8 Agencies Join Tobacco Control Effort to Keep Youth Away from E-Cigarettes

On November 7, the National Health Commission reported that eight departments, including the National Health Commission, the Publicity Department of the CPC Central Committee, the Ministry of Education, the State Administration for Market Regulation, the National Radio and Television Administration, the National Tobacco Monopoly Bureau, the Central Committee of the Communist Youth League, and the All-China Women's Federation, jointly issued a notice titled "Notice on Further Strengthening Tobacco Control Work for Youth" (hereinafter referred to as the "Notice"). This initiative will comprehensively promote awareness of the harms of e-cigarettes and regulate their management. E-cigarettes should not be promoted as a smoking cessation method, and youth are encouraged to stay away from e-cigarettes. Sales of e-cigarettes to minors are prohibited to effectively prevent youth from falling into the trap of e-cigarettes. In recent years, the usage rate of e-cigarettes among youth in China has shown a significant upward trend. The "Notice" points out that the components of e-cigarette liquids and the secondhand smoke they produce (including aerosols) are unsafe, and there is currently no conclusive evidence that e-cigarettes can effectively aid in quitting smoking. Local legislation, amendments, and enforcement should actively promote the prohibition of e-cigarette use in public places. Special actions should be taken in conjunction with comprehensive governance around primary and secondary schools to warn all market entities against selling e-cigarettes to minors, especially through the internet. Wang Ke'an, former director of the Chinese Academy of Preventive Medicine and current director of the New Exploration Health Development Research Center, stated that e-cigarettes pose four main harms: First, the primary component of e-cigarettes is nicotine, and excessive intake can be life-threatening; nicotine addiction is a disease. Second, e-cigarettes release aerosols that contain ethylene glycol, aldehydes, tobacco-specific nitrosamines, volatile organic compounds, as well as polycyclic aromatic hydrocarbons, metals, and silicate particles, many of which are known carcinogens. Third, e-cigarettes can cause various diseases, such as lung diseases, epilepsy, asthma, and allergies, and long-term use increases the risk of chronic obstructive pulmonary disease, lung cancer, heart disease, and stroke. Fourth, manufacturers of e-cigarettes add various additives to the e-liquid to enhance its appeal, such as chocolate, coffee, and lemon flavors, to attract young users. However, these additives can produce harmful substances when heated, posing health risks. Globally, the number of young people using e-cigarettes has significantly increased. According to data from the U.S. Centers for Disease Control and Prevention, the e-cigarette usage rate among high school students in the U.S. was approximately 1.5% in 2011, rising to 20.8% by 2018. In China, the number of people aged 15 and above using e-cigarettes is about 10 million. A 2014 survey on youth tobacco use in China indicated that 1.2% of middle school students had used e-cigarettes in the past 30 days. According to a report from Xinhua News Agency in Washington, the latest data from the U.S. Centers for Disease Control and Prevention shows that as of October 29, there have been 1,888 confirmed and possible cases of lung disease associated with e-cigarette use in the U.S., with at least 37 deaths. Hu Dayi, director of the Cardiology Institute at Peking University People's Hospital and president of the Chinese Tobacco Control Association, stated that e-cigarettes can also be addictive. Health initiatives in China must start with youth, and the harms of e-cigarettes should receive full attention from society. He calls on the entire society to recognize and pay attention to the dangers of e-cigarettes, especially urging young people to stay away from traditional tobacco and e-cigarettes.