The October 2019 Board of Health meeting location is in Windsor.
October 2019 Board Meeting
Main Page Content
Meeting Documents
- Call to Order
- Agenda Approval
- Announcement of Conflict of Interest
- Presentation: Vaping (W. Ahmed)
- Approval of Minutes
- Regular Board Meeting: September 19, 2019
- Consent Agenda
- INFORMATION REPORTS
- ProsperUs (T. Marentette)
- Media Recap
- RESOLUTION/RECOMMENDATION REPORTS
- Vaping (N. Dupuis)
- INFORMATION REPORTS
- Business Arising
- Board Correspondence – Circulated
- New Business
- ENWIN Utilities – Fluoride Update (T. Marentette)
- Other Board of Health Resolutions/Letters – For Support
- Simcoe-Muskoka District Public Health – Letter to Hon. Ginette Petitpas Taylor and Hon. Christine Elliott – Vaping
- Kingston, Frontenac and Lennox & Addington Public Health – Letter to Hon. Christine Elliott – Vaping
- Committee of the Whole (Closed Session in accordance with Section 239 of the Municipal Act)
- Next Meeting: At the Call of the Chair or November 21, 2019 – Essex
- Adjournment
View Document page
Prepared By:
Theresa Marentette
Date:
September 2019
Subject:
ProsperUs Board Information Report
Background
“ProsperUs is a collective of non-profit, government, health care, education, labour, business, and inspired residents with a shared vision of a prosperous Windsor-Essex County where every young person has the opportunity and support they need to thrive.”1 The unique aspect of ProsperUs is the value of collective impact, a term that captures the importance of organizations coming together to share experiences and expertise for the common goal of supporting youth in our community and making a positive impact in their lives.
The United Way, under the leadership of CEO Lorraine Goddard, is the backbone organization supporting these efforts led by Co-Chairs Janice Kaffer (HDGH) and Noah Tepperman (2018) and Jim Inglis (2019). Financial and in-kind support has occurred across organizations with the lead agencies of the United Way and Hotel Dieu Grace Healthcare dedicating funds and human resources to this initiative. An Investor Table strategy is currently in development.
The vision of ProsperUs is embedded in the work of the Windsor-Essex County Health Unit (WECHU). The Ontario Public Health Standards (2018) support working with priority populations and community partners to offer population-based activities that promote the health of the population and reduce health inequities.2 Collective impact initiatives such as ProsperUs’ Cradle to Career, are an effective way to approach large-scale social changes that fundamentally align with public health strategies.
Furthermore, the goal of WECHU’s school based programs and services is to achieve optimal health of school-aged children and youth through partnerships and collaboration with school communities and school boards. By bringing these, and other key strategic community partners together, we create opportunities for meaningful and effective engagement that will move us closer to realizing this goal.
Early work of ProsperUs formalized the Leadership Council, the Data and Evaluation Table, and the Marketing and Communications Working Table. A media launch one year ago introduced the community to the vision of ProsperUs “Every young person in Windsor-Essex County has the opportunity and support to succeed- from cradle to career.” Other sub committees would follow with the establishment of a Planning Committee in early 2019.
By late Fall (2018), data sharing agreements were established with organizations followed by a community engagement strategy led by Overlap Associates. The goal was to engage community members, including families and youth to gain insights into their perceptions about opportunities for youth in Windsor and Essex County. This strategy included an online survey, key informant interviews and ethnographic research. Street Teams were created from partnering agencies to engage people in the community and conduct brief interviews. Results of community engagement activities were presented to the Leadership Council in December of 2018.
Current Initiatives
The work of ProsperUs moved forward in 2019 with interactive Data Walks implemented in neighbourhoods across Windsor and Essex County to share existing data and engage participants in meaningful discussion about what they had learned and what was missing. In the coming months, further support was provided by the Data and Evaluation Table to examine key indicators and identify priority neighbourhoods.
