CDA Essentials 2019 • Volume 6 • Issue 3

28 | 2019 | Issue 3 I ssues and P eople successfully quit smoking, most (80%) remain active users of e-cigarettes. The evidence also suggests that rather than being smoking cessation devices for adults, e-cigarettes act as smoking initiation devices for youth. The National Academy of Sciences’ systematic review published in early 2018 found substantial evidence that e-cigarette use increases the risks that youth and young adults will start smoking cigarettes. It also found moderate evidence that vaping “increases the frequency and intensity” of subsequent cigarette smoking. This finding has been affirmed in study after study published after the 2018 review. The increased risk of smoking is particularly strong (8.5-fold increased risk) in those who would otherwise be at low risk of starting to smoke cigarettes.  Marketing and “science” conspire This pressing threat has been met with relatively muted concern. We don’t hear the fire alarms that should be sounding, perhaps because of the subversive social media marketing strategies pioneered by e-cigarette manufacturers — strategies that have created a social media landscape “dominated by pro-vaping messages disseminated by the vaping industry and vaping proponents.” Using a cloud of misinformation, vaping companies have revolutionized the marketing of e-cigarettes and significantly increased youth vaping. What’s more, the scientific research process can be corrupted. It is telling that studies published by the e-cigarette and tobacco industry are approximately 90 times more likely to find that e-cigarettes cause no harm than those published without such conflicts of interest. The public needs clear, evidence-based information to address this emerging public health crisis.  Celebrity endorsements, gummy bear flavour Communication to youth about the risks of e-cigarettes must address youth. Both youth and adults are attracted to e-cigarettes because they are thought to be cessation aids, to be a convenient way to avoid smoking laws and to be a safer alternative to smoking. But e-cigarettes appeal to youth for additional reasons. Youth in particular are attracted to e-cigarettes because of their novelty, perceived harmlessness and multiplicity of flavours such as fruit, vanilla, chocolate and gummy bear. Such appeal is actively cultivated by the e-cigarette industry through aggressive marketing campaigns that emphasize “lifestyle” and product design. This marketing also occurs through successful engagement on Twitter, Instagram and YouTube, with online celebrity endorsements and by profiling a variety of smoke blowing “tricks.” We reiterate that the most effective protection for children is evidence-based policy that addresses the reasons youth initiate e-cigarette use. To protect children, governments globally should promptly ban all advertising of e-cigarettes. Vaping devices should also be sold in plain packaging, should be banned wherever tobacco use is banned and should be placed behind the pharmacy counter. a References Available online at: theconversation.com/vaping-is-an-urgent-threat-to-public-health-112131 Disclosures: Dr. Reichardt created and is president of SAAVE (Stop Addicting Adolescents to Vaping and E-cigarettes). Dr. Guichon has received funding from the Canadian Institutes of Health Research and the Alberta Law Foundation. She is a member of SAAVE. The evidence also suggests that rather than being smoking cessation devices for adults, e-cigarettes act as smoking initiation devices for youth. ➜