According to the Drug, Tobacco, and Alcohol Control Department, the survey of European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 2019 has shown that around 90% of 15-16 year olds acknowledge varying degrees of risk associated with smoking conventional tobacco products. However, as many as 72% dismiss the risks of occasional vaping or consider the risks associated with electronic cigarettes to be minimal.

A 2023 survey of Lithuanians aged 15-74, commissioned by the Drug, Tobacco, and Alcohol Control Department, revealed that some young Lithuanians are still unaware of the harmful effects associated with electronic cigarettes. In 2023, 19.2% of young people aged 15-24 considered electronic cigarettes as non-addictive, while 25.9% believed they posed no harm to others. Among those young people aged 15-24 who had used electronic cigarettes within the past 30 days, as many as 27.2% endorsed the false claim that electronic cigarettes are non-addictive, while 39.9% perceived them as not harmful to others.

The fact that only a small number of young people are aware of the risks and actual harms associated with electronic cigarettes is clearly illustrated by the responses of the young respondents.

"I have noticed that vaping is quite popular among young people. It is prevalent in my social environment and in public settings in general. I will not deny that I occasionally vape myself, but I can assure that I do not have an addiction," confessed one young man.

"It seems that we, young people, who smoke electronic cigarettes, overlook the potential harm. It just become a habit," acknowledged a young woman.

As previously discussed by "My Impact", unfortunately, the health effects of electronic cigarettes are often underestimated, and not every young person considers their potential harm. According to cardiologist Professor Raimondas Kubilius, despite the fact that the European Society of Cardiology has been consistently emphasizing the catastrophic effects of any form of smoking, electronic cigarettes are frequently perceived as entirely harmless or at least less harmful than conventional ones.

"Electronic cigarettes, as they are presented as innovative, modern and fashionable, seem very alluring to adolescents and young people, who associates them not only with having fun, relaxation or stress relief. However, the truth is that they are highly harmful to individual’s health," explains Kubilius.

According to the cardiologist, there is one more trap electronic cigarettes try to lure us in.

"Unlike traditional cigarettes, an electronic cigarette never burns down, thus, the duration of a single smoking session can be significantly extended. Over the past decade, during the electronic cigarette boom, negative effects on many body systems have been observed. Worst of all, we still do not know what the long-term health effects will be in 5, 10 or 15 years, as electronic cigarettes accumulate in cells, disrupt their function, cause genetic damage to cells and that accumulative damage is happening every day," warned the cardiologist.

And scientifically based data tells it all.

"A study by American oncologists a few years ago revealed that when laboratory mice were exposed to electronic cigarette aerosol for 54 weeks, one in five of them developed lung cancer, and one in two developed pre-cancerous conditions of the urinary tract. 54 weeks of vaping for a mouse would be equivalent to 3-6 years of smoking electronic cigarettes for a human being," concluded Kubilius.

As cardiologist Kubilius has emphasised, there is no longer any doubt about the health risks of electronic cigarettes, but the most important thing is to made those who, despite the threat to their health or even their lives, still harm themselves with various psychoactive substances, to reconsider their choices.

"This year’s research analysis by the American Heart Association highlights the profoundly negative effects of electronic cigarettes on the heart and respiratory system. Even more alarming is the growing number of users: in just a few years, the number of electronic cigarette smokers has doubled (comparing 2017 and 2019). Despite the absence of long-term results on the effects of electronic cigarette smoking, the research evidence is already compelling," emphasizes the professor and provides some specific examples.

According to the cardiologist, electronic cigarettes cause premature changes in the blood vessel walls, such as stiffening of the blood vessels (hardening of the walls) and endothelial dysfunction, leading to an increase in arterial blood pressure and heart rate.

"All these changes induce other vascular pathologies and increase the risk of developing cardiovascular disease. The long-term effects of electronic cigarettes are also associated with an increase in sympathetic system tone: daily vaping for at least 30 minutes leads to a pulse increase," explains Kubilius.