In July, a media event highlighted the release of the Coming Together- Building a Hopeful Future for Children and Youth in Windsor-Essex County Executive Summary Report which identified Downtown Windsor, West Windsor and the Town of Leamington as priority areas for the initial Cradle to Career focus.
The next phase of the project is the recruitment of staff and community representatives to begin the work of the Community Action Network. It will be these groups, across the three identified neighbourhoods that will delve deeply into the issues and barriers that children and youth are facing in our community and propose innovative solutions to overcome these barriers.
There is much work to be done. The Chairs of the Leadership Council and members of the partnering agencies continue to celebrate milestones in the work that has been accomplished so far. The Windsor-Essex County Health Unit is proud to be part of this initiative and continues to provide human resources and expertise to the Cradle to Career initiative. Specifically, I would like to acknowledge Ramsey D’Souza, our manager of Epidemiology and Evaluation, who is a valued member of the Data and Evaluation Table. Jen Johnston, our Social Determinants of Health nurse participated as a member of the one of the Street Teams. In addition, our Health Unit has put forward names of several members of our Healthy Schools department to participate as co-chair, facilitators and content experts for the Community Action Network working tables.
- ProsperUs Communications, July 2018.
- Ministry of Health and Long Term Care, Ontario Public Health Standards, 2018.
View Document page
Prepared By:
Communications Department
Date:
October 2, 2019
Subject:
September 2019 Media Relations Recap Report
September Media Coverage
Total Media Coverage |
65 |
Interview Requests |
28 |
Mentions (In the news without direct interviews) |
32 |
Requests for Information | 5 |
September 2019 Media Relations Recap - Media Coverage
September 2019 Media Relations Recap - Story Source
Media Coverage
Outlet |
Number of Stories |
---|---|
AM 800 |
15 |
Blackburn |
8 |
CBC |
14 |
CTV |
11 |
London Free Press |
1 |
Mediaplex/St Clair College |
1 |
TVO |
1 |
Windsor Star |
11 |
windsorite.ca |
2 |
Yahoo News |
1 |
TOTAL |
65 |
News Release, Media Advisories and Media Statements
Date | Type | Headline | Response |
---|---|---|---|
September 10, 2019 |
News Release |
Health Unit Issues Clarification on Upcoming Cannabis Cruise |
9 Stories Reported |
September 16, 2019 |
News Release |
First Human Case of West Nile Virus Confirmed |
6 Stories Reported |
September 17, 2019 |
Media Advisory |
Windsor-Essex County Health Unit Board of Health Meeting |
1 Story Reported |
September 27, 2019 |
News Release |
Mosquito Activity And Surveillance Update |
3 Stories Reported |
Stories Reported by the Media
AM 800
Note: Digital stories were not available for three of AM 800’s requests.
Publish Date |
Title |
---|---|
September 6, 2019 |
Two Beaches Not Recommended For Swimming |
September 10, 2019 |
Cannabis Cruise Snuffed Out |
September 10, 2019 |
Windsor Pot Cruise Cancelled After Health Unit Cites Possible Violations |
September 11, 2019 |
Swimming Not Recommended At Two Windsor-Essex Beaches |
September 16, 2019 |
First Local Case Of West Nile Virus Confirmed |
September 17, 2019 |
Boil Water Advisory In Essex |
September 18, 2019 |
Swimming Not Recommended At Three Local Beaches |
September 19, 2019 |
Deadly Mosquito Borne Encephalitis Disease Claims Three Michigan Lives |
September 19, 2019 |
Boil Water Advisory Lifted In Parts Of Essex |
September 20, 2019 |
Opioid-Related Deaths Spike In Windsor-Essex |
September 27, 2019 |
Mosquito Capable Of Carrying Zika Virus Found In Windsor |
September 27, 2019 |
Anti-Stigma Campaign Launches Interactive Display |
Blackburn News
Publish Date |
Title |
---|---|
September 6, 2019 |
An Early Flu Forecast For Windsor-Essex |
September 11, 2019 |
Organizers Cancel Cannabis Cruise After Health Unit Issues Notice |
September 16, 2019 |
Human Case Of West Nile Virus Detected |
September 17, 2019 |
Boil Water Advisory Issued In Essex |
September 19, 2019 |
Ontario Tracking Vaping Related Illnesses |
September 19, 2019 |
Several Windsor-Essex Beaches Still Under Bacteria Warnings |
September 19, 2019 |
Essex Boil Water Advisory Lifted |
September 19, 2019 |
Health Unit To Consider Resolution To Ban Vaping |
CBC News
Note: Digital stories were not available for five of CBC’s requests.
