E-Cigarettes

E-Cigarettes: Their Rapid Growth in Popularity
and Public Health Concern

From 7 million users worldwide in 2011, the number of users grew 82 million by 2021. This rise is especially noticeable among young people.


Overall situation

E-cigarettes, or electronic cigarettes, have become increasingly popular over the last ten years. From 7 million users worldwide in 2011, the number of users grew 82 million by 2021. This rise is especially noticeable among young people. Unfortunately, a worldwide study revealed that vaping can lead to serious health problems like addiction, seizures, burns, and lung issues. What’s more concerning is that many young individuals who start with e-cigarettes, which contain the highly addictive substance nicotine, often end up trying traditional cigarettes. In fact, those who vape are three times more likely to smoke regular cigarettes compared to those who don’t.

Students and young adults

According to the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention (CDC), the situation is particularly worrying. In 2022, around 2.55 million middle and high school students were using e-cigarettes. Flavored e-cigarettes attract 85% of younger users. From 2020 to 2022, the percentage of teens aged 14-17 who vaped skyrocketed from 2.1% to 11.8%. Similarly, for young adults aged 18-24, the rate almost multiplied, jumping from 5.6% to 21.4%. Moreover, smoking rates among children aged 14-17, which had been declining for years, saw an unexpected increase. By 2023, more than 12% of these children were smoking, marking the first rise in two decades.


Vaping for quitting, is it true?

Whilst, e-cigarettes can lead to nicotine dependence and might even encourage non-smokers to take up tobacco smoking.

Move away from cigarettes

E-cigarettes emerged as a hopeful solution for smokers looking to move away from traditional cigarettes. They were designed to offer smokers a way to control the amount of nicotine they consumed, helping them gradually reduce their intake. Instead of burning tobacco like regular cigarettes, e-cigarettes function by heating a liquid solution containing nicotine, flavors, and other chemicals. This mechanism led many to believe that these devices produced fewer harmful substances. However, despite some claims suggesting e-cigarettes could aid in quitting smoking, several comprehensive reports indicated limited evidence supporting their effectiveness in this regard. In reality, many individuals can successfully quit smoking without any helps.

Nicotine dependence

The report also highlighted concerns about the widespread use of e-cigarettes, particularly among non-smokers. Worryingly, over half of the current e-cigarette users are traditional smokers. While a small segment of smokers might benefit from e-cigarettes as a nicotine replacement, there’s significant uncertainty about the overall risks and benefits associated with their use. Whilst, e-cigarettes can lead to nicotine dependence and might even encourage non-smokers to take up tobacco smoking. Moreover, there’s growing concern about industry pressures to relax e-cigarette regulations. While e-cigarettes might have a role in supervised smoking cessation programs for highly addicted smokers, using them alongside traditional cigarettes is not seen as a viable strategy.

E-cigarettes can lead to nicotine dependence and might even encourage non-smokers to take up tobacco smoking.

Factors Fueling the Rise of E-cigarettes

Several key factors contribute to their widespread adoption, combining design appeal, a variety of flavors, and a powerful presence.

In landscape of smoking alternatives, e-cigarettes have surged in popularity, capturing the attention of a diverse audience, especially the youth. Several key factors contribute to their widespread adoption, combining design appeal, a variety of flavors, and a powerful presence on social media platforms.

Design Appeal

E-cigarettes have undergone a transformation in design, departing from the conventional image of smoking. Crafted as sleek and stylish devices, adorned with colorful packaging, they represent a sense of trendiness and charm. The deliberate departure from the outdated and uncool perception of traditional smoking is evident in the vibrant colors and discrete packaging, strategically designed to resonate with the preferences of young people.

Flavouring

An intriguing aspect of e-cigarettes is the array of tempting flavors they offer. Ranging from fruity to dessert-inspired selections like cola ice and candy floss, these flavors significantly contribute to the overall appeal. Sweet and diverse, these flavors make the experience more enjoyable, adding a layer of novelty that traditional smoking lacks.

Social Media Marketing and Online Influencers

Multinational tobacco and vaping companies have strategically employed digital marketing tactics to directly target teenagers and young individuals through social media platforms, aiming to boost sales. These companies extensively utilize social media channels, such as TikTok and YouTube, to market and sell vaping products. Vape challenges, often sponsored by tobacco and e-cigarette companies, are promoted on these platforms and endorsed by influencers with substantial social media followings.

Vape retailers strategically leverage the algorithms of TikTok and Instagram to reach a significant number of young people. According to a study by VicHealth and Quit, the sheer volume of posts related to vaping on TikTok and Instagram is staggering, with over 18.1 billion posts using #vape on TikTok and more than 16.4 million using #vapelife on Instagram. This indicates a deliberate exploitation of the algorithms of these online platforms to reach a younger demographic. The study also revealed the creation of over 18,000 vaping-related profiles worldwide on Instagram, highlighting the global scale of this marketing strategy. Notably, TikTok’s content or interest graph, based on user interests, plays a pivotal role in showing content to users. On the other hand, Instagram relies on a social graph, showing content based on connections and friends. Many TikTok and Instagram accounts posting vaping content may seem non-commercial, created by everyday people, but often lead users straight to online e-cigarette stores.

The content shared by these platforms commonly employs humor to downplay vaping addiction and portray e-cigarettes as easily accessible for young individuals. The content often normalizes vaping, presenting it as a normal, sexy, funny, or cool activity and associating vape flavors with personal identities. Moreover, vape stores share content providing tips to young people on how to conceal their vapes at school or home, actively promoting products designed to hide or stash e-cigarettes from parents or teachers. The concerning trend of normalizing and promoting vaping on social media platforms demands heightened awareness and regulatory scrutiny.

Misperception

The allure of e-cigarettes is augmented by prevailing misperceptions regarding their safety. Perceived as a less harmful alternative to traditional smoking, the absence of tobacco and a reduction in harmful byproducts produced by combustion contribute to the misconception. Additionally, the mislabeling of nicotine e-cigarettes as non-nicotine allows them to be easily available at convenience stores and online without a doctor’s prescription. The impact on mental health, dependency issues, and the presence of toxic chemicals in e-cigarettes also remain largely misunderstood. Worryingly, statistics show that around 2 in 3 young people are concerned about the impact of vaping on the mental health of their friends and peers. Almost 2 in 3 know someone dependent on vaping, yet just over 1 in 3 know where to seek support, and only 1 in 3 understand the toxic chemicals found in e-cigarettes.

