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Canada’s chief public health officer says rising rates of youth vaping represent an “emerging and serious health trend” and that more research is needed to understand the long-term health risks posed by e-cigarettes.

Theresa Tam made the comments in her annual report on the state of public health in Canada, which was released on Wednesday and sent to the new federal Health Minister, Patty Hajdu. In her report, Dr. Tam highlighted the fact e-cigarettes increase the risk of nicotine addiction, which can alter brain development in young people. E-cigarettes also expose people to an array of harmful chemicals, such as formaldehyde and acrolein, as well as heavy metals and other contaminants, Dr. Tam wrote.

But because e-cigarettes are so new, the long-term health risks are not yet known. Some studies have also found that young people who use e-cigarettes are more likely to start smoking traditional tobacco cigarettes. Dr. Tam says more research must be done to determine the extent of the risks.

In addition to vaping, Dr. Tam’s report highlighted other important emerging health issues affecting Canadians, such as the rise of measles and other vaccine-preventable diseases, the continuing opioid-related overdose epidemic, the rise of chronic illnesses, sexually transmitted diseases and antimicrobial resistance.

But the bulk of her report focuses on stigma around groups and individuals who are often marginalized, and how misconceptions and stereotypes are causing many in Canada to die prematurely or receive inadequate health care. The report details how stereotypes, power dynamics and other catalysts help create conditions where people receive unfair treatment and experience higher rates of stress, which can lead to poorer physical and mental health.

Many First Nations, Inuit and Métis people, for instance, experience continuing racism, which is linked to poorer health outcomes, the report said. Racist attitudes and stigmatizing behaviour, the report notes, make it more difficult for those individuals to access postsecondary education, earn a good income and increases the risk of hunger, exposure to violence and avoidance of health-care institutions.

Dr. Tam highlighted the fact that stigma can also come from within health-care organizations, through use of words such as “addicts” to describe substance users or the unfounded belief that new immigrants have infectious diseases, such as tuberculosis. The report cites the case of Brian Sinclair, a 45-year-old Indigenous man who died of a treatable illness in a Winnipeg emergency room after being left to wait for 34 hours. His family said they believed underlying racism was one of the factors that led to his death.

The report includes a framework on how health professionals and organizations can start to combat stigma, including through increased education and training to address myths, and through media campaigns to challenge stereotypes.

Last week, Prime Minister Justin Trudeau asked Ms. Hajdu to create new rules to stop vaping companies from promoting their products to young people, highlighting the growing urgency around the rapid rise of youth vaping in Canada.

Rising rates of youth vaping have already prompted several provinces to introduce new measures to discourage teens from using e-cigarettes. For instance, Nova Scotia will become the first province to ban flavoured e-cigarette liquids as of April 1. A survey conducted by Smoke-Free Nova Scotia, a tobacco advocacy group, found that 96 per cent of 16- to 18-year olds said they preferred flavoured vape products compared to unflavoured. And 48 per cent of youth ages 16 to 24 said they would likely stop vaping if flavoured products were not available.

Schools are also struggling with how to respond. This week, Grand River Collegiate Institute high school in Kitchener, Ont., blocked access to all but one bathroom after a student who was vaping in a bathroom had to be rushed to the hospital in an ambulance.

Vaping-related illnesses have been in the spotlight recently amid accusations the makers of the products are targeting them at youth. Dr. James MacKillop outlines some strategies to use at home in conversations with your children about vaping. MacKillop is the director of the Peter Boris Centre For Addictions Research and co-director of the Michael G. Degroote Centre For Medicinal Cannabis Research.

The Globe and Mail (staff)