Electronic Cigarettes Boom? Reasons for the Massive Rise in Pakistan and Globally
ABSTRACT In our previous article on electronic cigarettes, we identified a shift in consumption patterns within vice products, highlighting a drastic move toward e-cigarette use. This article focuses on understanding the social, economic, and psychological reasons behind this significant rise in consumption, supported by peer-reviewed studies and credible academic sources. REASONS FOR THIS MASSIVE BOOM According to the 2024 National Youth Tobacco Survey (NYTS) conducted by the CDC, e-cigarette use among youth remains a severe public health threat. The survey found that 5.9% of middle and high school students — equivalent to 1.63 million individuals — reported current use of e-cigarettes in 2024. Alarmingly, 38.4% of these users reported frequent use, while 26.3% reported daily use, indicating signs of nicotine addiction. (Velayutham, 2025) A REMEDY FOR ADDICTIVE SMOKING? Although several factors have contributed to the rising consumption of e-cigarettes, one of the main drivers was the belief that they were harmless, or at least less harmful than traditional cigarettes. When e-cigarettes were introduced into the market, many countries, including the UK, initially viewed them as a safer alternative that could support the goal of becoming a smoke-free state. In some cases, the NHS promoted e-cigarettes as a tool to help long-term smokers quit conventional smoking. However, this created a wider misconception around e-cigarettes, especially among young people and even health science students. Many developed knowledge gaps regarding their chemical composition, addictive potential, and possible health risks. As a result, a vice product promoted as a harm-reduction tool became normalised. (Rocha-Ávila, Núñez-Baila and González-López, 2025) The misconception surrounding e-cigarettes even extended to regulatory authorities. Many economies welcomed the vice product with lenient policies, which became an increasing driver of higher consumption. Countries with limited regulations or poorly enforced policies often demonstrate a greater prevalence of e-cigarette use — an observation supported by a systematic review conducted across Southeast Asia. (Jayasinghe et al., 2025) This same pattern was evident in Pakistan. A study conducted in Peshawar found that 10.4% of respondents believed e-cigarettes are not harmful at all, while 39.1% considered them less harmful than conventional cigarettes. (Awan et al., 2025) AGGRESSIVE MARKETING? With the rapid evolution of marketing trends, social media has emerged as a significant channel through which businesses promote their products and services. Adolescents and young people, particularly those aged 13-17, constitute a large proportion of social media users across Asia and the United States, and this age group often perceives social media influencers as trustworthy and credible sources of information. Consequently, influencers have played an important role in the promotion of e-cigarettes, frequently presenting them favourably while providing limited information about potential health risks, often without adequate age restrictions or warning messages. (Jaffar et al., 2025) Platforms like Instagram and TikTok further amplify vaping's appeal by portraying it as fashionable and harmless, encouraging adolescents to initiate use. (Basit et al., 2025) A similarly aggressive marketing pattern is visible in Pakistan, where e-cigarettes are openly promoted via print and electronic media and portrayed as a risk-free alternative or smoking-cessation tool. (Jayasinghe et al., 2025) The widespread use of e-cigarettes among young people has been driven by the intensive promotion of flavoured e-liquids, the ease of purchasing products online, and weaknesses in existing regulation and enforcement — together increasing the likelihood of adoption, particularly among adolescents and young adults. (Jayasinghe et al., 2025) INADEQUATE POLICIES? Weak policy is a direct driver of rising e-cigarette consumption. In Pakistan specifically, comparatively liberal restrictions on vaping's use, advertising, promotion, sponsorship, and packaging have made it more accessible to a wider population. (Basit et al., 2025) There are, for example, no age restrictions on purchasing e-cigarettes in Pakistan, and no policy prevents under-18s from accessing them. Import restrictions on flavourings from China are minimal, keeping flavoured e-liquids widely available and appealing — particularly to the youth who remain the primary target demographic. Weak economic regulation — including the absence of taxation — has kept prices low compared to cigarettes, a statistically proven major determinant of e-cigarette use. (Jayasinghe et al., 2025) Regulation of the design, display, marketing, and sale of e-cigarettes also remains limited. In Pakistan, devices are often showcased in high-end retail outlets alongside recognised national and international brands, projecting an image of prestige, while e-liquid flavours and refills remain readily available through small local shops — a combination of premium branding and easy accessibility that likely contributes to growing acceptance among young people. According to Awan et al. (2025), e-cigarettes' compact design, ease of concealment, and wide range of flavours further add to their appeal among youth. In Pakistan, state disengagement from this space is particularly concerning, as the vaping market continues to expand with little regulatory oversight. FEAR OF MISSING OUT? Another prominent factor behind e-cigarette initiation among youth is peer influence. (Rocha-Ávila, Núñez-Baila and González-López, 2025) Exposure to peers who vape can normalise the behaviour, increasing the likelihood of adoption — adolescents may perceive vaping as a social norm and fear exclusion if they don't participate. According to Jayasinghe et al. (2025), peer influence and social acceptance are the main contributing factors in e-cigarette use, with influence from both friends and family members serving as significant determinants. Educational status is also associated with use: individuals with a bachelor's degree or higher report greater rates of e-cigarette use than those with lower education levels (Awan et al., 2025) — plausibly because higher education is linked to the transition into university life, itself identified as a key driver of e-cigarette initiation. (Rocha-Ávila, Núñez-Baila and González-López, 2025) REFERENCES Velayutham, D., 2025. The Rise of E-Cigarettes and Vaping: Health Risks and Policy Implications. Pakistan Journal of Health Sciences, 6(3), p.1. Rocha-Ávila, L.-R., Núñez-Baila, M.-Á. and González-López, J.R., 2025. E-Cigarette Use Among University Students: A Structured Literature Review of Health Risks, Behavioral and Social Determinants, and Nursing Implications. Healthcare, 13(21), p.2150. Jayasinghe, Y.A., Ratnapreya, S., Nawarathna, G., Peiris, P.M., Kanmodi, K.K. and Jayasinghe, R., 2025. Prevalence and determinants of e-cigarette use in South Asia: a systematic review. BMJ Global Health, 10, e018363. Awan, B., Khan, M.H., Khan, M.T., Afridi, I., Khan, M.Q. and Khalil, K.U.R., 2025. Perception and use of e-cigarettes among different age groups in the general population of Peshawar, Pakistan: A cross-sectional study. Journal of Saidu Medical College, 15(3), pp.346-354. Jaffar, N., Siddiqui, H.T., Amin, H. and Haque, M.A., 2025. Vaping — An emerging threat to youngsters of Pakistan. Addiction Biology, 30, e70017. Basit, A., Javed, S., Mehmood, Q., Hammad, M.A., Farzeela and Basil, A.M., 2025. Rising trend of e-cigarettes among adolescents of Pakistan and cardiovascular implications of electronic nicotine delivery systems. World Journal of Cardiology, 17(6), p.108567.