Publish Date |
Title |
---|---|
September 5, 2019 |
7 Months, 44,000 Needles Disposed Of In Sharps Bins In Windsor |
September 5, 2019 |
Swimming Not Recommended At Two Windsor-Essex Beaches |
September 10, 2019 |
Cannabis Cruise In Jeopardy Over Concerns With Provincial Smoking Rules, Says Organizer |
September 10, 2019 |
Cannabis Cruise In Jeopardy Over Concerns With Provincial Smoking Rules, Says Organizer |
September 19, 2019 |
22 People In Windsor-Essex Died From Opioid-Related Causes In First 3 Months Of 2019 |
September 16, 2019 |
Windsor-Essex Health Unit Confirms First Human Case Of West Nile Virus In 2019 |
September 18, 2019 |
Swimming Not Recommended At Three Windsor-Essex Beaches |
September 20, 2019 |
More Consultations For Supervised Injection Site On The Way, Location Now Key Focus |
September 27, 2019 |
Mosquito Capable Of Transmitting Zika Virus Found In Windsor Again |
CTV Windsor News
Note: Digital stories were not available for two of CTV’s requests.
Publish Date |
Title |
|
---|---|---|
September 6, 2019 |
Two Beaches Not Recommended For Swimming |
|
September 9, 2019 |
Windsor-Essex Residents Warned To Get Flu Shots Early |
|
September 10, 2019 |
Windsor Pot Cruise Cancelled After Health Unit Cites Possible Violations |
|
September 13, 2019 |
Windsor health officials and residents weigh in on the effects of vaping |
|
September 16, 2019 |
First Human Case Of West Nile Virus This Year Confirmed In Windsor-Essex |
|
September 19, 2019 |
Three Beaches Unsafe For Swimming In Windsor-Essex |
|
September 20, 2019 |
Over 20 Opioid-Related Deaths Reported In Windsor-Essex In First 3 Months Of 2019 |
|
September 29, 2019 |
New Campaign Takes Aim At Windsor-Essex Opioid Crisis |
|
September 27, 2019 |
Health Unit Warns Mosquitoes Still Thrive In Fall |
London Free Press
Publish Date | Title |
---|---|
September 19, 2019 |
Local Teen Suffers 'Severe Respiratory Illness' Link To Vaping: Health Officials |
Windsor Star
Note: Digital stories were not available for one of Windsor Star’s requests.
Publish Date | Title |
---|---|
September 3, 2019 |
Success Of Windsor's Sharps Program Shows Need For More Bins, Report Says |
September 10, 2019 |
Health Unit Puts Kibosh On Cannabis Cruise |
September 12, 2019 |
Mixed Reactions To U.S. Move To Ban Flavoured E-Cigarettes |
September 13, 2019 |
Temporary Overdose Prevention Facility Within Sight |
September 17, 2019 |
First Human Case Of West Nile Virus Reported In Windsor-Essex |
September 19, 2019 |
Three Local Beaches Unsafe For Swimming |
September 20, 2019 |
Local Health Unit On The Hunt For Supervised Injection Site Location |
September 23, 2019 |
Thousands Of Windsorites Hit The Road For Open Streets |
September 25, 2019 |
New Campaign Fights The Stigma Of Opioid Addiction In Windsor |
September 20, 2019 |
Guest Column: The Fact Is: Supervised Consumption Sites Save Lives |
Windsorite.ca
Publish Date | Title |
---|---|
September 10, 2019 |
Health Unit Says Smoking And Vaping Cannabis Not Permitted On Upcoming Cannabis Cruise |
September 16, 2019 |
First Human Case Of West Nile Virus Confirmed |
Yahoo News
Publish Date | Title |
---|---|
September 10, 2019 |
Upcoming Cannabis Cruise 'May Not Comply' With Provincial Smoking Rules, Says Windsor-Essex Health Unit |
Note: Digital stories were not available for MediaPlex (St. Clair College) and TVO.
