Why do girls use e-cigarettes more than boys?

A potent mix of marketing and a mental health crisis in female teens is fueling the rise of young girls vaping in the UK. Data from the NHS shows e-cigarette use is now higher among girls aged 11-15 than boys. One in five 15-year-old girls currently use e-cigarettes, and girls are smoking more than their male peers, too – meaning they aren’t just swapping vapes for cigarettes. 

We’re going to look at the factors driving the increase in young girls vaping in the UK, and what can be done to address it.

Marketing tactics

Smoking used to be more common among men than women – but that has progressively narrowed, and this is at least partially due to marketing.

The taboo against women smoking changed in the early 20th century. Marketer, public relations expert and Sigmund Freud’s nephew, Edward Bernays, marketed cigarettes to women as ‘Torches of Freedom’. During New York City’s Easter Parade, Bernays encouraged women to march while holding cigarettes to protest gender inequality. This was a massive success, and marketers quickly started pushing cigarettes to women as socially desirable, emancipating, and as a slimming aid. However, as the link between smoking and cancer became clearer, smoking declined in both men and women.

Many of these themes reappear in vape marketing aimed at women, often from the same tobacco companies that promoted smoking as empowering, using similar concepts like independence, glamour and health. Tobacco giants like Philip Morris have sponsored fashion, beauty shows and women’s sports events to promote their vape products. Sponsoring sports promotes vaping as a healthier alternative – something women are more conscious of than men.

Body image

Studies have found an association between vaping and eating disorders. This is unsurprising, as nicotine is an appetite suppressant, and vape liquids flavoured like sweets are common. Boys are not immune to eating disorders, and rates of eating disorders among boys have doubled in recent years. However, girls still experience eating disorders at a much higher rate and are more anxious about their bodies.

Peer contagion

Harmful behaviours like drug addiction and cutting among adolescent girls can often spread amongst friendship groups. This has been studied in the context of anorexia, where groups of girls compete, swap tips and can worsen each other’s symptoms. Vaping may follow a similar trajectory, especially when coupled with intense pressure to stay thin and to hyperfocus on body image. This pressure is particularly intense in the age of social media, where images of others surround young girls, who are encouraged to post pictures of themselves and subjected to harsh and immediate criticism for not complying with harsh and rigid beauty standards. 

Mental health 

Over half of teenage girls suffer from mental health problems, and by 18, girls in the UK are twice as likely to suffer from poor mental health than boys. People who vape have double the odds of a diagnosis of depression than someone who has never vaped. A study of Australian youths found they believed vaping helped with stress and mental health- when in reality, consuming nicotine simply stops addiction symptoms like anxiousness and irritability temporarily.

Girls from poorer families are more likely to vape. This is reflected regionally, with the NHS data showing vaping is more prevalent in the north than in the affluent south. As poverty is significantly associated with poor mental health outcomes, girls from deprived areas are at the most risk of vaping-related harm. With taboos against female smoking and vaping at an all-time low, it’s unsurprising that vulnerable girls are turning to vaping to manage mental health symptoms.

Next steps

Because the link between vaping and poor mental health is so strong, interventions focused on addressing the mental health crisis in the UK’s teen girls should be prioritised.

The number of children in addiction treatment in the UK has drastically fallen since 2009 – but the concerning rise in vaping and mental health problems suggests this may have more to do with underfunded services than a decrease in adolescent drug and alcohol abuse. The UK’s Child and Adolescent Mental Health Service (CAMHS) is struggling to meet its current caseload, with 32% of all referrals currently being refused due to a lack of resources. Young people are being left to struggle alone, and these young people are disproportionately female.

It is too early to say if proposed measures like flavour bans, advertising restrictions, and youth access laws will do anything to address the gender disparity in young people vaping. There has been little research, and any measures introduced to curb vaping in young girls must be evidence-based: but restricting vape access to youths overall could help. However, without tackling aggressive marketing, poor mental health and body image issues, we risk abandoning teen girls to simply trade one addiction with another.