The popularity of e-cigarettes is a relationship of design aesthetics, enticing flavors, and a powerful presence on social media platforms. Understanding these factors is crucial for crafting effective public health strategies, ensuring that the allure of e-cigarettes does not conceal the potential risks associated with their use.

Public Health Concerns
surrounding e-cigarettes

The e-cigarettes can significantly compromise respiratory health and elevate the risks of heart and lung ailments.

The advent of e-cigarettes has revolutionized the smoking industry, promising a safer alternative to traditional cigarettes. However, as these devices gain popularity, several public health concerns have emerged, casting a shadow over their perceived benefits.

Initiation and Addiction

The allure of flavored e-cigarettes, marketed with vibrant appeal, has become a gateway for many young people into nicotine addiction. The enticing flavors creates a misconception that e-cigarettes are less harmful, attracting individuals who may have never initiated nicotine consumption. This trend, particularly among youth, has sparked concerns of a potential reversal of decades of progress in reducing smoking rates and tobacco-related health issues. Furthermore, the transition from e-cigarettes to traditional cigarette smoking, especially among adolescents, raises the specter of exacerbated lung and health problems.

The enticing flavors creates a misconception that e-cigarettes are less harmful, attracting individuals who may have never initiated nicotine consumption.

Long-term Effects

The long-term health implications of e-cigarette use remain a topic of growing concern. While many view e-cigarettes as a safer alternative to traditional cigarettes, the full spectrum of their health effects is not yet fully understood. Recent reports highlighting severe lung injuries and vaping-related illnesses have intensified these concerns, underscoring the urgency for comprehensive research and understanding. Additionally, studies have indicated negative similarities in air quality between rooms where e-cigarettes are used and those where traditional cigarettes are smoked. The aerosols emitted by e-cigarettes introduce an array of pollutants, including fine particles, volatile organic compounds, heavy metals, and nicotine, which can significantly compromise respiratory health and elevate the risks of heart and lung ailments.

Furthermore, the vulnerability of adolescents and young adults to the adverse effects of e-cigarettes is particularly noteworthy. Given that adolescence is a critical phase for brain development, exposure to nicotine during this period can result in lasting repercussions. Nicotine has the potential to disrupt the development of the brain’s prefrontal cortex, impacting crucial functions such as decision-making, impulse control, and mood regulation. Such disruptions can precipitate cognitive and behavioral challenges. Moreover, evidence suggests that youth who engage in vaping may be at an elevated risk of mental health issues, including depression and anxiety, with potential long-term consequences for their overall health and quality of life. Thus, the multifaceted risks associated with e-cigarette use necessitate concerted efforts to mitigate potential harm and promote informed decision-making among users and policymakers alike.

Second-hand Exposure

It’s crucial to evaluate the potential risks of second-hand exposure to aerosols emitted from e-cigarettes and establish protective policies for non-users.

It’s crucial to evaluate the potential risks of second-hand exposure to aerosols emitted from e-cigarettes and establish protective policies for non-users. These aerosols contain a mix of chemicals and fine particles that can trigger adverse reactions in individuals nearby. Exposure to these aerosols may result in symptoms like coughing, wheezing, and heightened mucus production, underscoring the importance of safeguarding the health of those not actively using e-cigarettes.

Product Standards

The safety, quality, and consistency of vaping devices have come under scrutiny due to concerns such as the potential contamination of e-liquids. A particularly alarming issue is the risk of developing Popcorn lung, scientifically known as Bronchiolitis Obliterans (BO). This rare but severe lung disease damages the small airways in the lungs, resulting in symptoms like coughing, wheezing, and shortness of breath. The primary culprit behind this disease is Diacetyl, a chemical often added to flavored e-liquids to amplify their taste, highlighting the hidden dangers associated with vaping products.

E-cigarettes have Diacetyl, a chemical often added to flavored e-liquids to amplify their taste, highlighting the hidden dangers associated with vaping products.

Causing a Bronchiolitis Obliterans (BO), a rare but severe lung disease damages the small airways in the lungs, resulting in symptoms like coughing, wheezing, and shortness of breath.

Nicotine Exposure

It is imperative to regulate the levels of nicotine in e-cigarettes to prevent excessive exposure, especially among vulnerable populations. E-cigarettes typically contain nicotine in liquid form, known as e-liquids or vape juice. These liquids come in varying concentrations, and some may have nicotine levels equivalent to or even higher than traditional cigarettes. This heightened nicotine content significantly contributes to the addictive nature of e-cigarettes.

The design of e-cigarettes focuses on swiftly delivering nicotine to the bloodstream. When a user inhales, the device heats the e-liquid, transforming it into an aerosol that is then inhaled into the lungs. The absorption of nicotine through the lung tissue is rapid, reaching the brain quickly and providing a satisfying nicotine hit. This accelerated delivery mechanism enhances the habit-forming potential of e-cigarettes, emphasizing the need for careful regulation to mitigate the risks associated with nicotine exposure, especially for more vulnerable populations.

Effectiveness as Cessation Aids

Assessing the effectiveness of e-cigarettes as smoking cessation tools is crucial while simultaneously minimizing the risk of dual use, where individuals use both e-cigarettes and traditional cigarettes. Several studies indicate that young people who initiate vaping are more prone to transitioning to smoking traditional cigarettes. This concerning trend raises the risk of experiencing well-established health hazards associated with smoking, such as lung cancer, heart disease, and respiratory disorders. To address public health concerns, it is essential to carefully evaluate the role of e-cigarettes in smoking cessation programs, ensuring that efforts to quit smoking do not inadvertently lead to the adoption of another harmful habit.

Ensuring that efforts to quit smoking do not inadvertently lead to the adoption of another harmful habit.

The rise of e-cigarettes momentum after they were initially introduced as a tool for quitting smoking. Despite the Australian Government’s strong anti-tobacco stance, the import and sale of e-cigarettes were permitted under this premise. However, the subsequent proliferation of e-cigarettes has introduced an alarming number of young Australians to nicotine. The vaping industry, often supported by significant tobacco corporations, appears to be deliberately targeting the younger generation, even though their products consist of harmful and addictive substances.

Lack of awareness, regarding the contents of e-cigarettes

E-cigarettes can harbor up to 200 hazardous chemicals, including toxic compounds found in weed killers and paint strippers.

When inhaled, these substances can deeply penetrate the lungs, posing serious health risks. 

