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The number of Canadian teens who regularly vape nearly doubled in one year, coinciding with the first rise in cigarette-smoking rates in that age group in years, according to a new study that provides the first evidence of how vaping rates changed after they were legalized and new companies entered the market.

The findings, published in the British Medical Journal on Thursday, are based on surveys of Canadian 16- to 19-year-olds conducted in 2017 and 2018. The surveys found the number of teens who reported vaping in the past week rose to 9.3 per cent in 2018 from 5.2 per cent in 2017. The number of those who said they had vaped in the previous month rose to 14.6 per cent in 2018 from 8.4 per cent in 2017.

At the same time, the surveys found the number of 16- to 19-year-olds who smoked cigarettes in the past week rose to 11.9 per cent in 2018 from 7.6 per cent in 2017. The number of teens who reported smoking in the past month rose to 15.5 per cent in 2018 from 10.7 per cent in 2017.

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The study provides the first look at how vaping rates among Canadian teens changed after federal legislation legalized the sale of nicotine-containing e-cigarettes in May of last year. The second half of the study, conducted in August and September of 2018, also coincided with the arrival of Juul Labs in Canada. The company’s vaping products make up a large share of the e-cigarette market in the United States. According to the study, Juul’s products were developed to deliver a high concentration of nicotine without irritating the mouth or throat, a technology that competitors have since adopted.

For months, parents, teachers, politicians and health experts across Canada have been speaking out about the growing prevalence of teen vaping. Some high schools have removed doors from bathrooms as a way to discourage the habit. The legal purchase age for vaping products is 18 or 19, depending on the province or territory.

There isn’t enough evidence to connect the rise in vaping to the increase in smoking rates, but David Hammond, lead author of the study, said the trends are cause for concern. He singled out the fact that the number of teens who reported using e-cigarettes in the previous week or month is on the rise, which he said indicates they are regular users.

“The fact that we are growing a new generation of people who are using nicotine is of concern in its own right,” said Dr. Hammond, a professor in the School of Public Health and Health Systems at the University of Waterloo.

Last year, Ontario became the only province to allow e-cigarette companies to advertise their products. Two provinces, Alberta and Saskatchewan, still don’t have any e-cigarette legislation.

Amid growing concern over the rising rates of youth vaping, the federal government said it may introduce new measures, including advertising restrictions, a cap on nicotine concentration and a ban on certain e-cigarette flavours.

Dr. Hammond’s study, which also looked at the usage of e-cigarettes in the United States and England, found that rates increased in the U.S. but remained flat in England, where authorities have implemented a cap on nicotine content, advertising restrictions and other policy measures designed to limit use by young people.

Lisa Hutniak, director of communications for Juul Labs Canada, said the company views youth vaping as “completely unacceptable” and has taken measures to discourage this trend, including secret-shopper programs in retail stores and two-factor verification for online sales. But the company doesn’t support some of the restrictions proposed by Health Canada, notably a prohibition on point-of-sale advertising in convenience stores.

Such a prohibition would be "antithetical to what Health Canada’s objectives are to further reduce the smoking rates of adult Canadians,” Ms. Hutniak said.

Juul products were being carried in about 1,200 retail stores when the company launched in Canada last year, and are now available in approximately 11,000, Ms. Hutniak said.

Eric Gagnon, head of corporate and regulatory affairs with Imperial Tobacco Canada, said introducing new restrictions on e-cigarettes before understanding where young people are getting vaping products would be premature. He said banning flavours and restricting advertising could reduce the visibility of e-cigarettes to smokers, which is the market they are trying to attract.

Rob Cunningham, senior policy analyst with the Canadian Cancer Society, said much more could be done to address the growing problem of youth vaping. He pointed to the U.S., where a growing number of states are increasing the minimum purchase age for vaping products to 21. The U.S. Food and Drug Administration is also proceeding with a ban on most e-cigarette flavours, which is something Canada should implement immediately, he said.

“Nicotine is highly addictive,” Mr. Cunningham said. “We do not need a new generation of teenagers to be hooked on nicotine through vaping products.”

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