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Home > E-cigarette and smoking use among adolescents in Ireland: a focus group study. Report prepared on behalf of the Tobacco Control Operational Unit, Health Service Executive.

Evans, David S and Hickey, Paul (2020) E-cigarette and smoking use among adolescents in Ireland: a focus group study. Report prepared on behalf of the Tobacco Control Operational Unit, Health Service Executive. Dublin: Department of Health.

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With the growth in popularity of e-cigarettes in recent years, there is concern in terms of their use by young people. In Ireland, there is no mandatory age restriction on the sale of e-cigarettes and their marketing may promote adolescent use. Nicotine exposure can harm adolescent brain development, and may act as a ‘gateway’ to smoking initiation among the youth. The study aimed to obtain an in-depth understanding of current knowledge, attitudes and behaviour of schoolchildren in terms of e-cigarette use.

 

Eight focus groups were undertaken in a convenience sample of three schools. This included an all-boy (Cavan), an all-girl (Sligo), and a mixed gender (Louth) school. Each focus group discussed vaping among schoolchildren in Ireland, attitudes to e-cigarettes/vaping, the accessibility and availability of e-cigarette products, the health effects of vaping, and the combined use of vaping, smoking and alcohol. All focus groups were audio recorded and transcribed, from which a number of key themes were identified.

 

The following key findings emerged from the analysis of the focus groups:

 

  • E-cigarettes appear popular among Irish schoolchildren. Most participants were aware of schoolchildren that used e-cigarettes.
  • Most knew that e-cigarettes contained nicotine. However, it is not clear if they were aware of the risk of nicotine addiction, nor the adverse health effects of nicotine.
  • There was uncertainty in terms of the health effects of e-cigarettes. Overall there was a perception that they were healthier than cigarettes. There appears to be a lack of information about e-cigarettes from school education programmes on smoking.
  • Most participants felt that e-cigarettes were used both by boys and girls; although overall it was thought that they were used more by boys.
  • E-cigarettes are used as a group and as an individual activity. Some used them to help fit into groups.
  • Underage discos are a key location where participants reported that e-cigarettes are used, and could be concealed from security staff. If a venue for an underage disco had smoking areas, it was reported that security staff would not stop schoolchildren from smoking or vaping in these areas. E cigarettes are used at a variety of other locations where their use can be concealed (e.g. school toilets due to the absence of cameras).
  • The main types of e-cigarettes referred to were the basic stick type and disposable e-cigarettes. Brand names were rarely mentioned, but several were aware of ‘Juul’ (not available in Ireland at the time of the study). Nobody was aware of people modifying e-cigarettes to increase the nicotine dose, although some were aware of cases where e-cigarettes had “blown up.”
  • There was awareness of the numerous e-cigarette flavours. Sweet and fruity flavours were the most popular.
  • E-cigarettes appear to be relatively easy to access. Social media was the most popular way to obtain them with children using ‘Snapchat’ and ‘Instagram’ to buy and sell products between themselves. They were also purchased in shops such as discount stores and vape shops, where any age restrictions were not difficult to overcome. Online purchase was less popular.
  • Most had seen e-cigarettes advertised on social media, in retail shops and on the internet. Social media was also being used to view videos of people doing ‘vape tricks’ and also offering discount codes. Some had also seen ‘pop up’ advertisements online.
  • Most participants had not discussed e-cigarettes with their parents. By contrast, most had discussed smoking with their parents.
  • There was a lack of awareness of e-cigarette warning labels among many participants. Among those that had seen warning labels, there was a lack of consistency in terms of what was thought to be written on the warning label.
  • The findings suggest that smoking, alcohol consumption, and use of e-cigarettes are interlinked. Most participants felt that e-cigarette users also smoked cigarettes with only a minority thinking that users just vaped. Cigarettes remain more popular than e-cigarettes, particularly at teenage discos.
  • Alcohol consumption appears to be common among schoolchildren, particularly for those attending teenage discos (mostly travelling on the bus or outside the venue). This may be a contributory factor in affecting the decision to experiment with cigarettes, e-cigarettes and other substances.

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