Nova Scotia recently banned flavored cigarettes, citing the fact that flavored tobacco products play a role in the initiation of adolescent smoking. This prohibition was made in hopes of making cigarettes less appealing to youth, with the goal of reducing experimentation and use. A recent study found that cigarette use among high school students has dropped significantly across North America. However, while rates of adolescent cigarette use have been decreasing, a new player has jumped in the game. Perceptions that e-cigarettes are a healthier alternative to cigarettes are prevalent, and rates of “vaping” continue to increase. E-cigarettes come in a variety of different flavours and do not fall under the flavoured tobacco ban, making them an accessible substitute for youth who might otherwise use flavoured tobacco. Further, despite the fact that the majority contain nicotine, high school students typically believe they do not. This may pose a significant health risk, as the long-term effects and harms resulting from e-cigarette use are not well known. Furthermore, there are concerns that e-cigarette use may renormalize cigarette smoking, leading to an increase in cigarette smoking behaviour.
Along with increasing rates of e-cigarette use comes increasing rates of cannabis use. As Canada awaits legalization and many states having already legalized recreational cannabis, perceptions of risk are changing. Alcohol and cigarette use is becoming more disdained among youth, yet attitudes towards cannabis have not followed the same trajectory. Youth now perceive cannabis use as having very few negative side effects. Although these beliefs are not accurate, one family nurse practitioner working in a Boston high school says they are difficult to change.
The political and legal landscape surrounding cannabis use and possession is about to drastically change in Canada. While there are harm reduction merits related to the legalization of cannabis, we must be sure that Canada’s youth have the appropriate education and information to make an informed decision regarding cannabis use. A strong public education campaign should be an integral part of the legalization of recreational cannabis. We’ve come a long way in reducing the rates of cigarette use among youth, but the efforts will be wasted if e-cigarettes and cannabis promptly replace them.