A Coordinated Approach to Prevent E-Cigarette Use Among Post-Secondary Students

E-cigarettes, juuls, e-pipes, vape pens - whatever you may call them, they are quickly becoming very popular among university students as a presumably healthier alternative to traditional cigarettes.


When e-cigarettes were launched, they were targeted towards individuals who couldn’t seem to tackle their cigarette addiction. While they still contain nicotine, e-cigarettes are a popular choice because they lack tobacco, tar and other less-than-healthy ingredients found in traditional cigarettes. However, while e-cigarettes may have been introduced to help smokers quit, we are seeing a significant uptake among high school and university students, many of whom use vaping as a way to raise their status symbol or look cool. Unfortunately, because of the way e-cigarette companies have advertised their products, many teenagers and young adults don’t understand that these products, like their cigarette ancestors, also have negative ramifications.


            Currently, we don’t have a clear picture of the short- and long-term effects of e-cigarettes, though some users have developed serious lung conditions and a few deaths have been linked to these products. Because we have not yet learned exactly what the health effects are, and what conditions students are exposing themselves to by using these products, there needs to be greater educational and regulatory efforts to dissuade recreational use. While we wait for stricter regulation laws to be enforced and for awareness to increase, students will likely continue to use e-cigarettes in and around university campuses.


            In the meantime, there are things we can do to curb e-cigarette use. I am currently running a health initiative on the University of Waterloo campus under the Applied Health Sciences Advisory Committee on Health and Well-Being. My goal is to bring awareness and educate students about up-to-date recent research on e-cigarette products. I have set up booths around campus where I engage with students on a range of topics including why people turn to e-cigarettes, potential health impacts, the most recent reports and research, and ways we can help dissuade students from using these products.


            From my conversations with students, I have noticed that while they don’t necessarily have the strongest understanding of e-cigarettes, they generally understand that e-cigarettes are not completely harmless. This is a positive sign; however, it doesn’t reflect the increasing usage rates on our campus. Approximately ninety percent of students I spoke to claimed that they have friends who use an e-cigarette product; half claimed that they have used an e-cigarette product before, and most of the other half that they had friends who had tried one.  This raises the issue of peer-pressure and highlights an important area for intervention. University students, especially first years, are more likely to succumb to peer pressure and we therefore need to find a way to help students make informed decisions based on facts rather than follow the crowd. 


            How can we get involved with this issue? How can we support students with the best combination of resources across campuses? The answer is by taking a “Systems thinking approach”.   I spoke with Dr. Sharon Kirkpatrick, who is a faculty member under the Applied Health Sciences Faculty at the University of Waterloo, regarding this type of approach towards issues on university campuses. She noted that a systems thinking approach considers a challenge such as e-cigarette use from a holistic perspective, considering the range of factors that influence uptake among youth and young adults and pinpointing the ways in which these factors interconnect. Doing so can help us to consider a range of strategies to curb e-cigarette use, including “upstream” approaches such as regulations on the marketing and use of e-cigarettes on campus as well as “downstream” approaches that help individuals to understand the implications of e-cigarette use for health. This type of approach requires bringing together a range of campus stakeholders, including students, residence managers, campus health and wellness staff, as well as researchers with expertise in tobacco addiction. We need to communicate and work together to find new ways to support students


Most importantly, we need to have these conversations with students. We need to figure out what support they need to decrease their e-cigarette use. Students can give us the best insight as they are either e-cigarette users themselves or friends of e-cigarette users, and so it’s vital that we develop a strong relationship between students and campus staff so that we can work together to reduce e-cigarette use. This work must involve raising awareness on the potential long-term health impacts of e-cigarettes and can be carried out in the same way we talk about regular cigarettes, alcohol and marijuana use.


            We might not know exactly what the long-term health impacts of e-cigarettes are, but before we all start using them, it’s important that we wait for evidence-informed guidance rather than watching students act as test subjects. In the meantime, university campuses need to involve all stakeholders in health initiatives that support students. I will continue to advocate for awareness on the University of Waterloo campus, and I hope to see students at other Ontario universities follow suit. We will only see an impact and a decrease in e-cigarette use once we implement more awareness campaigns, more health initiatives, and more education projects.


            Let’s move forward by using a systems vision, collaborating on projects, and working in interdisciplinary teams to gather the best resources for healthier campuses across the province.