title: E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada.
abstract: An electronic cigarette (e-cigarette) is a battery attached to a chamber containing liquid that may (or may not) contain nicotine. The battery heats the liquid and converts it into a vapour, which is inhaled, mimicking tobacco smoking. The e-cigarette does not rely on tobacco as a source of nicotine but, rather, vaporizes a liquid for inhalation. E-liquids are often flavoured and may contain nicotine in various concentrations, although actual amounts are seldom accurately reflected in container labelling. The deleterious effects of nicotine on paediatric health are well established. The use of e-cigarettes in the paediatric age group is on the rise in Canada, as are associated nicotine poisonings. E-devices generate substantial amounts of fine particulate matter, toxins and heavy metals at levels that can exceed those observed for conventional cigarettes. Children and youth are particularly susceptible to these atomized products. Action must be taken before these devices become a more established public health hazard. Policies to denormalize tobacco smoking in society and historic reductions in tobacco consumption may be undermined by this new 'gateway' product to nicotine dependency.
authors.affiliation: Past president of the Canadian Paediatric Society.
authors.forename: Richard
authors.initials: R
authors.lastname: Stanwick
keywords: Healthy public policy; Heavy metal exposure; Nicotine dependency; Nicotine poisoning; Normalization; Smoking; Vaping
references.citation: Dev Cogn Neurosci. 2011 Oct;1(4):430-43
references.pmid: 22436565
references.citation: Tob Control. 1998 Autumn;7(3):215-8
references.pmid: 9825406
references.citation: Tob Control. 2014 May;23 Suppl 2:ii54-8
references.pmid: 24732165
references.citation: Prim Care. 1999 Sep;26(3):611-31
references.pmid: 10436290
references.citation: Tob Control. 2015 Sep;24(5):501-4
references.pmid: 24848637
references.citation: Tob Control. 2014 May;23 Suppl 2:ii47-53
references.pmid: 24732164
references.citation: Tob Control. 2014 May;23 Suppl 2:ii30-5
references.pmid: 24732160
references.citation: J Am Coll Cardiol. 1997 Jun;29(7):1422-31
references.pmid: 9180099
references.citation: Nicotine Tob Res. 2015 Feb;17(2):228-35
references.pmid: 25143298
references.citation: Pediatrics. 2014 Jul;134(1):e29-36
references.pmid: 24918224
references.citation: Nicotine Tob Res. 2014 Jun;16(6):815-9
references.pmid: 24500685
references.citation: MMWR Morb Mortal Wkly Rep. 2014 Apr 4;63(13):292-3
references.pmid: 24699766
references.citation: J Pharmacol Exp Ther. 1998 Jun;285(3):931-45
references.pmid: 9618392
references.citation: MMWR Morb Mortal Wkly Rep. 2013 Sep 6;62(35):729-30
references.pmid: 24005229
references.citation: N Engl J Med. 2015 Jan 22;372(4):392-4
references.pmid: 25607446
references.citation: Pediatrics. 2014 Jul;134(1):1-3
references.pmid: 24918219
references.citation: Tob Control. 2014 May;23 Suppl 2:ii4-10
references.pmid: 24732162
references.citation: Nicotine Tob Res. 2014 Oct;16(10):1319-26
references.pmid: 24832759
references.citation: Pharmacol Ther. 2009 May;122(2):125-39
references.pmid: 19268688
references.citation: Tob Control. 2014 May;23 Suppl 2:ii36-40
references.pmid: 24732161
references.citation: Circulation. 2014 May 13;129(19):1972-86
references.pmid: 24821826
references.citation: Tob Control. 2014 May;23 Suppl 2:ii23-9
references.pmid: 24732159
references.citation: Nicotine Tob Res. 2015 Feb;17(2):134-41
references.pmid: 24862971
references.citation: Neurotoxicol Teratol. 2002 May-Jun;24(3):369-84
references.pmid: 12009492