Use and perceptions of e-cigarettes among youth in Canada

Research Snapshot

By Amy Kuhn

In brief

E-cigarettes are becoming increasingly popular due to the marketing of their health benefits over regular cigarettes. E-cigarettes are commonly marketed and sold over the Internet. This is an important factor to consider because youth generally spend more time online than older generations. Therefore, the potential impact on youth of the availability of e-cigarettes on the internet is worth examining. Researchers looked at the rate of e-cigarette use among Canadian youth (16-30 years). They also examined youth perceptions of e-cigarettes and the factors associated with their use.

In this Research Snapshot we provide a summary of the research findings.  Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What you need to know

Electronic cigarettes (e-cigarettes) are devices that look and feel like cigarettes but release a mist, or vapour, instead of smoke. They contain a battery, a switch, a heating element, and a cartridge containing the “e-liquids” or “e-juices” that get vapourized when the user inhales. The liquids can be flavoured and can contain nicotine but do not contain tobacco. In Canada, e-cigarettes containing nicotine are banned; however, these products are still widely available with or without nicotine in many locations. he claim is that e-cigarettes deliver nicotine as effectively as regular cigarettes without the harmful chemicals, but this has yet to be proven scientifically. 

What is this research about?

E-cigarettes are becoming increasingly popular due to the marketing of their health benefits over regular cigarettes. Some of these claims include: they don’t release first- or second-hand smoke, they don’t stain teeth or damage skin, and they can be used to quit smoking regular cigarettes. Several studies have shown that consumer perceptions of e-cigarettes reflect these claims.

E-cigarettes are commonly marketed and sold over the Internet.  This is an important factor to consider because youth generally spend more time online than older generations.

herefore, the potential impact on youth of the availability of e-cigarettes on the internet is worth examining.

What did the researchers do?

Researchers looked at the rate of e-cigarette use among Canadian youth (16-30 years). They also examined youth perceptions of e-cigarettes and the factors associated with their use.

The researchers used a cross-sectional survey delivered by email to participants through a commercial market research company with an online panel of Canadians. The analysis included 1,188 respondents.  

After collecting information about respondents’ gender, age, ethnicity, and education level, the survey showed a picture of an e-cigarette, followed by a series of questions about e-cigarettes. Based on their results, the study classified participants in three categories:

  • Current smokers: Have smoked 100 cigarettes in their life AND have smoked in last 30 days;
  • Former smokers: Have smoked 100 cigarettes in their life but have NOT smoked in the last 30 days;
  • Non-smokers: Have smoked less than 100 cigarettes in their life.

The study then classified participants in three categories:

  • Current e-cigarette users: Have tried an e-cigarette AND have used one in the last 30 days;
  • E-cigarette ever-users: Have tried an e-cigarette but have NOT used one in the last 30 days;
  • E-cigarette never-users: Have never tried an e-cigarette.

Participants were also asked to answer on a scale from 1 “Not at all” to 10 “Extremely” the following questions about their perceptions and experiences of e-cigarettes:

  • Is this product harmful to your health?
  • Would you be interested in trying this product?
  • Should retail outlets, such as corner stores and gas stations, be allowed to sell this product?
  • Have you ever experienced any side effects or adverse outcome(s) while using e-cigarettes?
  • Would you recommend e-cigarettes to a friend?

What did the researchers find?

Prevalence of e-cigarette use:
From the surveyed sample (n=1188), 16.1% of participants reported using an e-cigarette at least once, only 5.7% reported being current users of e-cigarettes.

Current smokers of regular cigarettes were more likely than non-smokers and former smokers to use or to have used e-cigarettes. Former smokers were more likely to have tried e-cigarettes than non-smokers.

Among ever-users of e-cigarettes, 12% reported having side effects that they associated with their use. The vast majority (90.4%) of ever-users indicated they would recommend e-cigarettes to a friend. 

Factors associated with e-cigarette use:
The main factor associated with e-cigarette use is past or present use of tobacco. While respondents with low education levels were also more likely to have ever used e-cigarettes in the past, respondents with higher education levels were more likely to be current users of e-cigarettes.

Exposure and perceptions of e-cigarettes:
Nearly half of the participants (43.4%) said they had seen ads or sales for e-cigarettes. The main reasons for wanting to use e-cigarettes were:

  • To help cut back on how much they smoked (regular cigarettes);
  • As a long-term replacement for regular cigarettes;
  • For use when they don’t want to smoke around others;
  • To help them try to quit smoking; 
  • As a cheaper alternative to cigarettes;
  • To use in places where they can’t smoke regular cigarettes.

These perceptions and beliefs about e-cigarettes tend to be consistent with marketing messages.  

Interestingly, non-smokers or former smokers who were also ever-users of e-cigarettes felt the harms associated with the use of e-cigarettes were lower than ever-users who were current smokers. 

The study also highlights that awareness levels are similar among Canadian youth and adults and that there is some interest in experimenting with e-cigarettes among non-smokers. 

How can you use this research

This study provides a first glance at evidence of e-cigarette use among Canadian youth.  This market is growing quickly and should be studied in greater depth. Further research and data could provide good evidence to build and develop public health policy around the sale and use of e-cigarettes in Canada, especially with regards to youth.

About the researchers

Christine D. Czoli, is a PhD Student. David Hammond, PhD, is an Associate Professor and CIHR Chair in Applied Public Health.

Christine M. White, MSc, is a Project Manager, all with the School of Public Health and Health Systems at the University of Waterloo.

This Research Snapshot is based on their article: “Electronic cigarettes in Canada: Prevalence of use and perceptions among youth and young adults,” which was published in Canadian Journal of Public Health, volume 105, 2014.

Keywords

Tobacco products; young adult; tobacco use cessation; harm reduction 

This Research Snapshot is based on an article that has been critically appraised for quality and susceptibility to bias.

EENet has partnered with the Knowledge Mobilization Unit at York University to produce Research Snapshots in the field of mental health and addictions in Ontario.