E-cigarettes and youth health

Tobacco products in all forms are highly addictive because they contain nicotine, one of the most addictive substances used by humans. High-nicotine content in e-cigarettes poses as a potentially disastrous innovation in the 21st century and a well-known public health threat to our vulnerable children’s future and their overall health and well-being.

Even though we clearly know that the nicotine is addictive and poses significant challenges to smoking cessation, sophisticated social media campaigns tend to unduly discount the risks and overstate the benefits of e-cigarettes. Distorted risk perceptions are associated with adolescents’ decisions to initiate e-cigarette use, decisions they will likely regret in adulthood.

We need Health Canada’s sensible presence in e-cigarette prevention and control efforts, including federal government regulation over e-cigarette flavored products, online sales, and social marketing. We need creative strategies to put our children on a path to a healthy, tobacco-free lifestyle and ensure that young leaders influence future tobacco control policies in Canada and globally.[1-3]

E-cigarettes should carry health warnings like combustible tobacco, which could counteract misinformation suggesting that they are a less harmful and safer alternative to combustible tobacco. We should train student leaders to become peer counselors in their schools to help their peers to quit e-cigarettes. School administrators, teachers, parents, caregivers, and public health officials should build a meaningful partnership to address this issue in schools.

Every adolescent consultation is a golden opportunity for a “teachable moment,”[4] and engaging adolescents about their desire to change health behaviors and referring them to further support can make it more likely for them to make and sustain behavioral change.[5] Developing clinical guidelines incorporating the current best evidence to facilitate clinical decisions and gain more insight into the complex reality of e-cigarettes is of utmost importance.
—Aki Nilanga Bandara
—Mehara Seneviratne
—Senara Wanniarachchi, BSc
—Vahid Mehrnoush, MD
West Vancouver


1.    Bandara AN. Understanding adolescent perception on e-cigarettes is vital. Am J Public Health 2016;106:e13.

2.    Bandara AN, Jhauj R, Mehmoush V. The major causes of death in children. N Engl J Med 2019;380:1384-1385.

3.    Bandara AN. The consultation of youth in the public health care policy-making process. Can J Public Health 2016;107:e216.

4.    Cohen DJ, Clark EC, Larsen PJ, et al. Identifying teachable moments for health behavior counseling in primary care. Patient Educ Couns 2011;85(2):e8-15. www.ncbi.nlm.nih.gov/pmc/articles/PMC4389220.

5.    Lawson PJ, Flocke SA. Teachable moments for health behavior change: A concept analysis. Patient Educ Couns 2009;76:25-30.

Nilanga Aki Bandara, BSc, Mehara Seneviratne, Senara Wanniarachchi, BSc, Vahid Mehrnoush, MD. E-cigarettes and youth health. BCMJ, Vol. 62, No. 3, April, 2020, Page(s) 88 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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