Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies.

Children and adolescents are highly susceptible to nicotine addiction, which affects their brain development, even in those who smoke infrequently. Young people who become addicted to nicotine are at greater risk of becoming lifelong tobacco consumers. The use of nicotine-delivering electronic cigarettes has risen dramatically among youths worldwide. In addition to physical dependence, adolescents are susceptible to social and environmental influences to use electronic cigarettes. The product design, flavours, marketing, and perception of safety and acceptability have increased the appeal of electronic cigarettes to young people, thus leading to new generations addicted to nicotine. Moreover, there is growing evidence that electronic cigarettes in children and adolescents serve as a gateway to cigarette smoking. There can be no argument for harm reduction in children. To protect this vulnerable population from electronic cigarettes and other nicotine delivery devices, we recommend that electronic cigarettes be regulated as tobacco products and included in smoke-free policies. Sale of electronic cigarettes should be barred to youths worldwide. Flavouring should be prohibited in electronic cigarettes, and advertising accessible by youths and young adults be banned. Finally, we recommend greater research on the health effects of electronic cigarettes and surveillance of use across different countries.

The National Tobacco Control Program: focusing on policy to broaden impact.

Tobacco use is the single most preventable cause of death and disease in the United States, causing more than 440,000 premature deaths annually. We can dramatically reduce the health and economic burden of tobacco use by employing proven tobacco control and prevention strategies. Policy interventions offer the greatest opportunity to influence decisions regarding tobacco use at the societal level. Tobacco control policy can drive social, environmental, and systems changes, and has a substantially greater impact than interventions that target individuals. A policy approach engages the larger community and empowers it to establish healthy social norms. Health departments, the primary governmental institutions charged with protecting the health of the public, play many different roles in advancing policy. The National Tobacco Control Program funds state health departments to educate the public and decision makers regarding evidence-based policy strategies. This article outlines those strategies, critical success factors, and challenges associated with policy-based interventions.