Op-ed from Dr. Rosana Salvaterra, Medical Officer of Health
Peterborough Public Health
Thursday, November 14, 2019
Protecting Our Youth from Rising Substance Use
Each year, more Canadians end up in hospital from alcohol-related harms than from heart attacks. In fact, it is alcohol, not tobacco, not even opioids, that holds first place as the leading substance of harm when total societal costs are considered. And despite all our progress on restricting exposure to tobacco smoke, the risk of dying from cigarette smoking is on the rise. The recent focus on vaping and nicotine addiction among youth is just the latest indication of the widespread prevalence of both substance use and addiction. It’s a cause for concern.
One has to wonder why we have not learned our lessons, starting with alcohol. After a period where it was prohibited, the pendulum has swung in the opposite direction, so that now alcohol is seen by governments as a cash cow, heavily marketed by industry. Consumption anywhere anytime is almost seen as a right. Alcohol use has become normalized. Use by under-aged youth in Peterborough is staggering: in 2016, 52.7% of Peterborough residents had reported drinking under age. In a 2015 study, 38% of secondary school students in Peterborough had reported binge drinking (consuming five standard drinks or more on one occasion) at least once a month. Our youth are sounding the alarm that normalization of substance use happens; that the industry, without effective restrictions, will drive consumption; and that government can choose to play a role in either protecting the public, or not.
Commercial tobacco use began with combustible cigarettes but has now found an even better alternative for the delivery of nicotine. As early as 1958, cigarette manufacturer Philip Morris stated that a “synthetic aerosol to replace smoke” was preferred. After all, cigarette smoke kills about 50% of long-term users and it doesn’t make business sense to kill your customer. Vaping, or inhaling an aerosol directly into the lungs, can put booster rockets on the development of a nicotine addiction. Since e-cigarettes became legal for sale in March 2018, they have become the preferred method of promoting nicotine consumption, which quickly leads to addiction.
Ask anyone who has tried to quit smoking about the power of nicotine. British Tobacco projections show that 60% of e-cigarette users are new entrants – predominantly youth, driven by the very-high concentrations of nicotine available in vaping liquids. In the first year of marketing in Canada, studies show that 10% of Canadian youth have tried a fourth-generation vaping device that is providing a quick nicotine high with an even better sensory experience than a cigarette. The protection of our youth has become an urgent priority and thankfully, Ontario’s Minister of Health has heard the alarm bells and will be introducing restrictions on the promotion of e-cigarettes in January.
But the promised restrictions do not go far enough and much more is needed. For smokers, there’s no doubt that vaping is substantially less harmful but introducing greater regulation in order to protect youth will have no impact on those adult smokers trying to quit.
So how exactly do we protect our youth? Let’s begin at the corner store…retail settings where children often go in their neighbourhoods, at least in my opinion, should not be fueling substance use and addictions. With cannabis sales prohibited to adult-only specialty shops, why not treat nicotine, tobacco and alcohol in the same way? Flavouring that appeals to youth should be banned. Nicotine concentrations in vape juice capped. Prohibiting the advertising and marketing of all potentially harmful psychoactive substances, including alcohol is long overdue. And how about raising the legal age for consumption of alcohol, cannabis and tobacco to a minimum of 21 years as a way to buy a little more protection for developing brains?
Let’s stop the fallout before it happens and protect the next generation. We shouldn’t have to wait 20 or 30 years for all the evidence on e-cigarette use to accrue before we realize that we have a public health crisis on our hands.
For more information about Dr. Salvaterra, her bio is available on this webpage: