Structural Conditions as Cause: Explaining the Rapid Rise in Youth E-Cigarette Use by Re-thinking Models of Addiction

Abstract

Background: E-cigarette use has spread rapidly and widely among youth, to an extent that has surprised some researchers.

Objectives: We suggest that this surprise is owing to a particular limitation in the dominant models of addiction – namely, a strong focus upon addictive substances as cause. We argue that the phenomenon at hand is easier to comprehend when less attention is placed upon preventing the use of specific substances and more upon what we identify as structural susceptibility to addiction instead.

Results: Drawing upon neurobiology, history, public health theory, and social theory, we re-conceive addictive substances as mechanisms of escape from social structures that predispose whole societies to addiction.

Conclusions/Importance: We argue that the surge in youth e-cigarette use in particular, as well as the phenomenon of addiction in general, are easier to comprehend if models of addiction are expanded to conceptualize the problem in its wider dimensions. We invite addictions researchers to join us in expanding the field’s analytical view.

Keywords:

• e-Cigarettes
• vaping
• youth
• addiction
• susceptibility
• neurobiology
• social determinants
• political economy

Acknowledgment

Many thanks to Hannah Rae Behrens, a clinical herbalist in the Upper Peninsula of the state of Michigan, who contributed important early thinking.

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Notes

1 This data has not yet been published. Readers interested in methodological details for this study can consult (Sanchez et al., 2021), which reports a different set of findings emerging from the same study.

2 As stated in the prior footnote, this data has not yet been published, but readers interested in further methodological detail can find it in a paper reporting a different set of findings emerging from the same study (Sanchez et al., 2021).

Additional information

Funding

This work was funded by a grant from the Ontario Ministry of Health and Long-Term Care, Health Systems Research Fund [mdash]’Research on E-Cigarettes and Water-Pipe.’