For 20 years teenage smoking fell steadily in Ireland. Then along came vaping and it all changed

Shannon D’Arcy (20), from Palmerstown, Co Dublin, started smoking when she was 17. “I was with my friends and I just said, I’ll have one, and it just went on from there.”

She is standing with some other smokers on St Andrew’s Street, in Dublin city centre. School might have been a contributory factor in her developing a nicotine addiction, D’Arcy says.

“I started stress smoking. We’d go out for a break [from school] and have a smoke. Then I started working and getting my own money, and buying my own smokes, and it got even worse then.”

She smokes about 20 a day and says all of her female friends are smokers too. “I know it is bad for you but once you are addicted to it, it is hard to stop. I just can’t stop. I don’t know why.”

Farting barrister loses harassment claim against colleague who asked him to stop

---

Eileen Flynn: ‘I really hope that 2022 will be kinder to people’

---

Micheál Martin: ‘What I love about Christmas is: it’s a suspension of time’

---

She doesn’t touch e-cigarettes – or vapes – which work by heating up a flavoured liquid, usually containing tobacco, and inhaling the vapour. She doesn’t know anyone who does.

Over on South William Street Adam Ellis (19), from Donnybrook, Dublin 4 is pulling on a vape as he walks along with three male friends.

“I don’t smoke any more, I only vape,” Ellis says. “I started smoking at 17. I was just out drinking and my mate was smoking and he gave it to me and I started smoking when I was drinking.”

Soon, on days when he wasn’t drinking, he was smoking the cigarettes that he had left over from the night before. “That’s how I started.”

A few months ago Ellis started vaping in an effort to quit cigarettes. Cigarettes are expensive, he doesn’t like the taste and sometimes they make him sick. The day he spoke to The Irish Times he was inhaling from a “pineapple grapefruit ice” flavoured vape.

The percentage of Irish 15 and 16 year-olds who were smoking fell steadily from the mid-1990s to 2015, according to data collected by the Europe-wide ESPAD youth surveys, which are carried out every four years.

However, the steady downward trend had come to an end by the time of the 2019 survey, which showed that the prevalence of teenage smoking had begun to edge upwards again.

One of the largest drop-offs in teenage smoking in 1995-2015 was in the years preceding the 2004 ban on smoking in the workplace, a measure that, by definition, did not directly affect young people.

It was an unintended consequence, said Prof Luke Clancy, a consultant respiratory physician and founder of the Tobacco Free Research Institute, Ireland.

“By and large, if you want to get children not to start smoking, initiatives aimed at them alone are not really that successful. The reasons for this are complex, but they include the fact that teenagers want to be grown-ups.”

The widespread public discussion at the time of the workplace ban about the dangers of smoking and the desirability of not being addicted to cigarettes, made an impression on teenagers.

The public policies that drive down smoking rates include price increases, age restrictions on sales, and bans on advertising, said Clancy. “If you want young people to stop smoking, then what works for everyone else, also works for them.”

The study found that teenagers who experimented with e-cigarettes were at an increased risk of becoming cigarette smokers

The overall rate for smoking in Ireland is 18 per cent, according to the Healthy Ireland Survey 2021. The 2019 ESPAD survey found the rate was 14 per cent for those aged 15-16. Ireland has a strategy of trying to reduce smoking prevalence overall to 5 per cent by 2025, and up to 2019 it had looked possible that this would be achieved for teenagers, though not for older smokers.

“To find that the only group that were likely to meet that target, that they are not going to meet it either, is very disappointing,” said Clancy.

In a recent paper, called Increased Smoking and E-cigarette use among Irish Teenagers: A new threat to Tobacco Free Ireland 2025, Clancy and two others outlined how in the period between 1995 and 2015, teen smoking (cigarettes, not e-cigarettes) fell 41 per cent to 13.1 per cent; only for the 2019 survey to find that smoking among the teenagers had increased to 14.4 per cent.

The paper analysed how e-cigarette use had increased significantly in the four years to 2019, with the percentage of those who had ever used the addictive nicotine product going from 23 per cent to 37.2 per cent, while current use went from 10 per cent to 18 per cent.

The study found an association between smoking cigarettes and e-cigarette use. Teenagers who experimented with e-cigarettes were at an increased risk of becoming cigarette smokers – and seeing their lifespans shorten by between 10 and 15 years as a result.

Social media, flavours, and packaging are among the factors being used to target the young, Clancy believes

Smoking kills approximately 6,000 people in Ireland every year, more than Covid in its worst year, but unlike Covid “there is an industry driving [smoking],” says Clancy. “Their opportunity is anything they can see, and e-cigarettes are one of the things they see.”

Social media, flavours, and packaging are among the factors being used to target the young, Clancy believes. Flavours are used to “entice” the young, and the industry know this, he said. “They are a delivery mechanism.”

