This statement is currently under the Canadian Dental Association review process.


CDA strongly advises against the use of tobacco products and smoking of cannabis because of the unacceptable risks posed to general and oral health. The use of e-cigarettes (vaping) and waterpipe devices (shisha or hookah) are expanding in Canada. Tobacco use remains the leading cause of preventable death and disease in Canada.

CDA advises against the use of waterpipe devices because users inhale and absorb a significant load of toxic chemicals similar to cigarette smoke and known to cause dependence, cancer as well as other heart and lung diseases. With respect to e-cigarettes, the long-term effects on general and oral health are not yet known.

Current evidence shows that vaping is an increasingly potential gateway to conventional cigarette smoking, especially in young people; and may increase the risk of heart damage and stroke in similar ways to traditional cigarette smoking.

People who smoke tobacco or cannabis or use smokeless tobacco (also known as spit tobacco, snuff, and chewing tobacco) experience significant oral health problems, including periodontal diseases or life-threatening oral cancers. There is emerging research evidence that the risk of disease associated with using tobacco, cannabis or vaping products in various combinations is likely even greater than using each product alone. More research is needed to confirm associations.

CDA acknowledges that despite the already known risks, patients may still choose to use these products. In such cases, CDA recommends:

  • That patients review their use of smoking, e-cigarette or water pipes and consumption of tobacco, nicotine- or cannabis-based products with their dentist.
  • Based on current evidence, that dentists review the known and potential risks of exposure and consumption of tobacco, nicotine- and cannabis-based products with their patients; and recommend measures that promote cessation and reduce the harm caused by using these substances.

CDA endorses Government action to reduce the potential harm to Canadians, and:

  • Supports efforts to ban all advertising and promotion of all tobacco, cannabis, and e-cigarette products, along with other measures that would limit the use of these products.
  • Urges that regulations prohibiting the sale of all tobacco, cannabis and vaping products to minors be strictly enforced.
  • Urges that the health of non-smokers be protected in as many public places as possible by continuing to ban smoking of tobacco and cannabis, and by applying similar restrictions to e-cigarettes.
  • Encourages governments to develop educational programs aimed at preventing smoking of tobacco and cannabis and use of e-cigarettes among Canadians, particularly youth.
  • Urges the prohibition of exports of tobacco and tobacco products, especially to developing nations.


CDA Board of Directors
Approved: February 2005
Revised: July 2012
Revised: October 2018