As the cardiologist pointed out, the vast majority of electronic cigarette users are teenagers or young adults, whose lung and heart systems are not yet fully developed, and for whom the effects of vaping are particularly harmful.

"Several large studies in recent years have shown that nearly one in five electronic cigarette smoker is likely to suffer an acute myocardial infarction. In addition, if an electronic cigarette is smoked for more than 30 minutes, it has an adverse effect on the stiffening of the vascular wall, which is the same as smoking a regular cigarette," concluded Kubilius.

When asked why are tempted to try electronic cigarettes, young people provided several insights.

"I am not entirely sure. My social circle does influences me, or maybe I do not have enough willpower to resist harmful habits", expressed one young man.

"In my upbringing, I was often surrounded by smokers, that is, within my family. Maybe this is the reason why in my teenage years I have developed the perception that smoking is not so bad as it is made out to be, although I realise that this is just a kind of excuse," reflected a young woman.

According to the Drug, Tobacco, and Alcohol Control Department, the primary reason why young people opt for electronic cigarettes is their appealing flavours.

"These products do not have the unpleasant odour of traditional cigarettes, they have an attractive appearance, and vapour can be puffed in various ways. However, only a few consider the potential long-term harm of vaping. Electronic cigarettes are also often preferred to traditional ones as they are falsely perceived as a healthier alternative to traditional tobacco products or as a means to help people quit smoking. Although our understanding of electronic cigarette safety is incomplete and long-term follow-up and studies are needed, existing research has already revealed toxic effects of vaping on the heart and lungs. Furthermore, there are no scientific evidence that electronic cigarettes could help people quit smoking," the Department emphasised.

Additionally, according to the Drug, Tobacco, and Alcohol Control Department, whether minors will get interested in, buy and experiment with electronic cigarettes primarily depends on the attitudes of their surrounding environment, such as family beliefs.

"It is not only the state who is obliged to protect children by law; parents must also to be responsible and clearly draw the line that electronic cigarettes are not suitable for children," the comment said.

According to the Drug, Tobacco, and Alcohol Control Department, the results of the European School Survey on Alcohol and Other Psychoactive Substances, which is conducted every four years in schools, revealed that in 2019 65% of 15-16 year olds in Lithuania have tried electronic cigarettes at least once in their lifetime. 49% of students have used electronic cigarettes at least once in the past year, 31% have smoked them at least once in the past month, and 14% have used them daily or almost daily.

"The number of schoolchildren who have smoked an electronic cigarette at least once in their lifetime has increased from 46% in 2015 to 65% in 2019, one of the highest in Europe (in 2019, the European School Survey on Alcohol and Other Psychoactive Substances countries had average of 40%, and Lithuania had 65%). According to the 2019 survey, students aged 15-16 years old had tried their first electronic cigarette at the age of 13.9 years on average. As many as 19.5% of students who have smoked electronic cigarettes at least once in their lifetime tried their first vape at the age of 13 or even younger," the representatives of the European School Survey on Alcohol, and Other Psychoactive Substances explained.

As the commentary of the Drug, Tobacco, and Alcohol Control Department indicates, the proportion of schoolchildren who had their first electronic cigarette before the age of 13 has increased compared to previous survey results, and the proportion of schoolchildren who started smoking electronic cigarettes at a very young age is higher in Lithuania than the European average (7% in 2015, 19.5% in 2019; the average for the European School Survey on Alcohol and Other Psychoactive Substances countries is 11% for 2019).

"The proportion of schoolchildren aged 13 and younger who have started smoking electronic cigarettes regularly has also increased (2% in 2015, 2.7% in 2019, the average for the European School Survey on Alcohol, and Other Psychoactive Substances countries is average 1.7% in 2019). In 2019, the majority of respondents (three quarters) indicated curiosity as the most prominent motivation for trying an electronic cigarette for the first time. One third named the influence from their friends. Few (3.1%) have tried electronic cigarettes to quit smoking conventional tobacco products. A new study by the European School Survey on Alcohol and Other Psychoactive Substances is planned for 2024," the Department said.

