Sugar and spice and all things nice: How e-cigarette brands target girls

The use of e-cigarettes among teenagers and young adults is continuing to rise, with Thai girls in particular being tempted by clever marketing tactics to pick up the habit early and carry it forward into adulthood.

Vaping might look cool but it is also dangerous, so much so that reproductive health experts are stepping up their warnings about the dangers of vaping in pregnancy.

Vaping is not safe for you and your baby

Emeritus Clinical Professor Dr. Vitaya Titapant, president of the Royal Thai College of Obstetricians and Gynecologists, stresses that e-cigarettes are not safe to use during pregnancy. They are harmful to the mothers and their unborn babies.

Vaping while pregnant can have adverse effects on the placenta, he said, explaining that the nicotine, carbon monoxide and other toxic substances in vapes can pass through the placenta. These chemicals may impair the placental function, which can lead to pregnancy complications including miscarriage and premature delivery.

“If you vape during pregnancy, you are more likely to give birth too early. And being born preterm increases the baby’s risk of dying. This is because the body’s organs are not yet fully developed,” the doctor said.

He was speaking in a seminar entitled “Younger Females are the Target Audience for E-Cigarettes” at a hotel in Bangkok earlier this month.

When the mother is exposed to the harmful substances in vaping and e-cigarettes, he added, the placenta may develop in the wrong location in some cases. For example, it may attach itself too deep in the uterus wall or may cover the cervix.

“These disorders can lead to bleeding. Heavy bleeding after giving birth can kill the mother,” he said.

According to him, the placenta normally attaches to the top of the uterus.

When the mother smokes or vapes a lot while pregnant, Dr. Vitaya noted, she would have high blood pressure, swelling in some organs and too much protein in her urine.

“These symptoms and conditions, in severe cases, can lead to serious complications. They may cause seizures, a stroke and even death,” the doctor said, adding that the symptoms vary from person to person and can range from mild to severe.

Exposure to the dangerous chemicals in e-cigarettes and vaping affect an unborn baby’s development, Dr. Vitaya said, adding that they lower the amount of oxygen and nutrients available to a developing fetus.

If the deprivation is severe, the baby dies.

Mothers who vape are likely to give birth to a low birth weight baby. And babies with low birth weight are at great risk of developing chronic diseases including diabetes, high blood pressure and chronic kidney disease when they grow up.

Some of the babies may have developmental delays, which can affect their physical and cognitive skills as well as emotional and mental growth.

“They may have poor balance and lack of coordination. For example, they may appear awkward, clumsy and fall over a lot. When they have grown up, some may have problems with thinking and memory, depression and mood disorders. Many have a lower intelligence quotient,” the doctor said.

A sharp rise in use of e-cigarettes among Thai girls

Data from the National Statistics Office show smoking rates among Thai women in 2021 dropped to 1.3% compared to 34.7% for Thai men.

The decline of smoking rates was driven by Thailand’s cigarette consumption policy and increased public awareness about the negative consequences of smoking.

Now, vaping is increasingly rampant among Thai youth despite being banned.

A 2022 national-scale survey revealed that 15% of Thai girls aged 13-15 used e-cigarettes, which was ten times higher than using tobacco. 20.2% of Thai men surveyed said they vape.

“E-cigarette brands are trying to target younger female consumers. They pick flavors that attract girls, which entices them to try it and become addicted to it easily,” said Assist. Prof. Sarunya Benjakul of Mahidol University’s Faculty of Public Health.

Social media are blamed for smoking and vaping among Thai teenagers.

Thailand’s Global Youth Tobacco Survey in 2022 showed that 6 in 10 (around 61.3%) students said they noticed tobacco cigarettes and e-cigarette advertisements or promotions through content on social media channels.

The number of students who had been offered a free tobacco product from a tobacco and e-cigarettes company representative increased from 7.3% in 2015 to 11.1% in 2022.

