Kayitesi (not her real name), a 25-year-old Rwandan university graduate, told The New Times that when she was first introduced to e-cigarettes by her high school friends, in July 2021, they seemed like "the perfect way to fit in” without the associated risks of traditional cigarette smoking.

ALSO READ: Rwanda focuses on youth protection

"Everyone around me was using e-cigarettes and the smooth designs and flavored options made it seem harmless, even fun. I remember thinking, 'What could go wrong?' It felt like the safest way to be part of the in-crowd,” she said.

"But three years later, reality hit hard. What started as an occasional puff turned into an addiction. I could not go a day without it. Now I am diagnosed with a severe lung disease. Every time I breathe it is a struggle, and I am constantly reminded of the mistake I made.”

The tobacco industry's marketing strategy targeting youth appears relentless, as it persistently introduces and promotes products designed to appeal to young people.

ALSO READ: Smoking drops as high tobacco taxes take effect

According to reports, tobacco companies have, for decades, targeted children and teens – spending millions of dollars in marketing techniques, with schemes such as marketing candy, celebrity endorsement and misleading health claims contributing to tobacco youth addiction.

According to Rwanda Biomedical Center (RBC), in the country, there was a 5.8 per cent decrease in prevalence of tobacco smoking – from 12.9 % in 2013 to 7.1% in 2022.

People, especially the young, should be cautious and avoid the trending or tempting e-cigarettes as they gain popularity because they contain nicotine, says Dr Evariste Ntaganda, the Cardiovascular Disease Director at RBC.

According to Undo Tobacco Industry Damage (UNDO), a California Department of Public Health program that wants to undo the damage – poison, pollution, and prejudice – done by the tobacco industry, flavors such as menthol, Blue Razz, Banana Ice, and Arctic Cool Mint are created by the industry in electronic cigarettes (e-cigarettes) to mask the harsh taste of tobacco.

ALSO READ: Electronic cigarettes: Are they a safer alternative?

"Nicotine, whether delivered through traditional cigarettes, or vapes, is a highly addictive substance. In vaping products, the concentrated nicotine can be just as harmful, and sometimes even more, due to the ease with which users can consume high doses without realizing it,” said Ntaganda.

"Vape flavors, especially the sweet and fruity ones, act as a gateway for many users, particularly young people. The appealing flavors mask the harshness of nicotine, making it more attractive and easier to consume frequently, which in turn accelerates the path to addiction.”

Ntaganda said that the reality is that flavored vaping products tempt users in by creating the illusion that they are safer or less addictive than traditional cigarettes.

Impair blood circulation and damage joints

However, he noted, nicotine content is still potent enough to cause dependency, affecting brain development in young people and leading to long-term health risks such as heart diseases, lung cancer, oral cancer, and respiratory diseases.

ALSO READ: 30% of Rwandans exposed to tobacco smoke at home — study

Nicotine also affects the brain's reward system by creating a cycle where users seek more frequent and higher doses to achieve the same effect, said Ntaganda.

"Flavors in vaping products do not just appeal to the senses. Instead, they play a significant role in normalizing the habit. By making vaping more enjoyable, these flavors can trap users into regular use, making it much harder for them to quit in the long run,” said Ntaganda.

Ntaganda also said that nicotine consumption, especially through vaping, can significantly impair blood circulation and damage joints.

"For young people under 25, this poses a serious risk as nicotine can disrupt brain development and increase the likelihood of life-threatening conditions like strokes.”

Five important facts according to the World Health Organisation

1. E-cigarettes are not safe!

Electronic cigarettes do not contain tobacco, but they still contain nicotine, and numerous chemicals, additives, and flavours.

E-cigarettes may look less dangerous, but they are not.

When one uses an e-cigarette, one still inhales toxic vapes. Vapes that contain particles and chemicals that go down into the smallest airways and can be absorbed by the body. The chemicals, the additives, the nicotine are toxic and harmful, not just for the smoker but also for others as they can inhale the vapes as well, similar to second-hand smoking.

2. E-cigarettes deliver nicotine

Nicotine is the primary agent in regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is a toxic substance. It raises the blood pressure and spikes the adrenaline, which increases the heart rate and the likelihood of having a heart attack.

The consumption of nicotine in children and adolescents has important impacts on brain development and can potentially lead to learning and anxiety disorders. Yet, it is youngsters that are specifically targeted by the e-cigarette industry. Nicotine exposure in pregnant women can have similar consequences for the brain development of the fetus. Nicotine can also increase the risk of heart disease.

So, nicotine, a major component of e-cigarettes, is not only addictive. It is also a health risk.

3. E-cigarettes are as addictive as traditional cigarettes

Both e-cigarettes and tobacco cigarettes contain nicotine. Both are addictive.

Thus, it is not a good idea to use e-cigarettes to kick-off from tobacco cigarettes, because both contain the same additive substance, nicotine. A smoker just switches from one addition to another.

E-cigarettes are not a safe alternative.

E-cigarettes are often promoted as "reduced risk”, "smoke-free”, "socially acceptable” consumer products. They are marketed as being "cool” but there is nothing "cool” about e-cigarettes. They are still addictive, bad for health and cause second-hand smoking.

But these promotional strategies have the potential to re-normalize smoking and drive long-term use of addictive nicotine products.

4. A new generation is getting hooked

The e-cigarette industry has launched an aggressive multimillion marketing campaign that leans heavily on social media, concerts, and sporting events to encourage young people to pick up a deadly habit. Tobacco kills 8 million people a year globally.

5. E-cigarettes need to be regulated

E-cigarettes are currently banned in over 30 countries worldwide, such as in Thailand. In other countries they are regulated as consumer products, as pharmaceutical products, as tobacco products, other categories or totally unregulated.

WHO strongly supports the current efforts of Thailand on the ban on importation or sale of e-cigarettes as it reflects Thailand’s strong commitment towards protecting people in the country, particularly youth, from the harms of tobacco use.