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The majority of young people who try e-cigarettes do so because they seem "fun" and "cool," according to a new study of students from one Ontario region.

The study, published Monday in the Canadian Medical Association Journal, found that 10 per cent of Grade 9 students in the Niagara region had tried using e-cigarettes at least once. Those students were also more likely to be male, have tried cigarettes or have friends or family that smoke."It's quite an alarming rate," said Michael Khoury, lead author of the study who conducted the research as a pediatric cardiology resident at Toronto's Hospital for Sick Children. "This is a new public health issue that really needs to be addressed."

In the study, researchers surveyed more than 2,000 Grade 9 students about their use of tobacco and e-cigarettes, along with other demographic questions.

The findings are in line with what other research has shown about e-cigarette usage among young people and provide fresh proof that the federal government should step in to regulate e-cigarettes, according to an editorial published with the study.

E-cigarettes are battery-powered device that vaporize liquids – which often contain nicotine – and are designed to look like cigarettes.

In Canada, nicotine-containing e-cigarettes have not been approved for sale. Despite this, they are readily available online and in retail locations, which makes it easier for youth to access them, said David Hammond, associate professor and applied public health chair at the School of Public Health and Health Systems at the University of Waterloo. Many e-cigarettes come in candy or fruit flavours, which can be particularly appealing to young people.

Proponents of e-cigarettes say they can be used by smokers to help them quit. But the problem is that in the absence of federal regulation or a crackdown on sellers, e-cigarettes have become widely available across the country and can easily be purchased by young people.

Several provinces have moved to ban the sale of e-cigarettes to adolescents and adopt other restrictions to keep them out of the hands of minors. But more regulation on a federal level and enforcement across the country is needed, Hammond said. For instance, consumers have no way of knowing what they are getting when they buy e-cigarettes under the current system, he said, because there are no rules governing ingredients or nicotine levels allowed in the products.

It's unclear whether e-cigarettes are being used by youth as a "gateway" to cigarettes, he added. But what is known is that young people who use e-cigarettes are also more likely to smoke, suggesting there are certain traits that may make people more prone to trying risky things, Hammond said.

One of the concerns, said Khoury, is that e-cigarettes are "renormalizing" behaviours linked to cigarettes and smoking, which could drive up youth smoking rates.

The editorial, authored by Matthew Stanbrook, deputy editor of the CMAJ and a respirologist, also suggests e-cigarettes are reintroducing smoking culture to a new generation and combining it with technology, which may make them even more appealing to teens.

Stanbrook noted that many companies are appear to be targeting youth with the use of "provocative ads and celebrity endorsements" and that regulations are needed to clamp down.

"There is no good reason for youth – or any nonsmokers – to be using e-cigarettes," he wrote. "Nothing good can come of providing vulnerable individuals with a more appealing way to become addicted to nicotine."

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