A pressing concern arises from the evident lack of awareness among both young people and parents regarding the contents of e-cigarettes. A National E-Cigarette Awareness and Attitudes Survey disclosed that merely one-third of young individuals and their guardians have a grasp of the ingredients within e-cigarettes. This knowledge gap is alarming given that e-cigarettes can harbor up to 200 hazardous chemicals, including toxic compounds found in weed killers and paint strippers. When inhaled, these substances can deeply penetrate the lungs, posing serious health risks.

Leading cause of preventable mortality in Australia

Furthermore, global evidence underscores the detrimental health outcomes associated with nicotine e-cigarette use. Such outcomes encompass a spectrum of concerns, from poisoning and inhalation-related toxicities like seizures to addiction, physical trauma, burns, and lung injuries. Alarmingly, young individuals who vape are three times more likely to transition to conventional cigarette smoking. Such trends are deeply unsettling, especially considering the devastating toll of tobacco, which is responsible for claiming over 50 Australian lives daily—equivalent to approximately 20,000 death annually—and stands as a leading cause of preventable mortality and morbidity in the country.

The devastating toll of tobacco is responsible for claiming over 50 Australian lives daily—equivalent to approximately 20,000 death annually—and stands as a leading cause of preventable mortality and morbidity in the country.

Environmental burden of disposing e-cigarettes

Moreover, the environmental implications of e-cigarette usage cannot be overlooked. As the demand for e-cigarettes escalates, so does the environmental burden associated with disposing of e-liquids, e-waste, plastics, and lithium batteries integral to these devices. Additionally, the sought-after sensation of headspins reported by young vapers is a troubling symptom of nicotine poisoning. This condition, accompanied by symptoms ranging from nausea, seizures, diarrhea, confusion and irritability to abnormal heart rates and breathing difficulties, underscores the severe health risks posed by e-cigarette consumption.h2

E-cigarette vs tobacco situation

Current e-cigarette (vaping) situation compared to cigarette (tobacco) situation

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Concerns about e-cigarettes

The global regulatory landscape surrounding e-cigarettes, or ENDS (Electronic Nicotine Delivery Systems), is a complex tapestry influenced by various socio-cultural and economic factors. E-cigarettes have gained traction due to their perceived social acceptability, especially in public spaces where traditional smoking is prohibited. This shift is partly due to the successful implementation of smoke-free environment policies that have denormalized tobacco smoking in indoor public areas. However, the use of ENDS has raised concerns about renormalizing smoking behavior, particularly among younger populations. This challenge is exacerbated by the efforts of ENDS advocates and the tobacco industry to lobby for exceptions to indoor smoking bans, thereby undermining public health initiatives.

E-cigarettes aerosols are similar to tobacco smoke,

One of the key issues complicating the regulatory situation is the visual similarity between ENDS aerosols and tobacco smoke, making it challenging to discern if someone is vaping or smoking a tobacco product. This ambiguity is further muddied by the similarity between ENDS and HTPs (Heated Tobacco Products), which contain tobacco. Consequently, there is a growing consensus that ENDS should be banned in public indoor areas, workplaces, and public transport to safeguard public health and prevent the re-normalization of smoking in public spaces. As of now, only 42 countries have instituted a comprehensive ban on ENDS in all these settings, marking a modest increase from 2020.

Ban

Globally, 121 countries have implemented measures to address ENDS, ranging from outright bans on sales to various forms of regulation. While 34 countries have banned the sale of ENDS, 87 countries have opted for regulatory measures that include restrictions on advertising, health warnings, age restrictions, and flavor bans. Despite these efforts, 74 countries covering nearly a third of the world’s population, still lack any regulatory framework for ENDS. Notably, there is a disparity in regulatory action based on income levels, with 85% of high-income countries having some form of regulation, compared to only 40% of middle-income and 79% of low-income countries.

The evolving landscape of e-cigarette presents a challenge for public health officials and policymakers. Initially developed as a smoking cessation aid, e-cigarettes have increasingly attracted non-smokers, especially teenagers and young adults. This demographic shift has added complexity to the regulatory debate, as policymakers grapple with balancing the potential benefits of ENDS for smokers looking to quit against the emerging risks associated with youth uptake of vaping. As the global community continues to navigate this complex issue, finding the right balance between regulation and access remains a pressing concern.

Dramatically increasing vaping in Australia

In Australia, tobacco smokers significantly declined but recently vaping increased dramatically

Over the past two decades, Australia has seen a significant decline in the prevalence of daily tobacco smokers among adults, dropping from 22.4% in 2001 to 10.6% in 2022. This positive trend, however, has been offset by a concerning rise in e-cigarette use. Recent data reveals that 47% of Australians have either vaped or experimented with vaping. Among the younger demographic, aged 15-30, the numbers are even more startling: 14% are current e-cigarette users, and 33% have previously tried vaping.

A notable shift has occurred in the profile of e-cigarette users in Australia. In just four years, the number of adults and young individuals using e-cigarettes has doubled in which almost a quarter of these users have never been regular smokers of traditional tobacco products. The rapid adoption of vaping is further evidenced by research indicating a jump in e-cigarette use among Australians over 14 years of age, from 2.0% in early 2020 to a concerning 8.9% by mid-2023.

Dual use

The co-use of traditional tobacco and e-cigarettes, commonly referred to as dual use, presents an emerging public health challenge. This trend raises questions about the potential for e-cigarettes to act as a gateway to traditional smoking or to exacerbate nicotine addiction among existing smokers. Concurrently, tobacco smoking remains a significant health crisis in Victoria, responsible for 4,000 lives with $5 billion each annually.

E-cigarettes in Australia

Background

Initially, Australian governments endorsed e-cigarettes as a promising tool for smoking cessation. However, with growing evidence of their risks, especially their appeal to young people, the regulatory stance has evolved. In May 2023, Australia unveiled comprehensive legislation aimed primarily at safeguarding its younger generation from the potential pitfalls of e-cigarette use. Central to this legislation was the banning of single-use disposable e-cigarettes. The government is curbing the rapid adoption of vaping among the youth. Secondly, the legislation introduced strict quality standards, targeting specific flavors, colors, and ingredients, with a further emphasis on reducing the allowable nicotine content. The objective is to limit the attractiveness and potential harm of these products to younger demographics. Thirdly, the government made strides in raising public consciousness about the health ramifications of e-cigarettes. Such awareness campaigns serve a dual purpose: educating the public and deterring potential users. Lastly, understanding the powerful influence of marketing, especially on impressionable minds, the legislation took a definitive stand against advertising, promotion, and sponsorship of e-cigarettes, aiming to strip the product of its appeal. 