Meanwhile, a 2023 survey of the Lithuanian population aged 15-74, commissioned by the Drug, Tobacco, and Alcohol Control Department, found that vaping among young people is more prevalent than in other age groups, and that electronic cigarette use in the 15-24 years age group outpaces smoking traditional tobacco products, while traditional cigarettes remain the most popular among the older age group. According to the survey, in 2023, 29.3% of young people aged 15-24 smoked electronic cigarettes at least once in the last 30 days, while 18.9% of young people aged 15-24 smoked traditional cigarettes at least once in the last 30 days.

"Among young individuals aged 15-24 who have tried vaping, 21.1% have never smoked traditional cigarettes in their lives. Some of Lithuania’s young people are still unaware of the harm caused by vaping. In 2023, 19.2% of young people aged 15-24 said that electronic cigarettes are non-addictive, while 25.9% thought that electronic cigarettes are not harmful to others. Among young people aged 15-24 who had smoked electronic cigarettes in the past 30 days, as many as 27.2% agreed that electronic cigarettes are non-addictive, while 39.9% thought that electronic cigarettes are not dangerous to others," the Drug, Tobacco, and Alcohol Control Department commented.

In recent years, the rapidly growing problem of vaping and the use of psychotropic substances in schools receives more and more attention. Representatives from the Drug, Tobacco, and Alcohol Control Department outlined efforts being made to address this problem.

"In order to assist schools in preventing the use of psychoactive substances, promoting the health of schoolchildren, fostering healthy lifestyles, and ensuring safety and social well-being, the Drug, Tobacco, and Alcohol Control Department has prepared a methodological guide – "Psychoactive Substances and the School: Guidelines for Prevention and Intervention". This guide aims at raising awareness of psychoactive substances within the school community, helping to identify the risks leading to the use of psychoactive substances, identifying protective factors, and educating on recognising warning signs of student substance use or influence," stated the commentary.

Additionally, the guide and the guidelines provide information on actions to reduce the use of psychoactive substances among pupils and offers a recommended sequence of actions for school staff in the event of intoxication or poisoning by psychoactive substances at schools.

"These guidelines are based on the recommendations from international organisations and best practice from other countries. The recommendations have been distributed to all Lithuanian schools and Public Health Offices. Recently, schools have updated their internal documents regulating prevention of psychoactive substances, outlining the procedures for managing situations involving the use, possession, or distribution of psychoactive substance on school premises," added the Drug, Tobacco, and Alcohol Control Department.

As stated in the commentary, the Ministry of the Interior of the Republic of Lithuania has also taken appropriate actions.

"The Ministry of the Interior has launched a project for the implementation of a pilot model for preventing drug use and distribution by minors in schools. The aim is to develop and test a mechanism for preventing drug use and distribution in schools, thereby enhancing the safety of minors in and around educational institutions. The project is underway in selected schools in Vilnius City, Alytus City and Klaipėda District," stated the representatives of the Drug, Tobacco, and Alcohol Control Department.

As highlighted by the Drug, Tobacco, and Alcohol Control Department, in order to tackle the problem of electronic cigarettes among young people, not only legislators but also the environment of children should be involved. This included parents, relatives, or other adults in the lives of young individuals. However, according to the experts, parents in Lithuania are rather passive in preventing psychoactive substance use.

"When children start school, some parents may feel relieved to delegate some responsibility, assuming that the school will do all the work of educating their child, including prevention of psychoactive substance use. While school do a lot in educating about the effects and consequences of psychoactive substances, the role of parents remains paramount," emphasised the Drug, Tobacco, and Alcohol Control Department.

According to the Drug, Tobacco, and Alcohol Control Department, a strong bond between parents and children, based on attention, active listening, and appreciation can deter children from engaging in risky activities such as psychoactive substance use.

"Parents should monitor the child’s social behaviour, be aware of the company they keep, the environment the child spends time, and track their academic results. Parents should cultivate a negative attitude towards the use of psychoactive substances and establish clear rules and norms of behaviour, including consequences for non-compliance," the commentary said.