Good morning, Mr. Chair;. Good morning, members of the committee. Good morning, colleagues Dr. Strang and Dr. McKeown.
My name is Dr. Jennifer Russell. I'm speaking as the acting chief medical officer of health for New Brunswick.
E-cigarettes pose a risk to the efforts and successes in tobacco control. Many e-cigarettes look like cigarettes, and their vapour looks like smoke. Years of work in tobacco control have led to many successes in reducing smoking rates and improving the health of our population. Although we are starting to see some studies and evidence on e-cigarettes, for the most part the science and evidence are still in early stages. We cannot wait for 100% of the evidence; we need to act urgently, as the risks are too high.
Some literature and surveys have indicated that youth believe e-cigarettes are healthier and less harmful than cigarettes. Youth feel that their use can be concealed and that they can use them everywhere, and they are accessible. Concerns include the negative impact of nicotine on brain development and the risk of addiction and of the initiation of use of other products, including tobacco-containing cigarettes.
The look and feel of these products pose a threat of the re-normalization of tobacco and risk undermining the work that has been done to date by tobacco control programs. They therefore should be treated as cigarettes in terms of the policies that promote the de-normalization of tobacco.
The New Brunswick Department of Health supports the recommendations provided by the provincial and territorial chief medical offices of health's position on e-cigarettes and electronic nicotine delivery systems. Over the past couple of years, the emerging trend of the sale and use of electronic cigarettes has public health professionals concerned about the potential health risks. There is an urgent need for preventative action.
One of the main concerns is the impact that e-cigarettes have on youth and young adults. ln the U.S.A., the use of e-cigarettes among youth doubled from 2011 to 2012. U.S. studies also indicate that youth's perception of e-cigarettes is that they are less harmful than cigarettes.
Marketing strategies in the U.S. industry are very similar to those decades ago of the tobacco industry in making the product very glamorous. ln addition, e-juices are available in a variety of flavours, such as bubble gum, cotton candy, Mountain Dew, coconut, etc., all of which are attractive to youth and young adults.
Studies have shown that youth who try e-cigarettes as a cessation aid continue to smoke regular cigarettes, and therefore there is dual use, use of both products. They have also shown that e-cigarettes seem to inhibit rather than promote cessation.
Public health practitioners are concerned about the substantial probability that this product will re-normalize tobacco and become a gateway for the use of other types of tobacco products and that the outcomes will be significantly negative to the overall health and addiction of the population and will have a detrimental impact on long-term chronic disease rates.
In New Brunswick, there is a platform commitment by the newly elected government, which has committed to expanding the Smoke-free Places Act to ban smoking in places frequented by children, including beaches, public parks, outdoor restaurant patios, and sports fields.
I feel this is a very important step in terms of protecting the rights of youth and children. Under the UN Convention on the Rights of the Child, it is the primary responsibility of governments at all levels to ensure the provision and protection of the children's convention rights, which include protection from harmful substances such as nicotine and tobacco products.
I would like also to echo the comments Dr. Strang made earlier with respect to the recommendations by the federal, territorial and provincial chief medical officers of health that, given the current state of knowledge about electronic nicotine delivery systems, we are trying to achieve a balance of allowing accessibility to these products as potential aids for cessation or tobacco use reduction for existing tobacco users while minimizing their potential to both develop nicotine dependence and new tobacco users and to decrease the motivation for cessation among existing tobacco users.
Youth are particularly vulnerable to developing nicotine dependence. My work with addiction services for six years looked at the risks for developing an addiction, which include experimenting with the substance prior to the age of 15, having adults in their lives who condone the use of the substance, and peer pressure. These are all things that are increased in the youth population, who are much more vulnerable and at much higher risk of developing dependence on substances such as nicotine.
In conclusion, again I would like to echo the comments from Dr. Strang regarding the position of the chief medical officers of health of the provinces and territories in that we recommend that advertising restrictions for tobacco products would apply to electronic nicotine delivery systems. Standard labelling requirements would be required such as they are for tobacco products. Smoke-free requirements for federal workplaces and other federally controlled environments such as airports and airplanes would also include the use of electronic nicotine delivery systems. The ban on flavoured cigarettes should also be extended to flavoured e-juice containers that are part of electronic nicotine delivery systems.
I would also recommend strict enforcement of these regulations and stiffer penalties for violators, and also to include childproof and tamper-proof regulations with respect to the manufacturing.
Thank you very much.