Environment Scan on Adolescent Vaping in Canada

Currently there are very few true environmental scan articles for adolescent vaping. An article by Cole et al., (2020) has some elements of an environmental scan. 

Cole, A.G., Aleyan, S., Battista, K. et al. Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study. Can J Public Health 112, 60–69 (2021). https://doi.org/10.17269/s41997-020-00389-0

The article titled “Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study” by Cole et al., (2020) although not labelled an “environmental scan” explicitly, fulfills many of the characteristics in an environmental scan. The article highlights the prevalence, product/market shifts, and behavioural trends in the youth population with respects to vaping. This peer-reviewed study examines trends in youth e-cigarette and cigarette use across four Canadian provinces (British Columbia, Alberta, Ontario, and Quebec) using data from the COMPASS school-based surveillance system. Using data from more than 78,000 students in grades 9–12, Cole et al., (2020) assessed changes in ever-use and current use of both e-cigarettes and cigarettes between 2013–2014 and 2018–2019. The authors found an increase in youth e-cigarette use—from 8.4% to 29.4% ever-use and from 4.3% to 15% current use. Additionally, Cole et al., (2020) found that cigarette smoking remained stable or declined modestly. Additionally, Cole et al., (2020) highlight that vaping has rapidly replaced smoking as the dominant form of nicotine use among Canadian youth and emphasizes the need for stronger policy interventions and educational campaigns to counter youth uptake. This paper provides valuable data for health promotion practitioners as it reports demographic breakdowns, province-level variations, and compares vaping vs cigarette use. Additionally, this study provides context regarding policy changes and market shifts. Cole er al., (2020) highlight national and provincial tobacco control strategies and emerging gaps in youth protection policies. However, this article has some limitations, mainly as it is not a true environmental scan. The article by Cole et al., (2020) mainly focuses its study on quantitative trends in vaping prevalence and does not place much attention on environmental aspects such as social determinants of health, marketing exposure, social media and retail products. Additionally, this article does not incorporate qualitative data from youth to explore why vaping behaviors have changed. Exploring this could help enhance the understanding of situational components associated with youth vaping. Lastly, only four provinces were included, omitting many Canadian provinces and territories. As a result, this does not give a true reflect of Canada. This study does not take into account of the northern and Atlantic regions, where social contexts may differ and regulation/policies surrounding vaping may differ. Overall, Cole et al. (2021) offers strong evidence surrounding the vaping prevalence among Canadian youth but lacks the multi-sectoral, socio-ecological, and policy depth expected in a full environmental scan. This study does give health promotion practitioners relevant information that can be utilized to address the health issue of youth vaping.

References: 

Cole, A.G., Aleyan, S., Battista, K. et al. Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study. Can J Public Health 112, 60–69 (2021). https://doi.org/10.17269/s41997-020-00389-0

Guiding Questions for Stakeholder Identification.

When assessing, planning, implementing, and evaluating health promotion initiatives, a key consideration that needs to be addressed is who are the stakeholders. Bartholomew Eldridge et al. (2016) provide a comprehensive set of questions to consider when identifying and recruiting stakeholders. Utilizing these set of questions for decreasing vaping prevalence and uptake in adolescent teens and adolescent adults, I was able to generate the following information:

Health Promotion issue/opportunity: Decreasing Vaping prevalence and uptake in adolescent teens and adolescent adults.