Tools

However, legislation was not the only tool in the Australian government’s arsenal. Recognizing the global nature of the e-cigarette trade and the potential for illicit markets to thrive, the government also made provisions to monitor and prevent the illegal importation and supply of non-prescription e-cigarettes. This proactive approach ensured that the ban on imports, slated to be enforced from 1 January 2024, would not be easily circumvented.

Comprehensive approach

Building on this momentum, further legislative efforts were unveiled in December 2023, the Australian Government’s new Public Health (Tobacco and Other Products) (Consequential Amendments and Transitional Provisions) Bill 2023 was a landmark piece of legislation. Its provisions, ranging from enhancing graphic warnings on tobacco products to limiting the use of alluring names that suggest reduced harm, showcased the government’s holistic approach to tackling nicotine addiction. VicHealth, a leading health promotion foundation, echoed the sentiments of many health advocates, lauding the government’s unwavering dedication to curbing the influence of Big Tobacco and safeguarding the health of its citizens.

Balance between promoting public health and addressing the challenges

Australia’s evolving regulatory landscape on vaping underscores the delicate balance between promoting public health and addressing the challenges posed by emerging tobacco and nicotine products. Through a combination of legislative measures, awareness campaigns, and stakeholder collaborations, Australia stands as a testament to proactive governance in the face of evolving health challenges.

E-cigarettes in Thailand

The regulatory landscape in Thailand clearly prohibits the import, sale, and provision of services related to vaping. The Consumer Protection Board’s Order No. 9/2015 and subsequent legislations have placed a blanket ban on items like baraku, electric baraku, electronic cigarettes, and e-cigarette refills. Violating these laws is not taken lightly; offenders could face penalties ranging from imprisonment to heavy fines. Sellers or providers of e-cigarette refills can find themselves ensnared by the Consumer Protection Act (No. 4) B.E. 2019, facing imprisonment up to three years, fines up to 600,000 baht, or both. Moreover, the Ministry of Commerce’s 2014 announcement reinforces the prohibition, making it a grave offence to import such items, punishable by imprisonment up to 10 years, fines up to five times the product’s value, or both. The Customs Act 2017 further bolsters this stance, criminalizing the act of bringing e-cigarettes through customs and imposing strict penalties.

In reality

Despite the strict regulatory framework, the prevalence of vaping in Thailand remains significant. Many users, cognizant of the legal ramifications, indulge in vaping discreetly, often in private venues like homes, restaurants, or bars. The act of vaping in public spaces is a risky endeavor, with individuals constantly wary of attracting law enforcement’s attention. While the likelihood of prolonged incarcerations remains relatively low, those apprehended often find themselves navigating a complex web of bribes, fines, and confiscations.

Usage statistics

The digital age offers a workaround for enthusiasts eager to circumvent the ban. Online platforms have emerged as conduits, allowing users to get e-cigarettes secretly. A 2021 survey by the National Statistical Office revealed a significant number of e-cigarette users, with 30% falling within the 15-24 age bracket. Subsequent surveys underscored this trend, highlighting Bangkok’s youth as particularly susceptible, with 14.6% admitting to e-cigarette use. Significantly, 43.9%, acknowledged dual usage of traditional cigarettes and e-cigarettes.

Urgent need for comprehensive awareness campaigns

Misconceptions surrounding e-cigarettes’ safety and addictive potential persist, with many erroneously believing them to be harmless.

The escalating trend among Thai youth underscores the urgent need for comprehensive awareness campaigns. Misconceptions surrounding e-cigarettes’ safety and addictive potential persist, with many erroneously believing them to be harmless. Addressing these misconceptions and fostering informed decision-making is imperative to safeguard the nation’s youth from potential harm. Thailand’s regulatory stand on vaping reflects its commitment to public health. However, the dichotomy between legislation and ground realities necessitates an approach, combining strict enforcement, education, and community engagement to address the growing challenge effectively.

Challenges

The Challenges surrounding e-cigarette regulations

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Clear regulation is needed.

The lack of clear regulation and standards in the e-cigarette industry has resulted in a market widespread with potential risks and insufficient safety measures. A European survey gauging attitudes toward tobacco and e-cigarettes revealed that approximately 1/4 respondents reported witnessing e-cigarette use in drinking establishments. A broader study across 12 European countries exposed a concerning trend, with self-reported exposure to second-hand aerosols standing at 16%. This exposure rate varied widely across countries, ranging from 4.3% in Spain to 29.6% in England. These findings underscore the urgent need for stronger regulations and protective measures to address the widespread use of e-cigarettes in indoor environments, emphasizing the importance of safeguarding public health.

These findings underscore the urgent need for stronger regulations and protective measures to address the widespread use of e-cigarettes in indoor environments, emphasizing the importance of safeguarding public health.

To ban e-cigarettes

The difficulty in differentiating between various vaping products and their resulting aerosols contributes to a complex regulatory landscape. The increasing acceptance of these products, which closely resemble traditional smoking, may lead to the renormalization of smoking behaviors, undermining the progress made in safeguarding public health through smoke-free policies. Some of these products, both in use and appearance, mimic traditional cigarettes and even contain tobacco, emitting tobacco smoke. This complicates efforts to distinguish them, and the ongoing enforcement challenge suggests that these products should be subject to existing smoking restrictions or bans in public spaces. While the full extent of the negative health effects of these newer products is still under investigation, a growing consensus acknowledges that they pose substantial risks to health.

Loopholes

They have introduced ostensibly ‘non-nicotine’, many of which are deceptively labeled and, upon testing, reveal nicotine content.

Regardless of the nicotine content, both variants of e-cigarettes contain harmful chemicals that can cause significant damage when inhaled.

In recent years, Australia has grappled with a surge in challenges related to e-cigarettes, presenting multifaceted concerns for public health and regulatory authorities alike. Currently, purchasing or selling e-cigarettes or any nicotine-containing e-liquids without a doctor’s prescription is strictly prohibited. However, this regulation has not deterred big tobacco companies from exploiting loopholes. They have introduced ostensibly ‘non-nicotine’ e-cigarettes into the market, many of which are deceptively labeled and, upon testing, reveal nicotine content. Regardless of the nicotine content, both variants of e-cigarettes contain harmful chemicals that can cause significant damage when inhaled, posing severe health risks to users.

