Smoking and vaping among Canadian youth and adults in 2017 and 2019

Abstract

© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. Ecigarettes remain a contentious topic in public health, with debates focussing on their benefits as a smoking cessation aid versus potential increases in nicotine use among nonsmoking young people. Accordingly, the public health impact of ecigarettes will be determined by who is using them and for what purpose. To date, most studies exploring the prevalence of vaping have been conducted among either youth or adults, with little evidence on overall populations of vapers. Specifically, evidence is lacking regarding the relative contribution of youth and adults, smokers and never smokers, and how these groups have contributed to overall increases in vaping at the population level. Evidence is also required to evaluate the impact of ecigarette policies on patterns of vaping among these different groups. Canada represents an interesting case study given recent shifts in the regulatory framework for ecigarettes. Prior to May 2018, ecigarettes containing nicotine could not be sold or marketed without approval; although no products were approved for legal sale, they were widely available. In May 2018, the Tobacco and Vaping Products Act (TVPA) permitted the sale of nicotinecontaining ecigarettes, as well as wider advertising and promotion of ecigarettes, which increased retail accessibility and the presence of international brands. Studies have highlighted increases in youth vaping following implementation of the TVPA, 6 although there are few estimates on changes in vaping at the population level in Canada. This study uses data from nationally representative surveys to examine how smoking and vaping evolved at the population level in Canada following the implementation of the TVPA.