CDA Essentials 2019 • Volume 6 • Issue 3

27 Issue 3 | 2019 | I ssues and P eople Youth are using e-cigarettes (also known as vaping devices) at a rapidly increasing rate — a practice that constitutes an urgent threat to public health. Preliminary survey data suggests that, for the first time in 30 years, the youth smoking rate has increased in Canada, with e-cigarettes being the suspected cause. Recent data from the Centers for Disease Control in the United States also found that 1.5 million more youth used e-cigarettes in 2018 than in 2017. If unchecked by strict regulations, the next generation of youth is likely to be the most nicotine-dependent and the heaviest smoking in recent history, wiping out decades of efforts to protect them. As researchers in tobacco control and pediatric bioethics, we seek to protect children and youth from lifelong nicotine dependency, initiation of cigarette use and the damage to lungs associated with e-cigarette use. The most effective protection for children is evidence-based policy that addresses the reasons they start vaping. Advertising has been shown to promote a positive brand image for vaping devices and to spur youth to try them, while social media marketing has been linked to explosive growth in sales. Opinion VAPING IS AN URGENT THREAT TO PUBLIC HEALTH The evidence shows that vaping is creating a generation of nicotine-addicted youth, who start with e-cigarettes and move on to smoke tobacco products. Therefore, governments globally should promptly ban all e-cigarette advertising. Governments should also mandate plain packaging for vaping devices, ban their use wherever tobacco use is banned and strictly limit the accessibility of sales to youth — placing e-cigarettes behind the pharmacy counter.  E-cigarettes are smoking initiation devices Many people in the public health community had hoped that e-cigarettes would be an effective way for people to stop smoking (ourselves included). That’s because these battery-operated products deliver nicotine with fewer than the approximately 7,000 toxic chemicals in regular cigarettes. However, e-cigarettes still contain potentially harmful substances — such as heavy metals like lead, volatile organic compounds and cancer-causing agents — and evidence of vaping being an effective cessation method is limited and, in many cases, ambiguous. Research shows that most individuals (80%) who attempt to quit smoking using e-cigarettes fail to do so. Of the 20% who Theviewsexpressedarethoseoftheauthors anddonotnecessarilyreflecttheopinions orofficialpoliciesoftheCanadianDental Association. The following originally appeared in The Conversation (theconversation.com/ca ) and is reprinted with permission. By Elliott M. Reichardt and Juliet R. Guichon Dr. Guichon is assistant professor, Cumming School of Medicine, University of Calgary Dr. Reichardt is research associate, University of Calgary