Guise and Near educational institutions

Many e-cigarette retailers in areas like the Brimbank City Council are strategically located near places popular among the youth, including schools and leisure centers

Further complicating the scenario is the proliferation of e-cigarette retail outlets across the country. The rapid increase in stores selling these products, especially those strategically positioned near schools, raises alarm bells. Many of these outlets adopt the guise of innocent confectionary stores, clandestinely offering e-cigarettes under the counter. Such proximity to educational institutions increases the potential for young individuals to access and experiment with these products, leading to potential nicotine addiction and associated health issues. A study conducted in metro Melbourne, Victoria, revealed that many e-cigarette retailers in areas like the Brimbank City Council are strategically located near places popular among the youth, including schools and leisure centers. Such patterns underscore the urgent need for stricter regulations and oversight in the retail and distribution of e-cigarettes.

Nation’s commitment to public health

Until 2023, the e-cigarette industry operated with minimal regulation and oversight in Australia. However, recognizing upcoming challenges, the Australian Government introduced landmark tobacco legislation. This move not only underscores the nation’s commitment to public health but also reestablishes Australia’s position as a global advocate for stringent tobacco control measures. 

Ads and Social media

Yet, e-cigarette advertisers are adopting increasingly cunning tactics to attract younger demographics. Platforms like TikTok are inundated with vaping-related content, with retailers leveraging algorithms and collaborating with influencers to amplify their reach among the youth. Concurrently, big tobacco companies, through their vast lobbying machinery, are arranging sophisticated campaigns. These efforts aim to sow seeds of doubt, spread misinformation, and influence public opinion against stringent vaping regulations.

Big tobacco companies aim to sow seeds of doubt, spread misinformation, and influence public opinion against stringent vaping regulations.

Thailand needs more comprehensive approach

Thailand, like many nations, faces the growing challenge of e-cigarette usage, especially among its younger population. Despite having laws in place that prohibit the use, sale, and import of e-cigarettes, the prevalence of vaping remains pronounced. This persistence not only indicates a gap in law enforcement but also emphasizes the need for a more comprehensive approach to address this issue.

Thailand needs consistent enforcement of existing regulations.

One of the foremost challenges Thailand confronts is the consistent enforcement of existing regulations. While laws prohibit e-cigarette activities, their widespread use among young Thais suggests a need for stricter and more effective implementation. To truly control the vaping trend, the country must strengthen its monitoring systems. This involves tracking the various channels through which e-cigarettes enter Thailand’s borders and closely observing user behaviors and motivations. By understanding the reasons behind the increasing popularity of vaping, authorities can devise more targeted interventions. Regular monitoring can also help in updating the government’s knowledge base about the evolving vaping landscape, paving the way for timely interventions, such as bans on advertising and digital marketing, to reinforce the existing prohibitions.

Need for concerted efforts to educate and raise awareness.

A significant driver behind the surge in e-cigarette use among Thailand’s youth is the misconception that vaping is a safer alternative to traditional smoking.

A significant driver behind the surge in e-cigarette use among Thailand’s youth is the misconception that vaping is a safer alternative to traditional smoking. This perception underscores a critical need for concerted efforts to educate and raise awareness. Schools, families, and communities, alongside governmental agencies, must collaborate to dispel myths surrounding e-cigarettes. By emphasizing the potential harms and risks associated with vaping, especially its impact on young and developing bodies, there is a hope to instill a sense of caution and deterrence among the youth.

By emphasizing the potential harms and risks associated with vaping, especially its impact on young and developing bodies, there is a hope to instill a sense of caution and deterrence among the youth.

In brief

In brief, Australia faces a complex and evolving landscape concerning e-cigarettes. Addressing these challenges demands a collaborative approach, with regulators, communities, and stakeholders working cohesively to safeguard public health and counteract deceptive marketing tactics. Similarly, Thailand stands at a critical stage against the e-cigarette epidemic. Tackling this challenge demands not only stringent enforcement of existing laws but also proactive measures to understand, educate, and protect its younger generation from the potential harms of vaping.

Australia

  • Collaborative approach with regulators, communities and stakeholders working cohesively
    • to safeguard public health
    • to counteract deceptive marketing tactics

Thailand

  • Stringent enforcement of existing laws
  • Proactive measures to understand, educate, and protect the younger generation.

Movements in Australia

Notable initiatives/movements against vaping in Australia

Crucial steps forward in safeguarding Australians from the potential harms of vaping.

Reforms, towards a common goal

The recent legislative reforms represent crucial steps forward in safeguarding Australians from the potential harms of vaping. Such regulatory initiatives not only underscore the government’s commitment to public health but also serve as a testament to the evolving understanding of the risks associated with e-cigarette use.

VicHealth has been instrumental in shaping these reforms, collaborating closely with sector partners to rally public health stakeholders towards a common goal. However, VicHealth haven’t run any explicit campaigns on smoking and vaping over the past two years. Instead, VicHealth have amplified Quit’s ‘See Through the Haze’ campaign and the innovative “vape cloud” installation at Science works via a social media video called “what’s hiding in an e-cigarette?” A list of Australian campaigns are as follow;

“The Uncloud” campaign

Minderoo

The Uncloud campaign, supported by the Minderoo Foundation, not a government or health entity, is a member of the Australian Council on Smoking and Health and the Union for International Cancer Control. Crucially, it maintains a transparent position by not having affiliations with the tobacco or vaping industries. This foundation ensures that the information disseminated through Uncloud remains unbiased, grounded in research, evidence, and expert endorsement. As a result, Uncloud stands out as a trustworthy platform, dedicated to presenting the unvarnished truth about vaping.

The Uncloud campaigns stands out as a trustworthy platform, dedicated to presenting the unvarnished truth about vaping.

The essence of the Uncloud initiative is straightforward yet powerful: it aims to shed light on the realities of vaping. By serving as a centralized hub for factual information, the campaign endeavors to change perceptions and foster informed decisions. With a clear vision to unite young individuals in their resistance against vaping, Uncloud harnesses the strength of collective knowledge. Through its fact-based approach and by amplifying authentic voices, the campaign hopes to control the rising tide of vaping, emphasizing that together, the community can dispel the haze surrounding vaping once and for all.

With a clear vision to unite young individuals in their resistance against vaping.

“Vape Truths” campaign

QLD (Queensland government)

Educate and inform the public about the realities of vaping.

The Queensland government’s “Vape Truths” campaign is an effort to educate and inform the public about the realities of vaping.