"One out of three teenagers who starts smoking will end up dying from smoking," said Chris Macey, director of advocacy with the Irish Heart Foundation.

“You can’t prove that e-cigarettes are the cause of the change in the trend for teenage smoking, but the change in the trend coincides with e-cigarettes.”

This view is shared by Clancy and his co-authors of the recent study, who noted that other factors linked to teenage smoking did not change during the 2015-2019 period.

“We suggest that our findings highlight the negative impact that increased youth e-cigarette use had on current teenage cigarette smoking,” they concluded.

Joe Dunne, who owns a vape retailing business, and is the spokesman for the lobbying group Respect Vapers, has a different position on vaping and cigarette smoking.

Dunne left his role with Vape Business Ireland and set up Respect Vapers to represent those who use vaping products to help them quit smoking

There are 250,000 people in Ireland who have managed to stop smoking cigarettes by replacing their habit with vaping, he said, adding that studies have shown that vaping is at least 95 per cent less harmful than smoking. The often-made suggestion that e-cigarette companies are owned by the tobacco companies “couldn’t be further from the truth”, he said.

Dunne was formerly a spokesman for Vape Business Ireland, a lobbying group that says its membership is open to any business involved in the manufacture, supply, distribution or sale of vaping products. He told The Irish Times that he left his role with Vape Business Ireland and set up Respect Vapers to represent those who use vaping products to help them quit smoking.

Both vaping organisations have a position on the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill, which would ban the sale of e-cigarettes to those aged under 18 years, and was recently before the Oireachtas health committee for pre-legislative scrutiny.

On its website, Vape Business Ireland says it has been calling for the 18 years-of-age threshold for a long time but adds that other elements of the proposed law that might restrict choice of vaping products “could result in consumers moving back towards smoking after making the switch to vaping”. A request for an interview with someone from Vape Business Ireland was met with no response.

Dunne is in favour of people having to be over 18 to buy vapes, and “wouldn’t be against” the age threshold being raised to 21, but he is against vape flavours other than tobacco being banned.

The Bill that is before the Oireachtas does not include a ban on all flavours bar tobacco

“When people give up smoking, they get their tastebuds back, and they don’t like the taste of tobacco. Flavours are not there to target teenagers and vapes are not a gateway to cigarette smoking. If flavours go tomorrow, 62 per cent of vape users will go back to smoking.”

The Bill that is before the Oireachtas does not include a ban on all flavours bar tobacco. Macey thinks it should, because he believes the huge range of flavours that currently exist are being used to target young people.

When asked, Dunne confirmed that Respect Vapers is funded by the Wexford-based entity, the Edmund Burke Institute. Dunne said he did not know much about the Washington DC-based foundation, the Atlas Network, which provides funding to the Edmund Burke Institute.

The Atlas Network, which funds and supports hundreds of partner organisations around the world, promotes anti-regulation “libertarian” political views. It has been shown to have links with the tobacco sector, the billionaire Koch brothers, the oil industry, and think tanks that support libertarian and anti-regulation attitudes.

A 2017 study published in the International Journal of Health Planning and Management said the Atlas Network was a “strategic ally of the tobacco industry” and that there was a “coherent strategy by the tobacco industry to work with Atlas to influence public health policies from multiple directions”.

The Vape Business Ireland website shows that current members include Vuse, a subsidiary of British American Tobacco, IQOS, a subsidiary of Altria (previously Philip Morris), and Juul Labs, which is 35 per cent owned by Altria.

E-cigarettes are allowing tobacco companies introduce a whole new generation to nicotine addiction, Macey said

Vape Business Ireland is run by an international public affairs consultancy called Instinctif Partners, which has its headquarters in London and offices around the world, including on Merrion Square, Dublin. According to the University of Bath-based organisation, Tobacco Tactics, Instinctif Partners worked for Imperial Tobacco on an EU campaign for "smarter vaping regulations".

During an appearance before the Oireachtas Joint Committee on Health in November, Macey argued that four measures were needed to help resume the downward direction of smoking prevalence among the young. These were to: increase the legal age for the sale of cigarettes and e-cigarettes to 21; outlaw all e-cigarette flavours bar tobacco; ban all e-cigarette advertising; and introduce mandatory plain packaging for e-cigarettes.

“We risk losing the hard-won gains of the past 25 years, as the world’s big tobacco firms that now control much of Ireland’s vaping market, seek to addict a new generation of young people to nicotine,” he told the politicians.

The vaping sector’s marketing tools are almost 100 per cent directed at young people, he said, “because if young people are not addicted, there is no business model”.

E-cigarettes are allowing tobacco companies introduce a whole new generation to nicotine addiction, Macey said.

"Would Malboro manufacturer Altria have paid €12.8 billion for a 35 per cent stake in [vape business] Juul Labs just to help long-term smokers quit, ultimately putting itself out of business. Of course not."