Teens’ e-cig­a­rette use linked to later to­bacco smok­ing, study shows

Va­p­ing by young peo­ple is of sig­nif­i­cant con­cern, can­cer so­ci­ety an­a­lyst says

Calgary Herald - - CITY -

Teenagers who use elec­tronic cig­a­rettes are at risk of grad­u­at­ing to to­bacco smok­ing, a large Cana­dian study sug­gests.

The study of more than 44,000 grades 9 to 12 stu­dents in On­tario and Al­berta, pub­lished Mon­day in the Cana­dian Med­i­cal As­so­ci­a­tion Jour­nal, shows a “strong and ro­bust” link­age be­tween so-called va­p­ing and sub­se­quent to­bacco use.

“We found that youth that had used e-cig­a­rettes were sig­nif­i­cantly more likely to start smok­ing a year later,” said lead re­searcher David Ham­mond, a pro­fes­sor in the school of pub­lic health at the Univer­sity of Water­loo.

“They’re more likely to try smok­ing and they’re more likely to be­come daily smok­ers.”

The big ques­tion, said Ham­mond, is whether it’s the use of e-cig­a­rettes that is mak­ing some young peo­ple smoke.

“A lot of what we’re see­ing in our study and a lot of other stud­ies out there is a sim­ple fact, and that is the kids who do risky things, the ones that are more likely to try eci­garettes are also more likely to try smok­ing,” he said from Water­loo, Ont.

“And guess what? They’re also more likely to try al­co­hol and mar­i­juana. It’s all to do with the fact that kids who are sus­cep­ti­ble are go­ing to try dif­fer­ent things.

“We’ve had some­thing like two mil­lion Cana­dian youth try eci­garettes and we’d be fool­ish if we weren’t con­cerned about kids try­ing nico­tine prod­ucts at an ear­lier age than they typ­i­cally try smok­ing.”

The re­search, known as the COM­PASS study, looked at eci­garette use among stu­dents in 2013/14, with a fol­low-up a year later. Stu­dents were clas­si­fied into six cat­e­gories: cur­rent daily smok­ers, cur­rent oc­ca­sional smok­ers, for­mer smok­ers, ex­per­i­men­tal smok­ers, puffers; and those who had never tried smok­ing.


Those teens who vaped in the 30 days prior to the start of the study were more likely to start smok­ing cig­a­rettes and to con­tinue smok­ing af­ter one year, re­searchers found.

“Youth may be try­ing e-cig­a­rettes be­fore smok­ing be­cause they are eas­ier to ac­cess,” said Ham­mond, not­ing that to­bacco can­not be sold to mi­nors.

Rob Cun­ning­ham, se­nior pol­icy an­a­lyst for the Cana­dian Can­cer So­ci­ety, said va­p­ing by young peo­ple is of sig­nif­i­cant con­cern.

“Cer­tainly nico­tine is ad­dic­tive and we don’t want e-cig­a­rettes to be a mech­a­nism whereby youth get ad­dicted to nico­tine,” he said.

“And that’s why it’s so im­por­tant to pre­vent kids from us­ing e-cig­a­rettes or start­ing smok­ing.”

While Canada has not ap­proved nico­tine-con­tain­ing e-cig­a­rettes for sale in con­ven­tional re­tail out­lets such as su­per­mar­kets, the prod­ucts are widely avail­able on­line and in vape stores.

Non-nico­tine e-cig­a­rettes, which come in hun­dreds of flavours, do not re­quire gov­ern­ment ap­proval to be sold and make up a large part of the mar­ket in Canada.

How­ever, that is ex­pected to soon change. Bill S-5, which would cre­ate new reg­u­la­tions gov­ern­ing e-cig­a­rettes, was ap­proved by the Se­nate in June and is cur­rently be­fore the House of Com­mons.


Among its pro­vi­sions, Bill S-5 would out­law the sale of va­p­ing prod­ucts to mi­nors and pro­hibit the pro­mo­tion of e-cig­a­rettes con­tain­ing flavours that ap­peal to youth, as well as re­strict­ing ad­ver­tis­ing of th­ese prod­ucts.

But Cun­ning­ham said the pro­vi­sions in Bill S-5 for e-cig­a­rette ad­ver­tis­ing are weak com­pared to those for both to­bacco and for cannabis, when the lat­ter prod­uct be­comes le­gal next year.

“And I think the bill should be amended to strengthen the re­stric­tions on e-cig­a­rettes ad­ver­tis­ing,” he said.

The Cana­dian Med­i­cal As­so­ci­a­tion rec­om­mends a ban on the sale of all elec­tronic cig­a­rettes to those younger than the min­i­mum age for to­bacco con­sump­tion in their province or ter­ri­tory.

The doc­tors group also wants the li­cens­ing sys­tem tight­ened to limit the num­ber of out­lets where to­bacco prod­ucts, as well as va­p­ing de­vices, can be pur­chased, along with re­stric­tions on the pro­mo­tion of e-cig­a­rettes.

“Pro­tect­ing Canada’s youth should be of the ut­most im­por­tance for gov­ern­ment and health-care pro­fes­sion­als alike,” said CMA pres­i­dent Dr. Lau­rent Mar­coux.

“The find­ings in this (study) pro­vide even more ev­i­dence that the gov­ern­ment should con­tinue to work to limit sales and de­crease the ap­peal of prod­ucts that are of­ten tar­geted to­wards Canada’s youth,” Mar­coux said by email.

The CMAJ is ed­i­to­ri­ally in­de­pen­dent from the Cana­dian Med­i­cal As­so­ci­a­tion.


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