Vaping is spreading rapidly among young people, increasing the risk of addiction and switching to traditional tobacco. Experts are calling for tougher measures to protect public health.
In the early 1970s, scientific evidence of the serious health risks associated with tobacco use began to emerge, prompting international health institutions and individual governments to act. The adoption of the “Ottawa Charter” in 1986, restrictions on advertising and messages on cigarette packs, awareness campaigns to educate citizens and the expansion of the space for the dissemination of scientific evidence on the harms of smoking: all these initiatives have contributed to a significant reduction in the number of smokers in Europe over the decades. The spread of electronic cigarettes seems to have dealt the final blow to the vice of smoking…
Electronic cigarettes
Also known as electronic cigarettes or vaping (hence the verb ‘to vape’), they are devices that heat liquids containing nicotine, flavourings and other chemicals, which at high temperatures produce an aerosol that the user inhales. This vapour contains varying concentrations of nicotine but, unlike traditional cigarettes, there is no combustion, which is responsible for some of the carcinogenic substances typical of smoke.
This innovative device was patented in 2004 by the Chinese pharmacist Hon Lik, who began exporting it to Europe and the United States a few years later. Initially presented as a great innovation to help adult tobacco addicts quit smoking, they were an immediate success, with millions of smokers turning to them to reduce the harm associated with tobacco use. The idea that they were harmless was widespread at the time, and in the absence of scientific studies to prove otherwise, the vaping industry expanded very rapidly, making the electronic cigarette a global phenomenon. Eye-catching packaging and increasingly distinctive flavours helped to attract a growing number of curious consumers, including teenagers and pre-teens.
Electronic cigarettes are also harmful to health
Although they are presented as a harmless alternative to traditional smoking, recent research suggests that even electronic cigarettes can pose significant long-term health risks. While electronic cigarettes produce fewer toxic substances than pipes, cigars and cigarettes, they are not completely free of them.
According to the European Commission’s Scientific Committee on Health, Environment and Emerging Risks (SCHEER), the use of electronic cigarettes not only carries a high risk of addiction, but also has irritating effects on the respiratory tract, which can cause acute asthmatic symptoms due to the inhalation of polyols, aldehydes, metal nanoparticles (from the device’s heating elements), as well as carbonyls, formaldehyde, heavy metals and particles, which are known for their harmful effects on the respiratory and cardiovascular systems and their ability to alter DNA, increasing the risk of cancer.
The idea that electronic cigarettes are harmless is a dangerous myth, especially among young people, who have seen their use increase exponentially, increasing the risk of nicotine addiction and switching to traditional tobacco. Initially seen as a useful tool to help people quit smoking, it is now feared that these devices may actually increase the number of smokers. The use of electronic cigarettes is associated with respiratory damage (asthma and chronic obstructive pulmonary disease) and early cardiovascular changes that could have significant consequences in adulthood. Other studies warn of long-term effects on the reproductive system.
There is also the problem of nicotine itself, which is addictive and affects the brain development of adolescents, exponentially increasing the risk of switching to traditional cigarettes and creating a new generation of smokers.
Vaping among adolescents and young people
The habitual use of electronic cigarettes among young people in Europe has tripled in 5 years. This is alarming when you consider that most started vaping out of curiosity or social influence, without being fully aware of the risks involved. The average age of vapers has also fallen significantly, mainly due to aggressive marketing strategies on social networks, flavoured liquids aimed at under-18s (with flavours such as watermelon, marshmallow and candy floss) and the lack of regulation of sales (75% of young people aged 13 to 15 say they have no difficulty in buying these products despite the ban).
Among the possible dangers, there are also cases of accidental poisoning of children who ingest the liquids contained in the devices, attracted by the brightly coloured packaging, as well as the risk of burns due to accidental explosion of the electronic device.
The increase in the use of these “cigarettes” and the false perception of their safety call for effective prevention strategies and specific educational measures. Protecting the younger generations from early exposure to tobacco is essential to prevent the emergence of new addictions and to ensure better public health.
For this reason, several scientific societies have written an open letter to the Italian Ministry of Health. The Italian Society of Paediatrics (SIP), the Italian Society of Respiratory Diseases in Childhood (SIMRI), the Cultural Association of Paediatricians (ACP) and other patient and parent associations have disseminated some really worrying data:
- About 20% of teenagers aged 13-15 regularly use electronic cigarettes.
- This is in addition to the 14% who use heated tobacco products.
- 57.9% of children aged 11-13 who smoke prefer e-cigarettes, while among those aged 14-17, 38% choose a combination of traditional smoking and vaping.
- Among these young smokers, more than half say they have a strong desire to smoke as soon as they wake up, a clear sign of tobacco dependence.
Among the paediatricians’ main demands is the need to strengthen controls to prevent the sale of tobacco and nicotine-containing devices to minors, in line with the European Commission’s goal of creating a tobacco-free generation by 2028. The government is also urged to regulate packaging to make it less attractive to children and to ban the free distribution of electronic cigarettes and refills to minors. There are also calls to limit marketing strategies aimed at young people on social networks and to bring flavour regulations into line with those for traditional cigarettes, banning menthol or fruit flavours linked to nicotine. Finally, it stresses the importance of an information campaign aimed at doctors, parents, young people and school staff, to be disseminated through the media and by means of an inter-ministerial agreement.
The international context
Several European countries are taking measures to regulate the use of electronic cigarettes by minors. For example, Belgium has become the first country in the European Union to ban the sale of disposable electronic cigarettes, known as ‘puffs’, from 1 January 2025.
Other countries have started to introduce restrictive measures as early as 2023. The UK has launched a public consultation on electronic cigarettes, considering measures such as reducing the number of flavours in vaping liquids, regulating packaging to avoid attracting minors, banning the sale of disposable devices and increasing prices. The UK’s aim is twofold: to help adults quit smoking through electronic cigarettes, while protecting young people from taking up smoking.
In the Netherlands, the production of flavoured electronic cigarettes and refill liquids has been banned, according to the government’s website for entrepreneurs.
The European Commission has proposed extending the ban on smoking and vaping to outdoor areas frequented by children and young people, such as playgrounds and swimming pools, as part of the European Cancer Plan, which aims to create a “tobacco-free generation” by 2040.
And many EU countries have reaffirmed the ban on sales to under-18s and introduced stricter age verification procedures to ensure compliance.
These initiatives reflect the growing concern at European level about the use of electronic cigarettes by minors and represent important steps towards better protection of public health and the environment.