Beloved Australian scientist

Leveraging the credibility and familiarity of Dr. Karl Kruszelnicki, a beloved Australian scientist, the campaign probes into critical topics such as the contents of vapes, their health implications, and the existing legal and regulatory frameworks. This approach not only explains about vaping but also highlights the importance of understanding on what individuals inhale when they vape. Alongside this educational drive, the introduction of Quit HQ serves as a commendable initiative. Positioned as a comprehensive resource, Quit HQ offers Queenslanders a centralized platform to access essential information and support, marking the beginning of their journey to quit smoking or vaping.

Also highlights the importance of understanding on what individuals inhale when they vape.

New anti-vaping video ads by Dr Karl Kruszelnicki

“There’s nothing sweet about vaping” campaign

QLD (Queensland government)

A campaign to aid Queensland residents in their cessation efforts.

Furthermore, “There’s nothing sweet about vaping” is a campaign to aid Queensland residents in their cessation efforts. Offering a free and confidential service, Quitline stands as a pillar of support, providing counseling, encouragement, and tailored advice to those grappling with nicotine addiction. Research underlines the efficacy of coupling nicotine replacement therapy (NRT) with counseling, suggesting that this combination can significantly enhance the likelihood of a successful quit attempt. As such, the availability of this service seven days a week ensures that individuals receive the necessary guidance and support whenever they need it, reinforcing the state’s dedication to promoting a healthier, vape-free Queensland.

QUIT

Victoria

Collaborative by

Minister for Health + Cancer Council Victoria + National Heart Foundation of Australia

Quit Victoria is initiated in 1985 after a ministerial review pinpointed tobacco as Victoria’s top health concern. Quit was established collaboratively by the Minister for Health and Cancer Council Victoria. This foundational partnership included the Health Department Victoria and Cancer Council Victoria, later augmented by the National Heart Foundation of Australia (Victorian Division). Together, this collective not only shaped the direction of Quit but also advised the Minister for Health on pivotal policies and legislation aimed at diminishing the prevalence of smoking across Victoria.

VicHealth

In 1987, Victoria took a significant step forward with the introduction of the Victorian Tobacco Act. This legislation introduced a levy on the wholesale sale of tobacco products, leading to the inception of the Victorian Health Promotion Foundation, widely recognized as VicHealth. Tasked with allocating the funds generated by this levy, VicHealth became instrumental in amplifying Quit’s initiatives through enhanced financial backing. Today, VicHealth’s unwavering support ensures that Quit continues its essential mission in tobacco control. Gratitude is owed to VicHealth, not only for its substantial financial contributions but also for its invaluable expertise.

VicHealth, as substantial financial contributions and also its invaluable expertise.

Furthermore, Quit operates under the umbrella of Cancer Council Victoria, supported by a diverse range of entities including Cancer Council Victoria, VicHealth, the Victorian Department of Health and the Australian Government’s Alcohol, Tobacco and Other Drugs Branch. Collaborating closely with these stakeholders, along with the Cancer Council Federation and other governmental and non-governmental organizations, Quit remains dedicated to providing factual information about e-cigarettes and vaping, ensuring the community is well-informed about associated health concerns and effects.

“See Through the Haze” campaign

A critical message aimed primarily at the youth: many e-cigarettes contain harmful chemicals similar to those present in substances like biofuel, paint thinner, and insecticides.

The “See Through the Haze” campaign, initiated by Quit, stands as a pioneering effort across Victoria. This comprehensive initiative underscores a critical message aimed primarily at the youth: many e-cigarettes contain harmful chemicals similar to those present in substances like biofuel, paint thinner, and insecticides. Over 200 distinct chemicals have been identified in e-liquids.

The campaign’s primary objective is to prompt individuals, especially those between 14 and 39 years, to seek accurate information about the potential risks associated with vaping. Through digital platforms, this campaign will lead with 2 versions of a 30-second advertisements: one featuring individuals in their 20s and another showcasing those in their 30s. Both versions will guide viewers to a dedicated campaign webpage. Strengthening its reach, Melbourne’s metropolitan regions will see the campaign placed street posters. Recognizing the diverse fabric of Victoria’s populace, the campaign extends its focus to specific communities, including Lebanese Arabic, Chinese Mandarin-speaking males, and Vietnamese-speaking males, all falling within the 14-39 age bracket. Ensuring inclusivity, campaign materials are available in Arabic, Simplified Chinese, Mandarin, and Vietnamese, reflecting Victoria’s multicultural essence.

“The Con that Kills” campaign

“The Con that Kills” was reintroduced by QUIT across Victoria on 22 October 2023. This initiative aims to illuminate how these companies engineer tobacco products. Their modifications often serve to entice young individuals into smoking while ensuring existing smokers remain hooked to these perilous products. The campaign seeks to diminish smoking rates, ultimately safeguarding countless lives from the ravages of tobacco-related illnesses.

30-second ads

This campaign is a compelling 30-second advertisement slated for broadcast across television and various digital platforms in Victoria. Additionally, viewers will encounter 4 brief versions spotlighting alterations in filters, roll-your-own tobacco, and the insidious additives incorporated into tobacco products.

Diversity

Recognizing the diverse tapestry of Victoria’s population, the campaign zeroes in on specific communities with elevated smoking rates. These include the Lebanese Arabic-speaking community, Chinese Mandarin-speaking males, and Vietnamese-speaking males, all falling within the 18-64 age bracket. To ensure widespread comprehension and inclusivity, campaign materials are available in Arabic, Simplified Chinese, and Vietnamese.

Campaign’s key messages

The campaign’s key messages highlight the tobacco industry’s cunning: manipulating products to obscure the true harshness of smoke, thereby facilitating prolonged intake of cancer-inducing agents. The overarching advice remains unequivocal: to truly break free from this deceptive cycle, the most effective step is to quit smoking altogether.

NSW (New South Wales)

The NSW Ministry of Health stands as a fundamental pillar in ensuring the wellbeing of the New South Wales community. Its foundational role is to strengthen the efforts of the Minister for Health and Minister for Regional Health, in addition to overseeing portfolios such as Mental Health and Medical Research. The Ministry of Health bears the significant responsibility of a system manager for the extensive NSW public health framework. This complex system claims a vast network that includes over 220 public hospitals. Beyond hospital care, the NSW public health system, under the umbrella of NSW Health, extends its reach through various community health initiatives and other vital public health services. These services are further augmented by a collaboration of local health districts, specialty networks, and several non-governmental health organizations, all striving to enhance the health outcomes for the residents of NSW.

