Re: Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys
Recent research shows that e-cigarette use is increasing among Canadian and US adolescents (1). E-cigarettes are widely marketed as a tool for smoking cessation and a safer alternative to conventional cigarettes (2). Furthermore, in the broader community there is the misconception that e-cigarette use is relatively harmless (3, 4).
Adolescents are more likely to use e-cigarettes because of unique factors of e-cigarettes, such as perceptions that e-cigarettes are less harmful as this product is widely marketed as less harmful or as a therapeutic tool by the tobacco industry. Also the widespread availability of unique e-cigarette liquid flavors that may be especially targeted marketing to adolescents and youth. More specifically it is important to note that there is limited or no enforcement of restrictions on adolescents and youth easy access to online availability of e-cigarettes.
Further, adolescents are very puzzled over the contradictory information provided by social media, popular media, the e-cigarette industry and the widely divided stance in the clinical care community. However, the efficacy of e-cigarettes for successful smoking cessation is inconclusive (3, 5). This uncertainty is reflected in world’s credible health organizations' conflicting e-cigarette position statements (4). These differences may create further confusion among adolescents and may very well contribute to increase e-cigarette use. It is necessary to understand that the clear winner of the divided stance and the confusion of e-cigarette is the “tobacco industry”.
It is important to develop and implement an e-cigarette effective awareness campaign based on currently available best evidence research, which targets high school students and other vulnerable high risk groups. It is also true that many adolescents face tough choices regarding tobacco, alcohol and drug use due to peer pressure and lack of accurate information. Therefore, empowering adolescents to embrace healthy behaviors is very significant and we believe it is an important social responsibility.
(1). Hammond D, Reid JL, Rynard VL, Fong GT, Cummings KM, McNeill A, Hitchman S, Thrasher JF, Goniewicz ML, Bansal-Travers M, O'Connor R, Levy D, Borland R, White CM. Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys BMJ. 2019;20;365:l2219. doi: 10.1136/bmj.l2219.
(2). Mendel JR, Hall MG, Baig SA, Jeong M, Brewer NT. Placing Health Warnings on E-Cigarettes: A Standardized Protocol. Int J Environ Res Public Health. 2018; 15(8): 1578.
(3). National Academies of Sciences, Engineering, and Medicine . Public Health Consequences of e‐Cigarettes. Washington, DC: The National Academies Press; 2018. DOI: 10.17226/24952.
(4). McNeill A, Brose LS, Calder R, Bauld L, Robson D. Evidence Review of e‐Cigarettes and Heated Tobacco Products: A Report Commissioned by Public Health England. London: Stationery Office; 2018. Available at: https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobac.... Accessed June 22, 2019.
(5). Dib RE, Suzumura EA, Akl EA, Gomaa H, Agarwal A. Electronic nicotine delivery systems and/or electronic non-nicotine delivery systems for tobacco smoking cessation or reduction: a systematic review and meta-analysis. BMJ Open. 2017; 7(2): e012680.
Competing interests: No competing interests