By Leslie Phillips
Youth and young adults often arrive at my clinic feeling they have lost control of their nicotine use. When they come through the doors, they are usually in despair.
In short course, the temptation of vape flavours and the euphoric rush of nicotine give way to dependence. Continued use is no longer motivated by pleasure but rather driven by the need to avoid withdrawal. Fruit and candy flavours create a powerful sensory experience and mask the harshness of nicotine, drawing in youth like a moth to a flame. The nicotine content keeps them trapped.
This is how so many get hooked on vaping.
By the time youth and young adults reach my Quit Smoking and Vaping program, most are vaping continuously throughout the day to stave off nicotine withdrawal symptoms including agitation, anxiety, insomnia, restlessness, nausea and headache. For many, a “top up” before heading to class is mandatory and a two-hour university class or an evening’s movie or show too long to sit through without a brief escape to vape.
Even during the night, the vape is close by, under the pillow within easy reach in the dark.
At this point, rather than providing them pleasure, their nicotine addiction is controlling their lives. Most had tried quitting on their own with limited success, returning to the vape within hours or days to relieve the discomfort of withdrawal.
The majority of the young people that I see in my nicotine dependence clinic have never smoked cigarettes. They are vapers. While public health tobacco policies have significantly facilitated declining smoking rates among youth, the prevalence of vaping in this population has reached crisis levels, with Canada experiencing some of the highest teen vaping rates in the world.
According to Health Canada, in the 2023-24 school year, one in seven students in grades 7-12 across this country (data not available for Quebec and the territories) reported using e-cigarettes with nicotine in the past 30 days. In Newfoundland and Labrador, Nova Scotia and Saskatchewan, that figure is more than one in five.
In these three provinces, approximately one in 10 students in grades 7-12 vapes daily, compared to just one in 50 who smokes cigarettes daily. Across Canada fewer than one youth in 100 (0.8 per cent) smokes cigarettes daily.
Nicotine is one of the most addictive substances known. When marketed with enticing flavours (Cotton Candy, Mango Crush, Berry Blast, Strawberry Watermelon Ice, etc.), sleek, high-tech designs, and colourful packaging, its allure, particularly for young people, is substantial.
Efforts to deter youth vaping are undermined by a patchwork of different provincial and territorial regulations governing vapes in Canada. Six provinces and territories – Quebec, Nova Scotia, New Brunswick, Prince Edward Island, the Northwest Territories and Nunavut – have comprehensive vape flavour restrictions. But nearly three-quarters of Canada’s population resides in places – Yukon, British Columbia, Alberta, Manitoba, Saskatchewan, Ontario, and Newfoundland and Labrador – with only partial limits on vape flavour or no restrictions at all.
These jurisdictional gaps create inconsistencies in access, undermine the efforts of provinces and territories with more stringent regulations, and send mixed messages about the risk and acceptability of vaping in youth, and in young adults who were never smokers.
There is an urgent need for federal regulations to reduce the appeal of these products and help mitigate youth access and uptake. All Canadian youth deserve protection from the risk of lifelong nicotine addiction. Federal leadership would strengthen, not replace, existing provincial efforts and ensure all youth are protected.
Evidence from other countries demonstrates the effectiveness of such measures. Australia’s policy restricting vape sales to pharmacies has sharply reduced youth vaping and its social acceptability. Similarly, the Netherlands has seen an important reduction in e-cigarette use after their introduction of a flavour ban.
In my practice, I see firsthand the impact of federal inaction. Youth who succumbed to the allure of flavoured vapes have become frustrated young adults dealing with the consequences of nicotine dependence. A strong federal ban now would help ensure fewer young people ever have to come through our doors.
What are we waiting for?
Dr. Leslie Phillips is a pharmacist who heads the Quit Smoking and Vaping Program at the Medication Therapy Services Clinic of the School of Pharmacy at Memorial University of Newfoundland in St. John’s.
Photo: iStock