Diving deeper into the structure of NSW Health, one finds a constellation of state-wide and specialized health services that cater to the diverse needs of the population.

Furthermore, the Ministry of Health plays an instrumental role in shaping the path of health services and investments within the NSW public health system. Their strategic guidance ensures that the health goals and priorities set forth by the NSW Government are not just acknowledged but actively pursued and achieved for the broader NSW community. Diving deeper into the structure of NSW Health, one finds a constellation of state-wide and specialized health services that cater to the diverse needs of the population. A testament to its comprehensive nature, NSW Health encompasses 15 local health districts, each tailored to deliver health services across a spectrum of environments. These range from primary care facilities nestled in the remote expanses of the outback to state-of-the-art tertiary health centers situated in the bustling heart of metropolitan Sydney. With 6 local health districts dedicated to the expansive Sydney metropolitan region and the remaining nine diligently serving the rural and regional landscapes of NSW, the commitment of NSW Health to provide equitable health care remains unwavering.

“What’s in a vape” campaign

Aimed at enlightening young individuals about the details of vaping

Providing a plethora of creative assets, it equips educators, guardians, and carers with the necessary tools to foster informed discussions and address the burgeoning concerns surrounding vaping. 

The “What’s in a vape” campaign emerges as a crucial initiative aimed at enlightening young individuals about the details of vaping. Tailored specifically for the younger demographic, this campaign provides information, presenting facts about vaping, answering commonly posed questions concerning e-cigarettes, and offering a comprehensive vaping toolkit designed for a range of stakeholders including parents, teachers, and health professionals. This toolkit serves as an invaluable resource, particularly for those working directly with adolescents aged between 14 to 17 years. By providing a plethora of creative assets, it equips educators, guardians, and carers with the necessary tools to foster informed discussions and address the burgeoning concerns surrounding vaping. 

Enhancement of awareness

The toolkit endeavors to dispel prevalent myths and rectify misperceptions that might be prevalent among the youth.

These vaping toolkit is the enhancement of awareness regarding the potential health hazards associated with vaping. It endeavors to dispel prevalent myths and rectify misperceptions that might be prevalent among the youth. The toolkit’s user guide further elucidates its purpose and delineates its optimal utilization. Furthermore, aligning seamlessly with the brand ethos of the NSW Government, the user guide precisely outlines guidelines on typography, styles, and color palettes. Such meticulous attention to design ensures a harmonized and consistent visual identity across all resources within the vaping toolkit. Complementing this initiative is the vaping resources hub, a dedicated platform brimming with evidence-based materials. Catering to distinct audiences such as young individuals, parents, educators, and health practitioners, this hub is a reservoir of resources ranging from informative fact sheets and compelling posters to engaging videos and newsletters. Additionally, recognizing the pervasive influence of social media, the campaign extends its reach through tailored social media materials, amplifying its impact and fostering a more informed discourse on vaping.

Cancer Council WA

“Rotten Truth About Vaping” campaign

Shielding young individuals from the detrimental effects of smoking.

The “Rotten Truth About Vaping” campaign, initiated by Cancer Council WA, confronts the alarming surge in vaping among the youth, revealing unsettling truths concealed behind the vibrant facade of e-cigarettes. With the launch of their digital campaign, “Clear the Air,” they aim to prevent the rising trend of vaping, especially among 14-24 year olds, as recent data has shown a staggering increase in their engagement with vaping since 2020. Cancer Council WA highlights the urgency of the situation, emphasizing that this escalating trend could potentially reverse the hard-earned progress made over the years in shielding young individuals from the detrimental effects of smoking.

The campaign aspires to heighten awareness about

  • the inherent dangers of vaping
  • dissuade potential initiates
  • and prompt existing vapers to reconsider their choices.

Financially strengthened by a generous grant of $375,000 from Healthway earlier this year, the campaign aspires to heighten awareness about the inherent dangers of vaping, dissuade potential initiates, and prompt existing vapers to reconsider their choices. While the allure of vibrant varieties and tempting flavors initially fascinates the younger demographic, it is the pernicious nicotine content that ensnares them, setting the stage for potential health complications in the future. National statistics reveal that vaping prevalence among 14-17 year olds surging from a mere two percent in 2020 to an alarming 12 percent by 2022. A similar trend is observed among 18-24 year olds, with rates multiplying from nearly 6% to over 21% within the same timeframe. Such trends are particularly distressing, given that non-smokers venturing into vaping are marking a backward step in public health efforts.

“Clear the Air” advertisements

In collaboration with Gatecrasher and youth representatives, Cancer Council WA crafted “Clear the Air” advertisements that artfully unveil the sinister truths concealed within e-cigarettes. These adverts compare the initially enticing imagery of fruity vape flavors with jarring visuals, such as a lifeless cockroach or a heap of cigarette butts, to emphasize the underlying hazards.

Surveys conducted as part of the campaign revealed a real shock among the youth upon learning about

  • The myriad harmful chemicals present in vapes
  • The staggering nicotine equivalence to multiple cigarette packs
  • And the potential health ramifications ranging from nausea to severe seizures.

Symptoms induced by these toxic compounds not only compromise one’s well-being but also impede daily activities, with severe cases even warranting emergency medical intervention. With the campaign slated to span from October 29, 2023, to June 30, 2024, across a multitude of digital platforms, the Cancer Council WA remains steadfast in its mission to dispel vaping myths and safeguard the well-being of the younger generation.

The Cancer Council WA remains steadfast in its mission to dispel vaping myths and safeguard the well-being of the younger generation.

Bug-spray
Multiple packs of cigarettes
Dead body chemicals
Very high level of nicotine

The study to understand vaping among the youth

Descriptive feedback from the participants highlighted the potent impact of the advertisements, with many characterizing the portrayal of vapes as “dangerous and disgusting.”

In an effort to understand and address the growing concerns surrounding vaping among the youth, Cancer Council WA undertook a comprehensive research initiative, culminating in a revealing experiment. The study commenced with focus groups engaging 45 individuals between the ages of 14 and 24, aiming to gauge their perceptions, knowledge, and attitudes towards vaping. These invaluable insights then paved the way for the conceptualization of advertisements tailored to resonate with the target demographic. Subsequently, these ad concepts were subjected to rigorous online testing, involving an additional cohort of 440 young individuals within the same age bracket, to further refine and validate their impact.

