Think of the Children! (Reprise)

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It’s nearly a year since I wrote this piece about under-18 vaping in Sweden, highlighting the responsible behaviour of both a vape shop and a parent. I also linked to what I still consider to be the most pragmatic and understanding article written on this subject.

The reason I wanted to return to it is two-fold: firstly, CAN (the national body responsible for providing statistics on drug, alcohol and tobacco use in Sweden) have released their annual report; and also because I was intrigued by the SR (the state national radio) report on their findings, and how these stats will likely be interpreted by the enemies of vaping in particular, and harm-reduction in general.

So let’s start with how it was reported: More youth are trying e-cigarettes and one of the reasons could be that anyone can buy them

Apart from the fact that they ought to sack the sub-editor for that less than snappy headline, they are implying that both of these facts are a BAD THING. But as I’ve documented previously, one of the benefits of having a wide availability of THR products is their prophylactic effect: if young people can choose between two options, the majority are smart enough to choose the safer one. (Although it must be noted that Snus clearly appeals more to Swedish males than females for a multitude of reasons, not least the taste, the image, Swedish culture and tradition of use, and the anti-THR propaganda of the past 30 or so years).

Young people experiment. So if more young people are experimenting with vaping, and fewer are experimenting with smoking, surely public health bodies and the media alike would see this as a GOOD THING? Let’s have a look at the stats:

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Well now. That’s interesting. Very interesting indeed. We only have two years’ worth of data to go on for ever-use of e-cigarettes (and on first inspection I couldn’t find and data on daily or even regular use), but it appears that as one goes up, the other goes down. It’s also noticeable that unlike the heavily male-oriented prophylactic effect we see with snus, this seems to be a largely gender-neutral phenomenon.

To return to the Swedish Radio website’s epic of a headline, is this GOOD THING a direct result of the fact that “anyone can buy” e-cigarettes? To be honest, I doubt that’s the case at the moment, though that’s not to say it wouldn’t have had an effect in the long-term. The reason being that despite all the scaremongering headlines in the media, e-cigarette retailers simply aren’t that prevalent in Sweden, and those that exist appear to be selling responsibly.

One of the results of the ongoing court case to ban ecigs from sale entirely is that there are very few retail outlets, since few people were prepared to take the risk of investing in a business that could be closed down at any given moment. And it doesn’t take a genius to work out that if over 20% of young people are still experimenting with smoking, it’s not actually necessary for them to walk into shops in order to try things. So under 18s (and especially under-16s) are no doubt getting access via the same methods they get cigarettes – nicking them from parents and older siblings, and from mates who have already nicked them.

The headline invites the inevitable outrage from the usual suspects that, as the law currently stands, a 10 year-old could walk into a shop and buy an ecig (assuming they could actually find a shop that sells them of course). But Sweden only has itself (or more accurately its Medicines Licensing Agency) to blame for the current state of affairs: this court case has been going on for over two years. And until it’s resolved, the Government is unable to introduce legislation prohibiting the sale of e-cigarettes – to anyone, of any age. Don’t you just love unintended consequences?

Since it’s unlikely that anyone will ever dare to analyse the 6-7 year experiment that has resulted from inadvertantly allowing young adults free (though not widespread) retail access to e-cigarettes in Sweden, it will be hard to determine the overall impact (if any). What we can say for sure is that widespread use of e-cigarettes has happened, and that just as in the UK and US, it has coincided with several years of large declines in both occasional and daily smoking amongst the same groups of young adults. What remains to be seen is the effect on youth smoking rates for 2016/17, after either the total retail ban under medicinal regulation or the EU TPD takes effect.

UPDATE

I’ve tracked down the CAN smoking rates for 16 and 18 year-olds in Sweden. The vertical columns represent years 2011-2015 (they messed around with data-gathering methods in 2012, but this doesn’t appear to have affected the patterns), and the horizontal ones are: Male Smokers, Female Smokers, Male Daily Smokers, Female Daily Smokers.

16 year olds who smoke and smoke every day 2011 to 2015 Male and Female

16 year-olds

18 year olds who smoke and smoke every day 2011 to 2015 Male and Female

18 year-olds

 

Sources: CAN Skolelevers Drogvanor 2015

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