What are the harms of vaping in young people who have never smoked?

An increase in youth vaping has raised concerns, particularly for young people who have never smoked. However, most vaping by never-smokers is occasional and transient and frequent vaping by never-smokers is rare. Vaping is not risk-free but there is limited evidence of significant harm so far to young people who vape. There is weak evidence that vaping is a gateway to smoking. In fact, the evidence suggests that vaping is diverting young people away from smoking overall and is displacing smoking at a population level. The risk of nicotine dependence is very low in never-smokers who vape. Vaping is likely to be beneficial to young smokers who switch to vaping. Policy measures to reduce vaping are discussed. A tightly regulated, risk-proportionate consumer model is recommended to restrict vaping by young people while allowing easy access for adult smokers, for whom it is an effective and popular quitting aid.

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Déclaration de conflit d'intérêts

Declarations of Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Colin Paul Mendelsohn C.P.M. was an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a registered health promotion charity, from October 2017 to January 2021. ATHRA accepted unconditional seed funding from the vape retail industry to become established. Funding ceased in March 2019. C.P.M. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017. C.P.M. is the author of Stop Smoking Start Vaping, published by Aurora Press. C.P.M. has never received payments from electronic cigarette or tobacco companies. Wayne Hall No competing interests.