The following individuals contributed to this report: Jennifer Jershy, Marc Tortola, and Michael Janisse.
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Board Members Present:
Gary McNamara, John Scott, Tracey Bailey, Deborah Kane (4:15 pm), Judy Lund, Joe Bachetti (4:10pm), Larry Snively, Rino Bortolin, Fabio Costante, Gary Kaschak, Ed Sleiman
Board Member Regrets:
N/A
Administration Present:
Theresa Marentette, Dr. Wajid Ahmed, Lorie Gregg, Nicole Dupuis, Kristy McBeth, Dan Sibley, Elspeth Troy
QUORUM: Confirmed
- Call to Order
Board Chair, Gary McNamara, called the meeting to order at 4:02 pm - Agenda Approval
Moved by: Rino Bortolin
Seconded by: Tracey Bailey
That the agenda be approved.
CARRIED - Announcement of Conflicts of Interest
None. - Presentation: Vaping (Dr. W. Ahmed)
Dr. W. Ahmed began by explaining that an electronic cigarette (e-cigarette) is a device whose function is to vaporize and deliver a chemical mixture typically composed of nicotine, propylene glycol and other chemicals into the lungs. Upon inhalation, the heater known as the atomizer vaporizes the nicotine solution within the e-cigarette, turning it to vapour. There is still a lack of scientific data to support the alleged benefits of vaping. Additionally, there are many regulatory concerns including who is making the vaping products, what the ingredients in the product are and where it can be purchased. Potential health risks remain undetermined, as there are no studies on the results of long-term inhalation of propylene glycol. Few studies have assessed e-cigarettes as a cessation aid or harm reduction tool. There are many public health concerns including vaping related severe acute lung disease.
In Windsor, WECHU’s tobacco enforcement officers have been doing proactive inspections to ensure compliance with municipal by-laws and the provincial Smoke Free Ontario Act, 2017. There have been several charges issued to both students and vaping product vendors. WECHU staff is also addressing vaping among youth in the area.G. McNamara asked Dr. W. Ahmed for an update regarding a recent press release from WECHU regarding a mosquito pool testing positive for Eastern Equine Encephalitis (EEE) virus within Windsor and Essex County.
Dr. W. Ahmed explained that WECHU has a mosquito control program that runs through the summer months to look for the presence of certain diseases.
Upon routine testing of the mosquito pools, the presence of EEE virus was identified. The WECHU press release reinforced messaging around protection from bites and removing standing water on properties.
Moved by: Joe Bachetti
Seconded by: Fabio Costante
To accept the presentation as received
CARRIED - Approval of Minutes
- Regular Board Meeting: September 19, 2019
Moved by: Judy Lund
Seconded by: Rino Bortolin
That the minutes be approved.
CARRIED
- Regular Board Meeting: September 19, 2019
- Consent Agenda
- INFORMATION REPORTS
The following information reports were presented to the Board.- ProsperUs (T. Marentette)
Brought to the Board for information. - Media Recap
Brought to the Board for information.
Moved by: Ed Sleiman
Seconded by: Fabio Costante
That the Information Reports be received.
CARRIED - ProsperUs (T. Marentette)
- RECOMMENDATION/RESOLUTION REPORTS
- Vaping (N. Dupuis)
N. Dupuis explained that the proposed motion is to support the ban of the promotion of vaping products in retail settings and online and that the government should restrict vaping flavours except for tobacco. All regulations related to protecting young people from tobacco products should be applied to vaping.
View the Harms of Vaping and Next Steps for Regulation Resolution report.