Planning Group Need	Questions to Consider
Expertise in the health problem or its causes	Who has content knowledge relative to the health problem or its causes? Public health researchers, addiction specialists, epidemiologists, Respirologist, Respiratory Therapist, and youth behaviour experts. What disciplines can be most helpful in describing problems from an ecological perspective? Public health, behavioural science, health promotion, psychology, education, and social work. Who knows about similar problems? Tobacco prevention specialists, school health coordinators, healthcare workers and professionals involved in substance use prevention programs. Who is well respected for knowledge of this health problem or others like it? Canadian Lung Association, BC Lung Foundation, Health Canada’s Tobacco Control Directorate, BC Centre for Disease Control (BCCDC). Who has worked on a similar needs assessment or program? Local public health authorities (e.g. Fraser Health), Heart and Stroke Foundation, Canadian Lung Association (Quash and Crush the Crave), BC Lung Foundation (QuitNow) and provincial school-based prevention initiatives (e.g., Erase Vaping program).
Diverse perspectives and community participation	Who has needs and perspectives related to the problem? Adolescent teens, Adolescent adults, parents, educators, and community health workers. When programs are developed related to the needs and problems, who are the potential clients, participants, or beneficiaries? Adolescent teens and Adolescent adults aged 13–24, Adolescent teens in high school, young adults in post-secondary institutions, and families affected by vaping-related harms. Who already works with potential beneficiaries? School counsellors, youth mentors, primary care providers, community youth organizations, health organizations such as BC lung Foundation/Canadian Lung Association. Who can help the planning group clarify values related to the needs assessment and intervention development? Current Vapers, Youth advisory councils, Indigenous community representatives, LGBTQ2+ representatives, cultural liaison workers, and public health advisors. Who are the potential critics of the program or initiative? Vape retailers, industry lobby groups, and youth who perceive vaping as a socially acceptable or low-risk behaviour.
Responsibility and authority	Who will manage the needs assessment and program development? Regional health authorities in collaboration with schools and community partnerships. Who is the funder? Health Canada, BC Ministry of Health, and possibly community grants or foundations. Who can become a partner in the assessment and program development? Schools, parent advisory councils, local municipalities, non-profit health organizations, and Indigenous health bodies. Who can bring resources to the endeavor? Educational institutions, local media partners, health organizations such as BC Lung Foundation, and government-funded public health campaigns.
Influence	Who has served as a resource to community members for this problem or related ones? Public health nurses, Community Respiratory therapists, community wellness coordinators, and local harm reduction teams. What policy makers have worked on this type of problem? Health Canada regulatory staff, provincial MLAs on health committees, and municipal bylaw officers involved in vaping restrictions. Who are opinion leaders who might have an interest in this type of problem? School principals, youth advocates, social media influencers, healthcare professionals and community leaders. Who can help the planning team access expertise and other resources of the community? Local health units, recreation centres, and community service organizations. Who can garner support and buy-in to the project? Parent associations, student councils, local media, and respected healthcare providers.
Commitment to the issue	Who will want to help the needs assessment team develop and disseminate its conclusions? Public health agencies, school boards, and academic researchers Who might advocate for the assessment and intervention development? Health organizations, youth-led advocacy groups, and local governments. Who has been working on the problem from a practice perspective? School health programs, public health nurses, community Respiratory Therapists, and community addiction counsellors. Who has been working on the problem from a research perspective? BCCDC, academic researchers studying youth vaping trends and interventions. Who could bring creative energy to the project? Youth ambassadors, media specialists, communication specialists, and artists engaged in social media marketing campaigns.

 Answering these questions have helped guide my research and planning for this health promotion topic. By highlighting stakeholders, I am able to collaborate with these individuals/parties to create effective health promotion initiatives.

Thanks,

Vicky

References:

Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Fernández, M. E., Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: an intervention mapping approach. John Wiley & Sons.

Final Reflection

As I reflect on my time in this course, I only have positive thoughts and comments. I am grateful for the exponential amount of learning that took place. I have gained a better understanding of how to design, implement and evaluate health promotion programs. Additionally, I have learned the importance of utilizing theories, frameworks, and models when developing health promotion programs.

During this course, the greatest discovery for myself came through Assignment two. Creating an infographic was an extremely valuable skill. Through this assignment, I was able to develop clear communication skills to educate target populations. Furthermore, this assignment help reinforce critical thinking skills in identifying areas of need, gathering relevant background information and displaying it in a manner that is eye catching for individuals.

The most powerful learning experience for myself occurred working through the 3 assignments. Utilizing the feedback, I received from Assignment 1, I was able to take a generalized approach to adolescent vaping and focus my topic into a specific target population. Additionally, I was able to develop a much more focused intervention. This translated into a much more polished and focused infographic. Furthermore, I was able to take the feedback from Assignment 2 and utilize it during the final assignment. Instead of relying heavily on the socio-ecological model, I incorporated multiple theories, models and frameworks when developing my own proposed health promotion model. This process was eye-opening, as it highlighted how much I had learned throughout the course and the importance of utilizing multiple concepts when developing effective health promotion strategies.

This journey through this course has been so invaluable. Overall, this course has increased my dedication in utilizing evidence-based theories, models and frameworks when developing health promotion strategies. This course has inspired me to continue to advocate and promote the health and wellbeing of my patients by using health promotion strategies.