Vaping in boys

Abstract

By the spring of 2023 the proportion of children experimenting with vaping had increased by 50% in one year – from 1 in 13 to 1 in 9 – with boys much more likely to vape than girls. Children's awareness of the promotion of vapes has also grown, particularly in shops, where more than half of all children report seeing e-cigarettes being promoted, and online where nearly a third report e-cigarette promotion. The most popular disposable vape can be bought for as little as £2.99. Clinicians have criticised the government for failing to heed warnings about the risks of allowing e-cigarettes to be sold in child-friendly packaging that references the names of popular sweet treats – including banana milkshake and Jelly Babies, both of which products contain 2% nicotine, the highest concentration allowed in the UK. Worryingly, research in animals suggests that exposure to nicotine at an early age could make users more susceptible to other addictive substances later in life, and e-cigarette use can significantly increase a person's risk of developing chronic lung diseases such as asthma and emphysema. Nicotine may make anxiety and depression worse. It also affects memory, concentration, self-control and attention, especially in developing brains, negatively impacting on children's education. Vaping devices use an electric charge to vaporise a dose of nicotine (accompanied by various flavouring chemicals). The composition of the vapour varies between brands. Its main ingredients – propylene glycol and glycerol – are thought to be harmless when inhaled. Nitrosamines, a carcinogenic family of chemicals, have been found in e-cigarette vapour, albeit at levels low enough to be deemed insignificant. Metallic particles from the device's heating element, such as nickel and cadmium, are also a concern. High exposure to these can increase the risk of cancer. And some studies have found that the vapour can contain high levels of chemicals such as formaldehyde and acetaldehyde, derived from other ingredients that have been exposed to high temperatures. It also contains free radicals, which are highly oxidising substances that can damage tissue or DNA, and which are thought to be derived mainly from flavourings. Vaping also has negative environmental impacts, including litter from disposable devices: e-liquid containers, packaging and batteries, comprising not one but three forms of waste. It has to be conceded that e-cigarettes are less dangerous than traditional cigarettes, the smoke of which contains about 70 carcinogens, as well as carbon monoxide, toxic heavy metals such as cadmium and arsenic, and oxidising chemicals. Indeed, there is good evidence that vaping can help long-term smokers to quit. It is an offence to sell e-cigarettes to children under 18 years old in the UK. But the government should do much more to prevent young people from vaping, by banning child-friendly flavouring, packaging and marketing. More widespread bans risk forgoing the potential health benefits of people turning to e-cigarettes as a substitute for the conventional sort. Smoking still kills eight million people worldwide every year. That means regulators need to strike a balance – helping smokers to quit while deterring a new generation of nicotine addicts.