Moved by: Rino Bortolin
Seconded by: Joe Bachetti
That the Recommendation/Resolution Report be supported and approved.
CARRIED - Vaping (N. Dupuis)
- INFORMATION REPORTS
- Business Arising
- Additional SIS Application – New Addition to Agenda
R. Bortolin inquired whether the board would take a position on another SIS application going forward in the community. A local group is applying under an emergency need but this application still requires an endorsement by the Health Unit. He inquired as to what would happen if Health Canada reached out specifically to the Health Unit for support. Dr. W. Ahmed advised that the Health Unit is currently working on an SIS application that is carefully looking at risks and community concerns. This application will look to protect both those choosing to inject and the community. G. McNamara stated that as the community is looking to establish the first SIS, it is critical to ensure it is done correctly. He confirmed that should Health Canada reach out for endorsement, it would be brought to the Board.
- Additional SIS Application – New Addition to Agenda
- Board Correspondence – Circulated
- New Business
- ENWIN Utilities – Fluoride Update (T. Marentette)
After requesting further information and timelines from Enwin regarding the reintroduction of fluoride, they provided a letter stating the water in Windsor should be fluoridated by late in the third quarter of 2020.
Moved by: Fabio Costante
Seconded by: Judy Lund
That the above information be received.
CARRIED
- ENWIN Utilities – Fluoride Update (T. Marentette)
- Other Board of Health Resolutions/Letters
- Simcoe-Muskoka District Public Health – For Support – Letter to Hon. Ginette Petitpas Taylor and Hon. Christine Elliott – Vaping
- Kingston, Frontenac and Lennox & Addington Public Health – For Support – Letter to Hon. Christine Elliott – Vaping
Moved by: Joe Bachetti
Seconded by: Rino Bortolin
That the above correspondence be supported as noted.
CARRIED - Committee of the Whole (CLOSED SESSION, in accordance with Section 239 of the Municipal Act)
The Board moved into Committee of the Whole at 4:44 pm
The Board moved out of Committee of the Whole at 5:38 pm - Next Meeting: At the Call of the Chair, or November 21, 2019 in Essex, Ontario
- Adjournment
Moved by: Rino Bortolin
Seconded by: Larry Snively
That the meeting be adjourned
CARRIED
The meeting adjourned at 5:43 pm.
RECORDING SECRETARY:
SUBMITTED BY:
APPROVED BY:
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ISSUE
Recent increases in the popularity of electronic cigarette (vaping) products among youth and young adults has led the United States Food and Drug Administration to declare their use an epidemic among young people (U.S. National Academies of Sciences, Engineering and Medicine, 2018). E-cigarettes heat liquid (e- juice) producing an aerosol that e-cigarettes users inhale. The liquid in e-cigarettes or vapes as they are more commonly referred to can include nicotine, cannabinoid (CBD) oils, tetrahydrocannabinol (THC) or other substances. In Canada student use of vaping products increased by 30% each year between 2015 and 2017 (University of Waterloo, 2017), and a recent study by Hammond et al. (2019) noted vaping rates among 16 to 19 year olds in Canada increased 74% between 2017 and 2018. These nationwide trends are reflected in Ontario where 21.6% of students in Grades 7-12 reported use of a vaping product in their lifetime (Boak et al, 2017).
There are two pieces of legislation which regulate the promotion and sale of vaping products in Ontario. The federal Tobacco and Vaping Products Act (TVPA) aims to address the rising popularity of vaping products among young people by placing restrictions on how they can be advertised. At the provincial level, the Smoke-free Ontario Act (SFOA) 2017 further regulates these products by restricting their sale to minors, regulating how they can be displayed in storefronts, and restricting their use in certain public spaces. The Smoke-free Ontario Act 2017 is enforced locally by the Tobacco Enforcement Officers (TEOs) at the Windsor-Essex County Health Unit (WECHU) who inspect spaces proactively, ensure the region’s 223 e- cigarette vendors are operating in compliance, and conduct youth access test shopping inspections to discourage the sale of these products to minors. In spite of these protective measures their remains a lack of adequate safe-guards against promotion of vaping products in places where they may be observed by young people and other vulnerable populations. Promotions are commonly seen at point-of-sale in many convenience and grocery stores, as well as in locations like gas pumps, or parking lots associated with the places where vaping products are sold. As well, newer generation vaping products produced by companies such as JUUL©, VYPE©, STLTH©, or SMOK© are designed to be discrete and efficient nicotine delivery systems which in some cases deliver higher concentrations of nicotine per puff than tobacco cigarettes (American Cancer Society, 2019).
