1. Teen Vaping: A new generation of nicotine consumers
Dr Meena Dawar
Medical Health Officer
4 June 2019

3. 1. Electronic cigarettes: nicotine and non-nicotine delivery systems

4. 2. Flavours & Aerosol Attractive to youth Harm? taste good
enticing names
decrease perception of harm
mask the bitterness of nicotine
Likely less harmful than tobacco for tobacco users.
Completely safe? No.
Nicotine
Chemicals of concern
Pod = test tube
Physiological markers of concern
Long term disease outcomes unclear
Apple fritter, Blue Raz, Pineapple, Strawberry Lemonade, Pink lemonade, orange mango, frosted glass
Association Between Electronic Cigarette Use and Myocardial Infarction Alzahrani, Talal et al. American Journal of Preventative Medicine Vol 55 Oct 2018

5. Nicotine in e-juice (legal since 2018)
Harmful to a developing brain
memory and concentration
alter teen brain development
reduce impulse control
cognitive and behavioural problems
Highly addictive: “Vaping may predispose youth to nicotine addiction and possibly other drugs”
Poisonous, particularly to young children
Juul: efficient nicotine delivery, ‘smoother’ hit to throat, pod=1 pack cig, less vapor.
cause nicotine addiction among users who would not have started using nicotine otherwise (e.g. smoking)
Children and youth are especially susceptible to the harmful effects of nicotine, including addiction. They may become dependent on nicotine with lower levels of exposure than adults.Footnote2
Health Canada:

6. 3. Reversing progress in tobacco control
Tobacco company
ENDS product(s)
Altria: Philip Morris
MarkTen, Green Smoke, IQOS Mesh, Juul
British American Tobacco
(Reynolds American)
Vype iSwitch, Vuse, Ten Motives, Chic
Imperial Tobacco
Myblu, Nixx
Reynolds (Lorillard)
Blu, SkyCig
Now, over 95 percent of the market for e-cigarettes is dominated by five companies: MarkTen, XL, Logic. Vuse, Blu and JUUL. Vuse is owned by R.J. Reynolds Vapor Company, a subsidiary of Reynolds American Inc, which was acquired by British American Tobacco in 2017.
Electronic Cigarettes | OpenSecrets
19/09/2019

7. Aggressive marketing, renormalization of smoke
Claims:
Safer than cigarettes (“clean”)
Quitting aid
Freedom to use wherever you want
Cheaper than smoking
Better for others - no odour, no risk
from second hand vapour

8. Transition from vaping to tobacco?
Longitudinal studies from US, Canada, Taiwan show that youth who vape are at greater risk of initiating tobacco use.
Hammond D, CMAJ 2017 Oct 30; 189:E doi. 1503/cmaj
Aleyan, BMJ Open 2018;8:e doi: /bmjopen ; BMJ Open 2018;8:e021080corr1. doi: /bmjopen corr1
Berry KM, Fetterman JL, Benjamin EJ, et al. Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths. JAMA Netw Open. 2019;2(2):e doi: /jamanetworkopen

9. 4. Vaping by youth is on the increase
Overall across Canada, 22% increase in ever use, 67% increase in past 30 day use.
Youth: grades 7-9, 30 day use: 5.4 (16-17)up from 3.9 in
67% increase
Canadian Student Tobacco, Alcohol and Drugs Survey, analysis July 2018, Grades 10-12
**McCreary Adolescent Student Health Survey Students grade 7-12

10. 5. Conclusion
Use of nicotine and non-nicotine containing e-cigarettes by youth is a concern.

12. Tips for Parents & Educators
Get the facts, know the risks.
Start the conversation.
Be patient, ready to listen and supportive
Keep the conversation going.
Set a positive example.

13. Public health response
Inform youth, teachers, and parents about risks.
Presentations to youth, parents, teachers (nearly 100 since 01/19)
Materials are being developed in partnership with BC Lung
Training of VCH staff
Regulations now in place to prohibit sales to minors. Use in public spaces has to be consistent with smoking bylaws.
Attention needs to be devoted to restricting product promotion, preventing sales to minors.
Advocacy continues to make vaping less appealing by restricting flavours, limit access to adult only shops.
Federal govt has restrictions on brand sponsorship, advertisements, display within retail shops. Ont allows in-store promotion.

14. Resources
Thank you.