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

Abstract

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.