping: a review and update on global epidemiology, physical and behavioral health risks, and clinical considerations

Abstract

Worldwide, youth electronic cigarette use (vaping) has risen significantly over the past decade. This public health concern has spurred many high-quality studies characterizing country-specific prevalence, risk factors, physical and behavioral health complications, and optimal methods of assessment and counseling for youth vaping. Clinicians remain underexposed to this recent work, limiting translation of evidence into higher quality patient care. This review aims to provide pediatricians and other clinicians working with youth a clinically focused survey of key research findings and considerations based on recent evidence. This narrative review surveys emerging trends in EC use across different countries, reasons for youth vaping, characteristics of vaping materials that promote youth use, associations with combustible cigarette use, relation with cannabis and other illicit substances, physical and behavioral health risks associated with vaping, and methods of assessment, counseling, and intervention for problematic vaping in youth. Since vaping remains a relatively new phenomenon, long-term health consequences remain unknown. Conclusion : Youth vaping is an increasingly well-studied phenomenon with both physical and behavioral health risks. Pediatricians and other youth-focused clinicians can apply the lessons of recent research in work with youth and their families. What is Known: • Youth vaping is an increasingly prevalent public health concern . • Recent research demonstrates physical and behavioral health risks associated with vaping as well as methods for assessment, counseling, and intervention . What is New: • The current review summarizes the latest evidence in a clinically focused framework to facilitate translation of emerging knowledge to practice .

Reducing attractiveness of e-liquids: proposal for a restrictive list of tobacco-related flavourings

“…Flavours reduce product risk perception and increase willingness to try 12. Both smokers and non-smokers, regardless of their age, like sweet and mint-like flavours much more than tobacco flavours 13 14. Thus, it is not surprising that the majority of e-liquids have a sweet flavour 11.…”

“…E-cigarettes are becoming increasingly popular among young people 11 14. In recent years, prevalence of ever use of e-cigarettes among high school students in the Netherlands has increased to more than 25% 18.…”

Transfer of Metals to the Aerosol Generated by an Electronic Cigarette: Influence of Number of Puffs and Power

“…Although e-cigarette use is often touted as a safer alternative to tobacco combustion, the potential long-term health effects of e-cigarette use are not well understood [ 1 , 2 , 3 , 4 ]. The rapid increase of e-cigarette use, especially among adolescents, could present itself as an emerging public health concern [ 3 , 5 , 6 , 7 , 8 , 9 ], including potential associations with COVID-19 symptoms [ 10 , 11 , 12 ]. Although e-cigarettes are perceived to be safer than traditional combustion cigarettes, a specific health problem associated with e-cigarettes is the long-term exposure of users to potentially toxic metals.…”

School staff perceptions of the nature and consequences of students’ use of e‐cigarettes

“…Rates of youth vaping are increasing across the world, 1 including in Australia where there are strict regulations governing the availability of e‐cigarettes 2,3 . While there remains a degree of controversy within public health about the extent to which e‐cigarettes should be made available to the public to assist smoking cessation efforts, 4 there is general agreement that under‐age use of the devices is to be avoided because of the associated adverse health consequences and the potential for children and youth to become addicted to nicotine 5,6…”