There is currently little research on the long-term health impacts of e-cigarette use and second-hand exposure, although, preliminary research has shown a positive association between use of vaping products and the risk for the uptake and intensity of tobacco smoking (Ontario Agency for Health Protection and Promotion (Public Health Ontario), 2018). This is complemented by the finding by Hammond et al. (2019) that after several decades of decline, tobacco smoking rates among Canadian adolescents have recently increased. Outside of the risk for nicotine addiction and susceptibility for tobacco uptake, the long term health effects of vaping products are unknown. The potential for more acute implications of chronic use have recently been realized with the approximately 1,080 cases of severe respiratory illness and 18 deaths associated with the use of vaping products in the United States (Centers for Disease Control and Prevention, 2019). In September of 2019, Health Canada issued a warning to Canadians that use vaping products to monitor themselves for symptoms of pulmonary illness, which has resulted in Ontario’s health minister ordering all public hospitals to report vaping-related cases of severe pulmonary illness to the Ministry of Health.
BACKGROUND
The Windsor-Essex County Health Unit has been working with municipalities, business, and school administrators to ensure these groups are prepared and educated around the harms of vaping and the existing regulations around vaping in public spaces. Since February of 2019 WECHU Tobacco Enforcement Officers have engaged in enhanced proactive inspections to ensure compliance with both municipal Bylaws and the provincial SFOA 2017. Since the passing of the SFOA 2017 in October of 2018 these efforts have resulted in 25 charges issued to high school students for vaping on or within 20 metres from school property, several verbal and written warnings to both high school and elementary students, 11 charges issued to vaping product vendors for selling vapour products to a person who is under the age of 19 years old, and multiple charges being issued to vaping product retailers for improper display or promotion of their merchandise.
Additional efforts were further described in an information report provided to the Board of Health on June 20, 2019 in which existing and planned activities to address vaping among young people were detailed, including:
- Distribution of School Vaping Prevention Toolkit to school administrators
- Participation in a provincial vaping working group
- WECHU staff education and policy development for clients using vaping products
- Secondary school proactive enforcement inspections in partnership with local Police Services
- School and school board presentations for students, teachers, and administrators
- Policy support offered to school boards
- Under 25 Electronic Cigarette Vendor Education program
- Smoke/Vape-free Spaces media campaign
The Windsor-Essex County Board of Health has passed a series of resolutions beginning in 2014 encouraging action at the provincial and local level to curb the potential for harms of vaping particularly among young people and people who do not smoke. The WECHU has since been instrumental in developing and passing local regulations to further protect residents from exposure to smoking and vaping products in public spaces. Since 2014, eight municipal bylaws have been passed which build upon and surpass the existing provincial regulations for smoke/vape-free indoor and outdoor spaces. Support was also provided to the Essex Regional Conservation Authority in their development, passing, and subsequent revisions to include more public spaces in which smoking and vaping were not permitted. A summary of the Board of Health Resolutions which have supported this and future work related to vaping is provided below:
Board of Health Report | Vaping-related Resolutions |
---|---|
Smoke-free Outdoor Spaces November 20, 2014 |
|
Smoke-free Multi-Unit Dwelling May 16, 2019 |
|
Smoke-free Outdoor Spaces June 20, 2019 |
|
