A Systematic Investigation of Interventions Preventing Vaping Among Adolescents: A Multiple Method Study

Abstract

Background: E-cigarettes, also known as vaping devices, are the most commonly used nicotine product among Ontario adolescents, with past year prevalence doubling from 11% to 23% between 2017 and 2019. Since vaping has the potential to lead to future nicotine dependence this escalating prevalence is deeply concerning. The overall aim of this thesis was to examine public health interventions targeting the prevention of adolescent vaping and to identify characteristics associated with vaping among Ontario adolescents. Objectives: 1) To identify existing public health interventions targeting the prevention of adolescent vaping; 2) to determine and compare regional (Greater Toronto Area (GTA), north, west, east) variations in adolescent vaping rates and associated characteristics among a population-based sample of Ontario students; 3) to examine Ontario public health professionals’ perceptions of adolescent vaping. Methods: A multiple method study was used for this thesis. To address Objective 1, a scoping review was conducted using Joanna Briggs Institute methodology. Objective 2, a case-control analysis using cross-sectional Ontario Student Drug Use and Health Survey data was performed. A qualitative collective case study was conducted to address Objective 3. Results: Vaping prevention interventions found in the literature and real-world practice included: school-based, community-based, media/web-based, and policies/regulations. Factors enabling prevention efforts included partnerships and collaborations, and funding. Characteristics associated with vaping included: identifying as male (OR=1.36, 95% CI=1.11, 1.67), being a high school student (OR=2.61, 95% CI=1.95, 3.49); engaging in three hours or more of daily social media (OR=5.57, 95% CI=3.54, 8.76), alcohol use (OR=3.54, 95% CI=2.85, 4.37), smoking (OR=4.76, 95% CI=3.10, 7.30), cannabis use (OR=10.66, 95% CI=8.11, 14.0), having Canadian born parents (OR=1.37, 95% CI=1.06, 1.77); and feeling a part of the school community (OR=1.35, 95% CI=1.08,1.70). Of regional significance, students in northern, western, or eastern Ontario had increased odds of past year vaping compared to those in the GTA. Conclusions: Urgent action is needed to prevent adolescent vaping and protect this generation from associated risks. Public health interventions tailored to local characteristics and contexts are essential for maximizing impact. Study findings offer valuable insights for shaping and implementing effective vaping prevention strategies, contributing to improved population health outcomes for adolescents.