Vapes are being used by young girls as an appetite suppressant prompting concern from Scottish public health experts.
Staff involved in a new children's health service in Glasgow said girls were using the nicotine replacement products to curb hunger pangs.
Julie Gordon, of Glasgow City Youth Health Service, said there had been a "significant" rise in the number of young people aged 12-18 receiving help for eating disorders during the pandemic.
A breakdown in supports and increased isolation is thought to have contributed to the increase.
Ms Gordon said the use of e-cigarettes by girls was of concern as very little is known about the risks of vaping on "young lungs".
Vape shops and online stores in the UK are prohibited from selling the products to anyone under the age of 18 but there is growing concern the flavoured products are reaching children as young as primary age.
Vaping products are age-restricted for good reason
Glasgow City Council said a number of retailers had been issued with warnings about illegal sales and teams were regularly removing illegal and non-compliant disposable vaping products.
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Sheila Duffy, Chief Executive of ASH Scotland said their use by young girls as an appetite suppressant was alarming "on a number of levels" and called for tighter advertising controls.
Emma Broadhurt, Scotland officer for the eating disorder charity Beat said: "I know from previous roles [in health improvement] that teenage girls used to smoke to suppress appetite so this doesn’t surprise me."
Figures show the use of e-cigarettes among 11 to 18-year-olds in the UK has risen from 2.4% in 2015 to 4.1% in 2021.
Public health expert, Professor Linda Bauld was involved in research which suggested e-cigarettes can be useful for adults who have stopped smoking as a means to avoid weight gain.
In addition to the direct effects of nicotine, which affects the brain and metabolism, this was said to be due to factors include taste perception and sensation and behavioral replacement.
She said e-cigarettes were a valuable tool in helping adult smokers quit but said their use by young girls was "concerning".
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"We certainly need to be vigilant in relation to this," she said.
"Nicotine is an appetite suppressant and also raises the metabolic rate, so if these young girls are using vapes to control their appetite they are probably doing it for a good reason - because it actually will.
"Obviously very concerning if it is linked to eating disorders. What we found in our study was that these were smokers - which is a different group - who had switched to vaping. Instead of a pudding they might have a flavoured vape. The bottom line would be that we need to keep these products away from young people.
"There is certainly evidence that young people are using them and these are not products for non-smokers or children, that's why we have an age of sale but young people manage to get around that in the same way they do for cigarettes.
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"We need to ensure that we enforce the policies that we have now, schools need to be aware of it and retailers need to make sure they are not getting into the hands of children."
She said there was a bit of a "moral panic" around vaping amongst young people which had not been helped by a series of deaths in the US linked to contaminated cannabis oil.
However, she said there were no evidence yet what the long-term health risks might be.
She said: "We know that vaping will have far less of an impact on health outcomes than smoking but what we don't have is a cohort of people who have never vaped who have been followed up over time."
Sheila Duffy, Chief Executive of ASH Scotland, said the placement of vaping products next to sweets had been linked to increased use by children.
She said: “It is alarming on a number of levels to hear about young girls using vaping products to suppress their appetites.
“Vaping products are age-restricted for good reason as they can be highly addictive, and many include toxic chemicals that have not been safety tested and could damage health over time – this is especially a danger for children and young people as their lungs are still growing.
“ASH Scotland is concerned about young people perceiving vaping products to be safe due to promotions often being located close to sweets in retail outlets and research suggesting this visibility is associated with e-cigarettes experimentation by children and youths.
“Promoting novel products is a way in which the tobacco industry is seeking to reach future generations of potential consumers.
"It is vital the advertising and promotion of recreational tobacco related products like these, which often have flavours, colouring and packaging attractive to young people, is curbed to reduce experimentation and protect long-term health.”
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