The results

After viewing the advertisements :

Notably, over 62% of the young participants who were active vapers expressed diminished inclination towards continuing their vaping habits.

The results of this experimental campaign were both illuminating and promising. Post-viewing the advertisements, a significant shift in perceptions was evident. Notably, over 62% of the young participants who were active vapers expressed diminished inclination towards continuing their vaping habits. Equally striking was the fact that more than 60% of non-vapers felt disinclined to experiment with vaping in the future. Emotions ran high, with 61% of the respondents expressing feelings of concern, and a staggering 70% registering feelings of disgust. Descriptive feedback from the participants highlighted the potent impact of the advertisements, with many characterizing the portrayal of vapes as “dangerous and disgusting.” They lauded the campaign for serving as a stark “reality check,” effectively dissuading them from engaging in or perpetuating vaping habits.

A significant shift in perceptions was evident.

  • Over 62% of the young participants who were active vapers expressed diminished inclination towards continuing their vaping habits.
  • More than 60% of non-vapers felt disinclined to experiment with vaping in the future.
  • 61% of the respondents expressing feelings of concern
  • And a staggering 70% registering feelings of disgust.

Recognizing the pivotal role of informed decision-making, Cancer Council WA has also launched an interactive website, “Clear the Air” (www.cleartheair.org.au), to empower both the youth and their circle of influence. The platform serves as a reservoir of accurate information, enabling visitors to delve deeper into the nuances of vaping-related facts presented in the advertisements. Furthermore, an insightful quiz has been incorporated, designed to assist individuals in self-assessing their potential addiction to vaping. Through such holistic initiatives, Cancer Council WA remains steadfast in its commitment to fostering a healthier, more informed future for the younger generation.

Movements in Thailand

Notable initiatives/movements against vaping in Thailand

The primary focus is safeguarding the health and well-being of children and young people.

E-cigarettes have been at the center of regulatory attention in Thailand since 2014, with a robust legal framework in place to prohibit their import and sale. The primary focus of this legislation is safeguarding the health and well-being of children and young people.

Penalties

The stringent measures include criminal charges for those involved in the sale of e-cigarette refills, falling under the jurisdiction of the Consumer Protection Act (No. 4) B.E. 2019. Perpetrators of this offense face severe consequences, including imprisonment for up to three years, fines of up to 600,000 baht, or a combination of both penalties. Furthermore, the Customs Act 2017, Section 244 outlines strict punishments for individuals attempting to bring e-cigarettes into the country through customs, with potential sentences of up to ten years in prison and fines reaching 500,000 baht. Possession of prohibited e-cigarettes could result in a jail term not exceeding five years, a fine amounting to four times the product’s value, or a combination of both penalties.

Hotline

To fortify these regulatory measures, Thailand has established a dedicated hotline for reporting violations related to e-cigarettes. The Office of the Consumer Protection Board has instituted a hotline, 1166, accessible 24 hours a day. Additionally, individuals can report violations online through the “Consumer Complaint System” or the “OCPB Connect” mobile application. This proactive approach ensures that citizens have direct avenues to raise concerns and contribute to the enforcement of anti-e-cigarette laws.

WHO FCTC Knowledge Hub

Recognizing the global nature of the challenge posed by e-cigarettes, Thailand has taken a significant step in establishing the “WHO FCTC Knowledge Hub for Article 5.3” at Thammasat University. Supported by the Convention Secretariat of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), this hub serves as a vital platform to counter the industry’s influence and strengthen tobacco control measures worldwide. The focus on monitoring e-cigarettes’ policy interference in various countries is a key aspect of this initiative. By understanding and addressing industry tactics globally, Thailand aims to fortify its defenses against tobacco and e-cigarette consumption within its borders and contribute to the broader global effort.

Movements in Vietnam

Notable initiatives/movements against vaping in Vietnam

Designed to foster behavior change and reshape societal norms across various age groups, including adults, youth, and children.

Proactive

Vietnam has been proactive in its efforts to combat tobacco consumption through a series of impactful national mass media campaigns since 2015. Supported by VNTCF (Vietnam Tobacco Control Fund), these campaigns have been precisely designed to foster behavior change and reshape societal norms across various age groups, including adults, youth, and children. A primary objective has been to dissuade the younger generation from initiating smoking habits while rallying non-smokers, with a particular emphasis on women, to advocate for policy changes and transform prevailing attitudes towards tobacco use.

Central to the success

Central to the success of these initiatives is their foundation on data-driven and evidence-based strategies, drawing insights from esteemed sources like the Global Adult Tobacco Survey and prior campaign evaluations.

Propagated through various platforms

These influential messages have been propagated through an array of media outlets, encompassing television broadcasts, towering billboards, dynamic social media platforms, and educational settings within communities. The outreach extends to provincial hubs and everyday locales such as hospital waiting areas, buses, and train stations. Collaborative efforts with esteemed organizations like the Vietnam Women’s Union and the Youth Union have facilitated tailored campaigns aimed explicitly at women and youth. These campaigns, characterized by national competitions and impactful messages, have garnered the attention of millions, intensifying awareness about the detrimental effects of tobacco and e-cigarettes.

These campaigns have garnered the attention of millions, intensifying awareness about the detrimental effects of tobacco and e-cigarettes.

Safeguarding younger population

Accordingly, Vietnam has prioritized safeguarding its younger population by forging partnerships with the Ministry of Education and Training. This collaboration aims to instill awareness and equip educational institutions and students with the tools to resist the allure of emerging tobacco and nicotine products. Encouragingly, these concerted efforts have yielded promising outcomes, with a notable surge in public awareness, bolstered support for tobacco control policies, and heightened consciousness regarding the perils of smoking and passive smoke inhalation. Importantly, a significant proportion of smokers have expressed an increased inclination to embark on cessation journeys, while non-smokers have become more assertive in voicing grievances concerning exposure to smoke in communal areas.

In conclusion

In conclusion, Vietnam’s robust approach to leveraging mass media campaigns stands as a beacon of success in the realm of tobacco control. By prioritizing behavior modification and awareness, particularly among vulnerable demographics like youth and women, Vietnam has achieved commendable strides in augmenting public support for tobacco control policies and curtailing tobacco-related health hazards. As the discourse surrounding e-cigarettes unfolds, the overarching consensus underscores the imperative to recognize and address their substantial health risks.

The beacon of success is due to

  • Leveraging mass media campaigns
  • By prioritizing behavior modification and awareness, particularly among vulnerable demographics like youth and women