Emeritus Professor Dr. Prakit Vathesatogkit, president of the Action on Smoking and Health Foundation noted that women who started using tobacco and e-cigarettes products have more difficulty quitting them than men.

“It may be tougher for women to quit smoking and vaping. Once becoming addicted to vaping, female users have a higher risk for vaping-related health problems than male users do because of sex hormones,” the doctor said.

Younger women – the target audience for e-cigarettes

Tobacco companies and e-cigarette brands are using marketing strategies to target younger female consumers, Assoc. Prof. Dr. Roengrudee Patanavanich, a lecturer at the Department of Community Medicine from Ramathibodi Hospital’s medical faculty, noted.

“They use tactics to equate smoking with gender equality to market their products to women,” she said.

Many are also using other techniques that include emotional appeal, celebrity endorsement, product testing, introducing appealing flavors, and sponsoring events on social platforms to hook them.

“Brands, for example, tout their product as being modern and glamorous and make an association with freedom, fun and health-consciousness. They use female influencers to review their products. They invite them to take part in recreational activities and sports events. They offer a free sample to them. And that leads to false advertisements,” Dr. Roengrudee said.

The lecturer also debunked some of myths about vaping.

One of the most common claims is that vaping is better than smoking when pregnant.

In fact, she said, the safest option is to not smoke and vape at all, when pregnant. Exposure to hazardous chemicals in tobacco smoke and e-cigarette vapor harm both the mothers and fetuses.

Advertising, she added, also makes vaping an effective method to help people lose weight, but it’s not true.

“Vaping is not a healthy way to deal with weight loss. Honestly, it may have short-and-long term effects on your health,” Dr. Roengrudee said.

Another popular claim is that e-cigarette is a stress reliever.

She debunked that myth too, saying vaping doesn’t help you cope with stress and difficult emotions. In fact, it can worsen the feeling of stress. And using e-cigarettes can have short-and long-term health consequences.

With the alarming rise of Thai girls and young female adults using e-cigarettes, Dr. Roengrudee is calling on the policymakers to spend time deliberating the e-cigarettes policy to avoid damage.

“Vaping is the new wave of nicotine addiction. All parties need to work together to help teens stay nicotine-free,” she said.

“It smells nice, like you’re inhaling sweet fruit”

Pum (not her real name) was a heavy vaper. The 15-year-old student who studies in a local school in Amnat Charoen province found the sweet and fruity flavors of vapes appealing. She often saw friends vaping while hanging out at school and that made her want to try them.

“I just wanted to know what it’s like. So, I was like ask my friends ‘can I have a try? It’s not a bad thing to try once. When I vaped, it smelled nice, like you’re inhaling sweet fruit. It’s refreshing and makes me feel happy,” she says.

Pum had never smoked but started vaping when she was just 10 without being aware of what she was inhaling.

“I didn’t know it was nicotine at that time. I got really dizzy,” she recalls.

She had tried vaping again with her friends at school. Before long, she had an e-cigarette device of her own and vaped whenever she could even when her friends were not around.

She enjoyed the grape and cola-flavored nicotine the most, she says, adding that she only smoked around the school’s toilets, away from her mother and grandmother’s prying eyes.

“I did not do it at home. It was not allowed,” Pum says.

She developed a habit and become addicted to vaping. She had spent her pocket money on the device and juices. She got her supply through her friend who buys them from a Facebook page.

Pum continued to vape through the day for about four years. A few months ago, she was rushed to a provincial hospital unable to breathe. She spent many days in a coma.

A doctor who diagnosed her said she had a serious lung condition. Fortunately, thanks to the efforts of the medical staff, she made a full recovery. “I almost died. I should never start vaping,” Pum says today.

Vaping is illegal in Thailand. Anyone who sells e-cigarettes and related equipment could face a three-year jail term, a maximum fine of 600,000 baht, or both.

An importer could be jailed for at least ten years and fined five times the cost of the imported items. Buyers can also be jailed for at least five years and fined four times the cost of the items they had bought.