Electronic cigarettes pose an urgent threat to public health

Young people use electronic cigarettes (also known as vaping devices) at an increasingly rapid pace – a practice that poses an urgent threat to public health.

Preliminary survey data suggest that, for the first time in 30 years, the rate of youth smoking has increased in Canada, the presumed cause being the electronic cigarette. Recent data from the US Centers for Disease Control also found that 1.5 million more young people were using e-cigarettes in 2018 than in 2017.

If it is not controlled by strict regulations, the next generation of young people will likely be the most nicotine-dependent and heaviest smoker of recent history, reversing decades of effort to protect them.

As researchers in tobacco control and pediatric bioethics, we seek to protect children and adolescents from permanent addiction to nicotine, initiation to cigarette use and associated lung damage. to the use of the electronic cigarette.

The most effective protection for children is an evidence-based policy that addresses the reasons why they start to vapot. Advertising has been shown to promote a positive brand image for vaping devices and encourage young people to try them, while social marketing has been associated with explosive sales growth. Therefore, governments around the world should quickly ban all advertising on electronic cigarettes.

Governments should also require neutral packaging for vaping devices, prohibit their use wherever tobacco is banned, and strictly limit the accessibility of sales to young people – by placing electronic cigarettes behind the counter of the pharmacy.

Electronic cigarettes are devices for initiation to smoking

Many members of the public health sector had hoped that e-cigarettes would be an effective way to quit smoking (including ourselves). This is because these battery-powered products provide nicotine with less than about 7,000 toxic chemicals in regular cigarettes.

However, e-cigarettes still contain potentially harmful substances – such as heavy metals such as lead, volatile organic compounds and carcinogens – and evidence that vaping is an effective method of cessation is limited and in many case, ambiguous.

Research shows that most people (80%) who try to quit using electronic cigarettes do not do so. Of the 20% who successfully quit smoking, most (80%) are still active users of e-cigarettes.

Evidence also suggests that, rather than being adult smoking cessation devices, electronic cigarettes are smoking initiation devices for young people. The systematic review of the National Academy of Sciences published in early 2018 found substantial evidence that the use of e-cigarettes increases the chances of young people and young adults starting to smoke. He also found moderate evidence that vaping "increases the frequency and intensity" of subsequent smoking.

This finding was confirmed in study after study published after the 2018 review. The increased risk of smoking is particularly high (risk multiplied by 8) among those who would otherwise be unlikely to start smoking cigarettes.

Marketing and "science" conspire

This pressing threat raises relatively mild concerns. We do not hear the fire alarms that should be sounding, perhaps because of the subversive social media marketing strategies being developed by the electronic cigarette manufacturers – strategies that have created a media landscape "dominated by pro-vapotant messages broadcast by vaping proponents. "

By using a cloud of misinformation, vaping companies have revolutionized the marketing of electronic cigarettes and significantly increased the vaping of young people.

In addition, the scientific research process can be corrupt. It is telling that the studies published by the e-cigarette and tobacco industry are about 90 times more likely to conclude that e-cigarettes cause no harm than those published without such conflicts of interest.

The public needs clear and factual information to deal with this emerging public health crisis.

Celebrity endorsement, gummy bear flavor

Communication to young people about the risks of e-cigarettes should be addressed to young people. Young people and adults are attracted to e-cigarettes as they are considered cessation aids, a practical way of avoiding tobacco laws and a safer alternative to tobacco.

But e-cigarettes attract young people for additional reasons. Young people in particular are attracted to e-cigarettes because of their novelty, perceived safety and the multiplicity of flavors such as fruit, vanilla, chocolate and gummy bears.

The e-cigarette sector is actively cultivating this attraction through aggressive marketing campaigns that focus on "lifestyle" and product design.

This marketing also occurs through a successful engagement on Twitter, Instagram and YouTube, with the support of online celebrities and by profiling various "tips" to explode the smoke.

We reiterate that the most effective protection for children is an evidence-based policy that addresses the reasons young people start using e-cigarettes. To protect children, governments around the world should quickly ban all advertising for e-cigarettes.

Vaping devices must also be sold in plain packaging, banned wherever smoking is prohibited and placed behind the counter of the pharmacy.

Elliott M. Reichardt, Research Associate, University of Calgary and Juliet R. Guichon, Assistant Professor, Cumming School of Medicine, University of Calgary.

This article first appeared on The Conversation.