In their consultation process, Health Canada and the Ontario Ministry of Health (formerly, the Ministry of Health and Long-term Care) provide public health units, other health organizations, stakeholders, and the general public with the opportunity to provide feedback into new regulations related to public health matters. The WECHU has responded with feedback at every opportunity provided by these levels of government in their consultations related to vaping. A summary of the feedback provided can be referenced below:
Consultation | Summary of Feedback Provided |
---|---|
Smoke-free Ontario Act 2017 Ontario’s Regulatory Registry October 2018 |
|
Reducing the Impact of Vaping Product Advertising on Youth/Non-Users of Tobacco Health Canada Consultation Document March 2019 |
|
Measures to Reduce Youth Access and Appeal of Vaping Products Health Canada Consultation Document May 2019 |
|
PROPOSED MOTION
Whereas, the WECHU Board of Health has passed three previous resolutions related to vaping to encourage further regulation at the federal, provincial, and local levels of government;
Whereas, the WECHU has submitted feedback independently and through regional collaborations for the increase in regulations related to vaping products;
Whereas, there is evidence that vaping products have short-term negative health effects and contain harmful chemicals like nicotine;
Whereas, the restrictions on the promotion and display of tobacco products and the removal of tobacco flavouring from the retail marketplace has contributed to the reduction of tobacco smoking among young people;
Whereas, Individuals who do not smoke should not start vaping, especially youth, young adults, pregnant women, and those planning on becoming pregnant;
Whereas, vaping rates among young people have increased 74% between 2017 and 2018;
Whereas, Vaping products have the potential to re-normalize smoking and lead to tobacco use among youth;
Now therefore be it resolved that the Windsor-Essex County Board of Health supports the ban on the promotion of vaping products in the retail setting and online, and
FURTHER THAT, the provincial government further restricts the sale of flavoured vaping products to include only tobacco flavours targeting current smokers who are looking to quit, and
FURTHER THAT, all regulations related to protecting youth and young people from the harms of tobacco smoke be applied to vaping products.
References
- American Cancer Society. (2019). What do we know about e-cigarettes? Retrieved from American Cancer Society
- Boak, A. Hamilton, H. A., Adalf, E. M., & Mann, R. E. (2017). Drug use among Ontario students, 1977-2017: Detailed findings from the Ontario Student Drug Use and Health Survey (OSDUHS) (CAMH Research Document Series No. 46). Toronto, ON: Centre for Addiction and Mental Health.
- Centers for Disease Control and Prevention. (2019, 10 08). Smoking and Tobacco Use. Retrieved from Centers for Disease Control and Prevention
- Hammond, D., Reid J. L., Rynard, V. L., Fong G.T., Cummings K. M., McNeill A., et al. (2019).Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys.
- BMJ; 365 :2219. Retrieved from https://doi.org/10.1136/bmj.l2219
- Margolis, K. A., Donaldson, E. A., Portnoy, D. B., Robinson, J., Ne, L. J., & Jamal, A. (2018). E-cigarette openness, curiosity, harm perceptions and advertising exposure among U.S. middle and high school students. Preventive Medicine 112(September 2017), 119–125
- National Academies of Sciences, Engineering, and Medicine. (2018). Public health consequences of e- cigarettes.Washington, DC: The National Academies Press. Retrieved from https://doi.org/10.17226/24952
- Ontario Agency for Health Protection and Promotion (Public Health Ontario). (2018). Current evidence on e- cigarettes: a summary of potential impacts. Toronto, ON: Queen's Printer ofr Ontario.
- Smoke-Free Ontario Scientific Advisory Committee, Ontario Agency for Health Protection and Promotion (Public Health Ontario). Evidence to guide action: Comprehensive tobacco control in Ontario (2016). Toronto, ON: Queen's Printer for Ontario; 2017.
- The Ontario Tobacco Research Unit. (2019). Promotion of Flavoured Vaping Products that appeal to Youth. Available here.
- University of Waterloo. (2017). Canadian student tobacco, alcohol and drugs survey. Retrieved from Canadian Student Tobacco Alcohol Drugs Survey
- U.S. National Academies of Sciences, Engineering and Medicine. (2018). Public Health Consequences of E-cigarettes.
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