We’ve seen backlash for ads featuring Santa Claus, we’ve seen the UK ad regulator ban e-cigarette ads from Instagram, and yet a significant number of youth are vaping, upwards of two million in 2021 according to the CDC. According to new research done by a team based in North Carolina, there are a few tips and tricks that are useful in order to create effective anti-vaping advertising. The study published in the latest issue of Tobacco Control states that “Promising vaping prevention messages focus on the adverse consequences of vaping, use negative imagery and avoid speaking for teens using their vernacular or perspective.” So emojis are out, tough conversations are in, but how did we get here and how can vaping affect youth mental health?

Mental Health Impact Not Fully Studied

The study took 1,501 American kids aged 13-17 and presented a series of anti-vaping messages. What they found was that messaging which mirrors that of traditional anti-tobacco advertising had a high perceived effectiveness rate. In many countries, such as Canada,advertising regulations have matched already existing legislation that was created to curtail tobacco use and promotion. Dr. Michael Roeske, PsyD, says he sees the parallels and that part of the problem is that many teens are drawn to vaping as what he calls “a health seeking behavior” with an impact that is “bi-directional.” In other words, some users choose to vape because they see it as a way to alleviate symptoms of anxiety, when what is more likely to occur is an addiction and increased symptoms of the very thing they are trying to combat. Combine this with the ease of use, as an e-cigarette is easier to hide and doesn’t require an illegal act to consume, and Roeske says you have a recipe for trouble.  “So, you already have a person whose frontal lobes are not fully developed so they can’t really do what we’d call executive function, they can’t really protect the head-based long-term plan already; and then you have something that really produces very little consequence. And you run into a real challenge of trying to get them to anticipate that there are long-term problems here.” Roeske adds that the mental health effects of vaping are understudied, primarily because the advent of these products is so new. “I think we’re not going to know several long-term effects for a while, there’s not really a lot of research. Even in combustible tobacco research, there’s not a lot in terms of the impact on mental health.”

Parents Express Concern

E-cigarette use by children has been a longstanding concern. The CDC, as far back as 2014, cited the number of middle and high school students who had used a vape in the previous 30 days as close to 2.4 million. Meredith Berkman’s son was one of those children. She, along with two other co-founders, started advocacy group Parents Against Vaping E-Cigarettes after their sons were faced with a school event being conducted by a vaping company staffer. She says that the study proves that some important progress is being made as the gap between research and the realities of vaping narrows. “We know the health harms, but there’s no long-term data, right? I mean, the kids began using these products really around 2016, when JUUL came on the scene. So, our kids are essentially being used as lab rats for this experiment.” Despite that acceleration in use, JUUL was founded in 2015 and has been regularly cited as the leading e-cigarette brand in the United States. However, it should be noted that the FDA has banned the sale of JUUL cigarettes as of June 23, 2022. Berkman points to organizations like Truth Initiative—a non-profit also cited in the study—as a place for knowledge building and research gathering. Truth Initiative wrote in 2018 that four key marketing methods were fueling a vaping epidemic, including introducing flavors, offering scholarships to students, sponsoring musical events, and leveraging social media. For Berkman, supporting her own kids’ mental health means engaging with a system and a society that has preconceived notions about what addiction means for the lives of children and their families. She says there is a lack of a certain type of support. “People who will listen and not judge because there’s so much stigma around addiction in this country, which I did not understand. There’s even stigma within the addiction psychiatric field, and there are so few addiction psychiatrists in this country, which I also didn’t understand. But I’ve learned from our partners. And that has to change in all ways for everyone’s public health benefit."