A total 16 youth who identified as Syilx First Nation youth participated in this study. Youth ranged in age from 11 to 26, with the average age being 15.8. Most (62.5%) (10/16) of the sample was male. All participants were born in Canada. With the exception of one youth who had recently graduated high-school, the participants were all currently attending school, which ranged from grade 6 through to University. In relation to their social context, the majority of the sample lived in British Columbia and resided with 4 to 5 other individuals (68.75%;11/16 and 62.5%; 10/16 respectively). Most (81.25%) (13/16) of them had older peers. In relation to their tobacco-product use and exposure, many (56.25%) (9/16) youth had tried smoking and vaping, and most of them had friends who smoked (68.75%) (11/16) and vaped (87.5%) (14/16). Five (31.25%) youth reported living with someone who vaped, 50% (8/16) of youth reported that someone had tried to sell them vape juice, and 62.5% (10/16) of youth reported living close to a vape retail outlet.
We also examined social media use among youth. Most of the youth used Instagram (87.5%; 14/16), Snapchat (87.5%;14/16), YouTube (100%; 16/16) and Tik Tok (81.25%; 13/16) sometimes or all the time. Facebook (50%; 8/16) and Messenger (56.25%; 9/16) followed in popularity. Many youth reported seeing e-cigarette advertisements sometimes or all the time on Instagram (56.25%; 9/16), Snapchat (43.75%; 7/16), YouTube (37.5%; 6/16) and Tik Tok (43.75%/16).
The findings were grouped under three major categories, and include: context of vaping among Indigenous youth, UTB determinants to vaping decision-making, and suggestions for prevention messages. Each of these categories have embedded themes with exemplary quotes. Each theme is associated with the number of participants endorsing that theme to indicate thematic saturation. Given shared perceptions between both those who vaped and those who did not vape (many of which had tried it at some point), their data was pooled together. See Figure 1 for a conceptual framework that presents how each of these findings relate to one another, and to the UTB framework.
Context of vaping among Indigenous youth
Disproportionate impact of the tobacco industry (n=9)
First Nation youth agreed that vaping, although linked to tobacco, did not hold any spiritual value. They explained that vaping is too modern and does not have that historical and traditional connection in the same way as tobacco. Conversely, youth described e-cigarettes as another product that further emphasizes how Indigenous youth are disproportionately impacted by the tobacco industry. They explained that First Nation youth, especially those on reserves, have limited access to vaping both physically and financially. They cautioned that this lends to the purchase of non-reputable and cheaper products, ultimately lending to the use of more harmful vaping devices by First Nation youth.
Not to be stereotypical. But I mean, like most indigenous youth, their family is poor. So I mean, like, they don't exactly have the money to buy the vape themselves. So they'll have to buy some off brand, that's cheaper (Sharing Circle).
Vaping as Colonialism (n=12)
Described vaping as being directly opposed to traditional ceremony, and as something that is in conflict with their cultural values. They explained how important it is to feel connected to their community, family, and culture, and the value of role-modeling within their band and community. Connection and role-modeling came up frequently during the interviews and the sharing circle, which they described as very important to their Indigenous culture. Youth often saw vaping as something that would take away their ability to connect with and participate in their culture and community. Several youth described the importance of being a role model in the community, and they saw vaping as something that would detract from that.
Community, I’m thinking…of Indigenous communities so, making sure that people are sticking to like their ways and values… (Interview, 1012).
[I want to be] like this good role model so that they’re like, “Oh I want to be like her she doesn’t vape, she participates in culture, and she does her best to connect with her community.” That’s the kind of person I want to be. I don’t want to be that kind of person where it’s like, “Oh she vapes, oh she might get into drinking.” (Interview 1003)
UTB determinants to vaping decision-making
Themes related to UTB determinants to vaping decision-making among Indigenous youth are detailed in Tables 2 and 3. Table 2 provides a list of individual determinants that influence intentions to vape and determinants that translate intentions to vape to decision to vape. Table 3 provides a list of individual determinants that influence intentions to not vape and determinants that translate intentions to vape to decision to vape.
Suggestions for prevention messages
Need to resonate with why Indigenous youth vape (n=12)
Youth agreed that current prevention strategies were not resonating with youth. They said that prevention efforts are not acknowledging what is driving the behavior in the first place. One youth mentioned that many youth are vaping to help them cope. In this case, confiscating vapes is not helping them in any way:
All I can say is that the methods that we have now for prevention of youth using vapes, drugs, this and that are just not really working. If I'm gonna be honest, at least in my general area, because I see people do it more and more and more because they get more and more annoyed at the fact that their things are getting taken, and they get more stressed, and have anxiety, and then they go back to it, and then they get into that loop of, “I need something to help me with this problem”…that's their only way of coping. (Sharing Circle)
The youth emphasized the need for prevention efforts that resonate with youth, not only such that they address the underlying factors that lend to vaping uptake, but also leverage the strengths and resiliency of Indigenous youth to affirm intentions to stay away from vaping.
Need to be where youth are at (n=12)
Youth explained that message content and delivery channels need to meet youth where they are at. They said that prevention needs to be a focus within their community, as well as on social media channels that they frequently use (e.g., Instagram). Messages that would resonate with them should include a focus on helping youth self-reflect (e.g., asking yourself “why?”, “what’s the point?”, “what do you gain”, “how does this impact your culture?”, “how does this impact your role modelling?”), describing things that they could buy instead of vaping, helping them build skills to manage situations of social panic, have peers share their personal experiences with vaping, and have endorsement by celebrities/influencers.