Increased E-cigarette Use in High Schools

South Saskatchewan River in Medicine Hat, Alberta. (Dr. Noorali Bharwani)
South Saskatchewan River in Medicine Hat, Alberta. (Dr. Noorali Bharwani)

Cigarette smoking is dangerously addictive and lethal. Now there are new concerns with the introduction of electronic cigarettes or e-cigarettes.

E-cigarettes are cigarette-shaped canisters used to simulate the action of cigarette smoking.
The e-cigarettes are fluid-filled cartridges that contain varying concentrations of flavouring agents, propylene glycol, glycerine, water and other chemicals. The batteries within the canisters heat up contents of the e-cigarette.

Some e-cigarettes contain nicotine. The cartridge content varies widely according to the manufacturer and distributor. The act of smoking an e-cigarette is called “vaping,” because the user inhales vapour, not smoke.

A new study by Khoury and colleagues published in the Canadian Medical Association Journal (CMAJ August 9, 2016) reports that 10 per cent of a representative sample of grade 9 students in Ontario had tried electronic cigarettes (e-cigarettes).

An editorial in the CMAJ says this finding is likely an underestimate of rates across Canada. For example rates in Quebec are double those in Ontario.

Usually smokers start using e-cigarettes to kick the smoking habit. But Khoury and colleagues found that most smokers were motivated to try e-cigarettes by their novelty and “coolness” – rarely did youth use e-cigarettes to quit smoking.

The study found e-cigarette use was highest among the most vulnerable youth who are in poor health, high stress or low socioeconomic status. The study also confirmed that most were not substituting e-cigarettes for cigarettes: instead, the odds of e-cigarette use were 12-fold higher in youth who also smoked cigarettes (i.e. “dual users”).

Evidence shows increasing use of e-cigarettes in Canada and U.S. A recent study in the US involving youth found that those who did not smoke from grades 11 to 12 and used e-cigarettes, had six fold higher odds of becoming cigarette smokers a year and a half later when they reached the legal age to purchase tobacco. The typical fruit and candy flavourings of e-cigarette liquids are the number one reason they appeal to youth.

What is the government doing about this?

In Canada, governments have begun to take action to protect our youth from e-cigarettes. Ontario and seven other provinces have now passed or tabled legislation that treats e-cigarettes similarly to tobacco products – including a prohibition on selling or supplying them to minors, says the CMAJ editorial.

There is no good reason for youth – or any non-smokers – to be using e-cigarettes. Nothing good can come of providing vulnerable individuals with a more appealing way to become addicted to nicotine, says the editorial.

Some of the things the government can do are: prohibit flavourings in e-cigarettes and introduce advertising restrictions currently in place for tobacco products.

Parents and teachers have an important role to play in engaging our youth in a conversation about the harms of e-cigarettes, lest we lose the progress against tobacco that we have worked so hard for decades to achieve, says the editorial.

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