Concern that vaping or e-cigarettes could be promoting a new generation of young people addicted to nicotine

For the first time in 25 years, rates of smoking among teenage boys in Ireland are increasing, according to new research.

The study also shows that rates of vaping among teenagers have risen in the last four years and that teenagers who use e-cigarettes are more likely to smoke.

According to the researchers, these findings indicate that Ireland will not meet its targets to reduce smoking rates and add to evidence that vaping could be promoting a new generation of young people addicted to nicotine.

Smoking is a major risk factor for cardiovascular disease including heart disease and stroke.

The study was led by Professor Luke Clancy, Director General of the TobaccoFree Research Institute Ireland.

Prof Clancy said, “Smoking rates among teenagers have been falling in Ireland, as with many other countries in Europe and in the USA. On the other hand, use of e-cigarettes is increasing around the world.

“The dangers of smoking are well-known. We are still learning about the effects of e-cigarettes, but we know that the nicotine they contain can cause brain damage in teenagers. There’s also a concern that they could lead to an increase in smoking.”

The researchers examined data on Irish teenagers from the European School Survey Project on Alcohol and Other Drugs (ESPAD), a survey of around 100,000 15- to 16-year-olds, conducted every four years in 35 European countries. There were 1,493 Irish teenagers involved in the 2015 survey and 1,949 teenagers in 2019 survey.

Results from the 2019 survey showed that 16.2  per cent boys were smokers, compared to 13.1 per cent in 2015, while in 2019 12.8 per cent of girls were smokers compared to 12.8 per cent in 2015.

In 2015, 23 per cent of teenagers said they had used e-cigarettes at some point, and this increased to 37 per cent  in 2019. In 2015, 10.1 per cent said they were currently using e-cigarettes, and this increased to 18.1 per cent in 2019.

The data also showed that teenagers who said they had used e-cigarettes at some point or were currently using them were also 50 per cent more likely to smoke.

Professor Clancy said, “In Ireland, the government have set out an aim to make the country ‘tobacco-free’ by 2025, meaning the rates of smoking should be below five per cent. Our previous research suggested this goal may not be met for the whole population, but until now, we thought it could be achieved in teenagers. That now looks very unlikely, meaning that smoking and all the death and disability that is associated with it will continue.”

Ireland was the only country to include questions about e-cigarette in the 2015 ESPAD survey, offering a unique opportunity to monitor the trend in e-cigarette use and its effect on smoking rates in teenagers.

Mark Murphy, Advocacy Officer with the Irish Heart Foundation said the research was “deeply concerning, as it saw an increase in current cigarette smoking associated with an increasing use of e-cigarettes.”

“The fantastic progress Ireland has made in reducing teenage smoking rates over the past few decades is at risk if we do not introduce stronger regulations to limit adolescent tobacco use.

“Smoking is extremely harmful to health, damaging nearly every organ of the body. Unfortunately, the younger you are when you start smoking, the more likely you are to smoke for longer and die early from smoking. As such, it is critical that we do everything we can to reduce adolescent smoking rates.”

Mr Murphy added, “Urgent research is required to investigate why the youth smoking rate has increased over the past few years and if it is linked to a proven gateway effect of e-cigarettes. If this is found then stronger e-cigarette regulations are paramount including the immediate prohibition of the sale to under 18s, a ban on flavours, the introduction of plain packaging, and restrictions on where these devices are sold.”

“Moreover, the findings of this research underlines the need to reinvigorate the Tobacco Free Ireland program as stronger measures are required to meet the goal of having a smoking prevalence rate of 5 per cent by 2025. We simply cannot lose an entire new generation of young Irish people to the addictive and life-threatening habit of smoking’’.

Support is available to stop smoking

Quit.ie is Ireland’s dedicated smoking cessation service and smokers can give themselves the best chance of stopping by following the plan, which sees thousands of people successfully give up each year.

The HSE QUIT service provides personalised, free support by phone, email, SMS and live chat. Smokers can free call 1800 201 203 or visit www.QUIT.ie for stop smoking tips and resources, a free QUIT Kit, and to create a QUIT Plan. Peer-to-peer support is available on the QUIT Facebook Page www.facebook.com/HSEQUIT or on Twitter at HSE QUIT @HSEQuitTeam  #TheLastStop #QuitandWin.

(‘Increased smoking and e-cigarette use among Irish teenagers: A new threat to Tobacco Free Ireland 2025’, by Salome Sunday, Joan Hanafin & Luke Clancy, ERJ Open Research 2021; DOI: 10.1183/23120541.00438-2021 [https://doi.org/10.1183/23120541.00438-2021])