What are Bubblegum, Snickerdoodle and Sweet Tarts? They are flavours for e-cigarettes, meant to entice youth to try this new device, which contains a power source and heating element designed to produce a vapour that can be inhaled by the user. The vapour may or may not contain nicotine, and a senior investment analyst with Wells Fargo Securities estimates that e-cigarette sales could surpass cigarette sales within the next ten years.
E-cigarettes have emerged in Ontario as a hot new trend. A recent survey of Peterborough high school students found that 24.1% of students reported trying e-cigarettes. The proportion of students trying e-cigarettes increased each grade, from 15% in Grade 9 up to almost 30% by Grade 12.
But much of the science on e-cigarettes is still emerging. Although some jurisdictions are more welcoming of these devices as another method to assist smokers to quit, we still do not know whether or not they are effective as smoking cessation aids – this claim is unsupported by the evidence at this time. It is true that they are most certainly less harmful than cigarettes as they do not contain tobacco, but they may pose a risk to the user, both in the short term and the long term. Perhaps the biggest reason that Ontario has decided to put the brakes on e-cigarettes is the risk that they may once more make smoking okay, undoing years and years of hard work to de-normalize smoking so that it is no longer a rite of passage or an expected behaviour. To see how dramatically our societal norms on smoking have changed, just watch any film or archived broadcast from the last century where cigarettes were often featured in a supporting role. And, in case you’ve missed it, Hollywood celebrities have already been photographed using e-cigarettes.
The many brands, flavours, and associated e-cigarette materials are being aggressively marketed through traditional media, online, and celebrity endorsements. In the past couple of years, all three major tobacco companies have purchased existing e-cigarette brands and also launched their own brands. In response to the changing market and potential risk, especially to youth, Ontario has recently passed legislation that bans the sale or supply of e-cigarettes to anyone under the age of 19. At this time, regulations in Ontario that restrict the use, sale, display and promotion of e-cigarettes, are not yet in force.
The uncertainty of the effectiveness of the e-cigarette as a cessation tool, the lack of regulation of the manufacturing of the devices and the e-juice, concerns about safety, the increasing investment by the tobacco industry, and the strong marketing and promotion of e-cigarettes, in my opinion, warrant a precautionary approach to protect youth and young adults of Ontario. This is a high stakes game. Tobacco is the only legal substance that kills 50% of its users. Given the risks, we need to take whatever time is required before we issue a final verdict on e-cigarettes. The jury is still out.
By Dr. Rosana Salvaterra, Medical Officer of Health, Peterborough County-City Health Unit
