On April 9, the University of Public Health held a workshop to present results from the study titled “Violations of regulations on the sale, advertising and promotion of e-cigarettes and heated tobacco products at retail points, and exposure to new tobacco product marketing among adults.”

According to the research, the average age at which individuals begin using e-cigarettes or heated tobacco products is 16.9. Initial use often stems from social outings, curiosity, peer influence, and the appeal of flavors and novelty.

A survey of 2,462 students in Hanoi, Da Nang, Hue and Ho Chi Minh City found that 14.3 percent had tried e-cigarettes, while 3.3 percent were current users. For heated tobacco, the figures were 6.2 percent and 0.8 percent respectively.

Misconceptions remain widespread

Notably, misconceptions about these products are highly prevalent. Dr Tran Thi Phuong Thao, representing the research team, said 37.8 percent of students believe e-cigarettes contain no nicotine, while 15 percent think the smoke is merely “harmless vapor.”

In addition, 43.6 percent believe e-cigarettes can help users quit traditional smoking, and 32.5 percent think secondhand vapor is safe.

“Many young people also associate e-cigarettes with positive imagery. Up to 74.8 percent think vaping looks ‘cool’, 57.7 percent feel more confident when using them, 41.7 percent feel calmer, and 38.3 percent feel happier,” Dr Thao noted with concern.

Risks to adolescent brain development

Experts emphasized that despite being marketed as a “less harmful” alternative, e-cigarettes and heated tobacco products still pose significant health risks.

These products typically contain nicotine, a highly addictive substance that can affect brain development in adolescents, particularly those under 25. Long-term use may lead to dependency, behavioral disorders, and an increased likelihood of transitioning to traditional cigarette smoking.

E-cigarette liquids may also contain chemicals, heavy metals, and volatile organic compounds that can irritate the lungs, cause respiratory inflammation, and even lead to acute lung injury. Some international studies have also identified potential risks to cardiovascular and immune systems.

Misunderstanding these products as “safe” makes young users more complacent, increasing frequency of use and making it harder to quit.

Sales shift to more covert channels

Following stricter regulations, a survey of 126 retail outlets found that 64.3 percent had shut down. However, rather than disappearing, sales have shifted to more discreet forms.

Around 34.9 percent of sellers have moved online, using disguised tactics to bypass platform moderation. Products are mislabeled as items such as “electric shavers,” “room sprays,” or “toothbrush heads,” while actually being e-cigarettes.

Advertising images are also edited to evade detection. Buyers can place orders without age verification, and products are additionally sold discreetly in cafes, beauty salons, or through personal networks.

“These practices make regulation more difficult, especially when it comes to protecting adolescents,” Dr Thao said.

N. Huyen