Eliminate choice | Define a civil penalty structure for youth who violate the laws, providing alternative penalties to fines. This would reduce the chances of creating adverse consequences among those youth who already experience a disproportionate burden of social disadvantages. Enforce and apply monetary fines for international vendors involved in illegal sale of vaping products to youth. This may be a challenge to address considering the loopholes in government regulations around online sales to youth. Eliminate cross-border advertising to reduce exposure to vaping products and devices and prohibit the promotion of them in an appealing way for young people—even though it requires coordinated efforts between countries. Outlaw power wall displays of vaping products and devices in retail stores, as well as ban sales of these products to youth.
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Restrict choice | Limit nicotine strength to lower levels. Restrict marketing of vaping products and devices as smoking cessation services (ie, harm reduction promotion despite the limited evidence on the long-term safety risks of vaping). Develop regulatory strategies to restrict packaging design. This may have the potential to reduce vaping appeal and desirability, particularly for younger youth (eg, ages 12–14) who are more likely to be drawn to the varying shapes and sizes of vaping products and devices. Implement regulations on the current aggressive advertising techniques, including in the social media landscape.
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Guide choices by changing the default policy | Develop graphic warning labels on the packaging of vaping products and devices. Encourage the adoption of household smoke-free policies. Disseminate messages on health or financial rewards as they are well received by youth.
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Enable choice | Use interactive, short modules each covering a specific topic (eg, marketing strategies, flavours) in school-based vaping prevention programmes. The modules should be embedded in a user-friendly online portal, be collaboratively delivered by (eg, physical education) teachers and student-peer leaders, or follow physical activities that are based on the movement-oriented games in the modules. Prefer peer-led vaping prevention interventions on refusal skills over those led by experts. Deliver effective educational campaigns and programmes to increase youth awareness. This has the potential to address the current uncertainty and misperceptions about the source of nicotine in e-cigarettes and the meaning of tobacco-free nicotine or synthetic descriptors. Such strategies are even more critical when regulations are not yet in place for the marketing and selling of vaping products that still cause lifelong chemical dependence. Through educational programmes, equip youth with knowledge and skills on how to make the best, informed decisions for themselves. This should include learning about how to identify targeted marketing and advertising strategies (eg, sleek designs, fruity flavours) used by the vaping industry. Use educational strategies to provide training (via role-playing, virtual reality games, etc) for youth to develop lifelong refusal, resistance and assertiveness skills and navigate peer pressure and overcome social influences. Create a culture where non-vaping becomes synonymous with ‘being cool’ and ‘leading a healthy lifestyle’. This may help deconstruct the current positive image associated with vaping.
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Provide information | Deliver vaping prevention messages (in print, static web or video format) tailored to the youth. Through those messages, public health organisations have successfully reached youth and changed their perceptions and beliefs. Messages are more effective when they speak of addictions, brain and lung damage, death risks, harmful water vapour, or include the nicotine chemical symbol. Use a variety of platforms, including television and social media, to improve the dissemination of educational campaigns on the vaping risks to health. Through educational campaigns, provide information on the environmental risks posed by vaping products and devices, as well as the health risks of exposure to secondhand aerosol from vaping. Such strategies may be effective considering youth’s sensitivity to environmental issues and unintended health consequences of exposure to vaping. Send brief text messages that use loss-framed messaging (ie, highlighting the negative consequences of vaping) to smartphones. Deliver educational programmes in school settings. Regardless of the format or who delivered the interventions, they support preventing youth vaping behaviours. Avoid single vaping prevention events in school settings. They have no impact on preventing youth vaping and may unintentionally increase curiosity about vaping products and devices. In school settings, consider implementing vaping prevention programmes with multiple sessions more than once a year to better respond to the evolving vaping landscape. Develop partnerships between schools and public health organisations, antivaping advocacy groups and other municipal and provincial departments concerned with vaping. Given schools’ limited capacity, time and resources, such partnerships can bring know-how and support the implementation and evaluation of evidence-based vaping prevention programmes. In school-based interventions, use vaping prevention resources created by public health organisations (eg, hanging posters in restrooms that mention the marketing strategies used by the vaping industry). Ensure vaping prevention programmes are up to date with information on the latest products introduced in the market. Frequent adaptations and revisions of the resources are needed to reflect the most recent changes in the rapidly evolving vaping world. Keep vaping prevention programmes free of cost. This increases accessibility and is more inclusive and equitable.
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Do nothing or simply monitor the current situation | Ensure health warnings are revised periodically as their preventive effects may wear off over time. Encourage families to keep the household rules on youth vaping behaviours. This may have a stronger impact on youth than community norms.
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Reorient government action | |