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Canada’s top public-health officers are urging governments to ban the sale of flavoured e-cigarettes and require all vaping products to be sold in plain packages to help discourage young people from using them.

The Council of Chief Medical Officers of Health released a series of recommendations on Wednesday designed to address rapidly rising youth vaping rates that also include a call for the minimum purchase age for tobacco and e-cigarette products to be raised to 21 and for manufacturers to disclose all ingredients in their products.

The Canadian Medical Association also called on the federal government to ban flavours in a submission made to Health Canada this week. The submission was in response to the government’s proposed new advertising restrictions for vaping products.

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The council’s recommendation to ban the sale of e-cigarette flavours comes as the federal government is deciding which direction to take on the issue. In December, Ottawa announced it is moving to ban all forms of e-cigarette advertising that could be seen by youth, including on social-media channels and in public places. The government said it would also introduce new rules governing flavoured vaping products this year, which has the industry and health groups on high alert.

Under the current rules, it is illegal to promote any e-cigarette flavours that could appeal to young people, such as candy or dessert flavours. But a recent Globe and Mail investigation found many Canadian e-cigarette companies regularly flout these restrictions, selling e-liquids in flavours such as ice cream and birthday cake.

But members of the e-cigarette industry say flavours are essential to attract existing adult smokers to their products. Onerous restrictions could discourage smokers from trying e-cigarettes, which Health Canada says are a less harmful option than smoking.

Health organizations, on the other hand, say flavoured products are a key draw for young people and that restrictions are needed to stop the explosive growth in youth vaping.

A recent survey found that one in three high-school students in Alberta and Quebec, and one in four high-school students in Ontario, have used e-cigarettes in the past month. Rising youth rates, along with concerns over the short- and long-term health risks associated with vaping, including nicotine addiction and heart and lung problems, are fuelling calls for more action.

There have been 16 confirmed cases of serious vaping-related illness in Canada. Of those, nine cases involve people who only consumed nicotine e-cigarettes. In the United States, most of the cases of vaping-related illness have been linked to people who consumed e-cigarettes with tetrahydrocannabinol or THC.

In April, Nova Scotia will become the first jurisdiction in Canada to ban all flavoured e-cigarette products.

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The Council of Chief Medical Officers is recommending that other provinces or, preferably, the federal government, ban all flavoured products and then authorize a small handful of flavours that existing adult smokers could use.

Sarah Butson, public policy analyst with the Canadian Lung Association, said the recommendation to tightly restrict e-cigarette flavours strikes the right balance and would likely help reduce uptake by youth and non-smokers.

“The evidence is out that we have a youth vaping problem here,” she said. “We can’t afford to not take action.”

While more research is needed to fully understand the health risks of e-cigarettes, mounting evidence shows they do cause harm. A study published in December found that people who use e-cigarettes face a higher risk of emphysema, asthma and other chronic lung problems.

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