E-cigarettes and vaping: the bad, the good, and the unknown


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  1. Bandara AN

    We thank Healthy Debate and Colacci and his colleagues for their timely important contribution to e-cigarette prevention (1). Even though e cigarette industry is aggressively advocating and promoting nicotine vaping as a safest tobacco cessation tool “few adolescents try to quit smoking using any sort of cessation aid or professional intervention and the efficacy of e-cigarettes in improving smoking cessation in youth is equivocal”(2).

    We thank Healthy Debate for continued advocacy in support of the adolescent health and well-being (1). Getting adolescents involved in this prevention program is crucial and the key to success (3, 4, 5). We urge Canadian Physician Organizations to take a leadership role in a Canada-wide comprehensive school awareness and prevention program. We could perhaps tailor e-cigarette prevention programs similar to the old combustible cigarette prevention education programs (3). We need an effective social media campaign to enhance adolescents’ knowledge about the ingredients in e-cigarettes, their potential adverse effects and the known health hazards of prolonged use and misuse. There also needs to be a strong public education and awareness campaign to counter common myths and misconceptions (e.g., like e-cigarettes are a safer therapeutic tool) (3).

    It is urgently needed to introduce a brief online training module as part of continuing medical education (CME) on how to use every opportunity of “teachable moments in the respective clinical practice”. “Teachable moments” has been commonly described as an opportunity to facilitate education and patient behavior change. Every clinical visits potentially could be an instance of a ‘‘teachable moment’’ to help educate young patients with vaping related potential serious adverse events and motivate behavioral change. It is important that the training module should develop in consultation with the Canadian Medical Association, Canadian Pediatric Society and the College of Family Physicians Canada. It is also important to involve adolescents in the process (4). Educational tool may be designed taking in to consideration of the context of interactive clinical scenarios.

    REFERENCES:
    (1). Colacci M. E-cigarettes and vaping: the bad, the good, and the unknown? Healthy Debate Jan. 2020- https://healthydebate.ca/2020/01/topic/a-deep-dive-into-vaping
    (2). Wolfenden L, Stockings E, Yoong SL. Regulating e-cigarettes in Australia: implications for tobacco use among young people. Med J Aust 2017; 208 (1):1. || doi: 10.5694/mja17.00787
    (3). Bandara NA. Would e-cigarette regulation alone improve adolescents’ health? CMAJ. 2016 Oct 18;188(15):1106.
    (4). Bandara NA. The consultation of youth in the public health care policy-making process. Can J Public Health. 2016 Aug 15;107(2):e216. doi: 10.17269/cjph.107.5446.
    (5). Bandara NA, Seneviratne M. Adolescents’ Electronic Cigarette Use. Pediatrics. 2019 Jan;143(1). pii: e20183151. doi: 10.1542/peds.2018-3151.

    Aki Nilanga Bandara
    Founding Chair-Global coalition to empower adolescent and youth on harmful therapeutic interventions to prevent combustible tobacco use.
    Instructor, Faculty of Land and Food System, University of British Columbia, British Columbia, Canada, 2357 Main Mall, Vancouver, BC V6T 1Z4 Canada.
    Mehara Seneviratne
    Coordinator-Global coalition to empower adolescent and youth on harmful therapeutic interventions to prevent combustible tobacco use.
    Dr. Vahid Mehrnoush
    Senior Advisor-Global coalition to empower adolescent and youth on harmful therapeutic interventions to prevent combustible tobacco use.
    Postdoctoral research fellow, Section of Trauma, Acute Care, and Global Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC

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