United States: Vaping more widespread among the most athletic teenagers

A study shows that in Georgia, the level of use of electronic cigarettes among adolescents would be correlated with the importance of physical activity. The authors conclude that there is a need to implement preventive actions aimed at adolescent athletes.

A US study seems to confirm that the most athletic adolescents are more frequent exclusive users of electronic cigarettes than others.[1]A Canadian study of the same type published in 2019 had highlighted similar results.[2].

11,% of Georgia teens vape, smoking declines

Using data from an annual survey of all Georgian school-age adolescents, the U.S. research team examined the links between physical activity and health behaviors. The data came from self-reported responses from 362,933 high school students enrolled in 439 Georgia schools, or three-quarters of all adolescents in school.

Among the responses collected, only 1 % high school students declared themselves to be exclusive smokers and 4 % were dual users of cigarettes and e-cigarettes. Around these 4 % vape smokers, there were 7 % exclusive vapers, for a total of 11 % regular or occasional users of e-cigarettes. The level of physical activity of high school students who smoked or vape smoked was significantly lower than for the whole. On the other hand, high school students who were active 2 to 3 days a week or 4 to 5 days a week were respectively 11 % and 23 % more users of e-cigarettes than the others. The use of pre-filled e-cigarettes, e-cigars, e-pipes and e-hookahs were assimilated to the use of e-cigarettes.

Different avenues to explain overconsumption among young athletes

Several hypotheses have been put forward to explain these differences according to physical activity. One of them is that the most athletic high school students would be more sensitive to the marketing discourse presenting e-cigarettes as less harmful than traditional cigarettes. These most athletic high school students are also those who develop the most social interactions, whether with their peer group or through their activity on social networks. In competitive team sports, the influence of peers on consumption behaviors would be verified not only with the use of e-cigarettes, but also with heavy occasional alcohol consumption (BAC) linked to victory celebrations and social pressure to participate. The use of e-cigarettes after sport would constitute one of the vectors of this socialization.

Another hypothesis would be related to weight-regulating behaviors, more present among young adult athletes (18-25 years old) and which would encourage them more to turn to e-cigarettes than to traditional cigarettes; the decline of this observation is also supposed among adolescent athletes. Since male subjects are both more users of e-cigarettes and more inclined to get involved in sports activities, the 2019 Canadian study questioned the role of gender in these behaviors.

Call for prevention actions targeted at young athletes

Although sport is frequently given as an example of healthy behaviour, this study seems to confirm, after others, that young athletes can also engage in risky behaviour. The authors of the study point out the need to initiate prevention actions focused on young athletes, in particular by including sports teachers and sports coaches in the delivery of targeted prevention messages.

"If I put my public health expertise aside, I can say to myself, as a parent, 'At least my child doesn't smoke. Better that he vapes,' but that's not the case. We have evidence that vaping can be harmful.", said Janani Rajbhandari-Thapa, lead author of the study, in an interview.[3]. She points out that electronic cigarettes can emit benzene, a carcinogenic agent. Other carcinogenic molecules could be discovered and the aromas could also be involved in pulmonary pathologies.

The data on which the Georgian study is based date from 2018 and are self-reported, so the results obtained would still need to be confirmed by other studies, particularly using longitudinal studies, as suggested by the Canadian study.

Keywords: youth, e-cigarette, vaping, sport, Georgia, United States,

©Generation Without Tobacco

MF

[1] Rajbhandari-Thapa J, Thapa K, Li Y, Ingels J, Shi L, Zhang D, Shen Y, Chiang K, Electronic Vapor Product Use and Levels of Physical Activity Among High School Students in Georgia, Tobacco Use Insights (2022) 15:1–5.

[2] Milicic S, Piérard E, DeCicca P, Leatherdale ST. Examining the association between physical activity, sedentary behavior and sport participation with E-cigarette use and smoking status in a large sample of Canadian youth. Nicotine Tob Res. 2019; 21(3):285-292.

[3] Beeson L, Physically active teens more likely to vape, UGA Today, published August 31, 2022, accessed September 5, 2022.