The debate over what to do about the rise in Canadian teens sucking nicotine-laced vapours into their lungs has reached a predictable impasse.
On the one hand, you have health experts who say governments need to respond to the uptake in youth vaping with stricter enforcement of laws on how products are advertised and packaged, and by banning flavours designed to appeal to young people.
On the other hand, you’ve got industry spokespeople arguing that vaping reduces the health risks related to nicotine addiction, and that restrictive laws could stop tobacco smokers from using a legitimate harm-reduction tool.
Both sides have a point.
Teen vaping rates have doubled since Canada legalized and regulated e-cigarettes last year, according to research published in the British Medical Journal. One recent survey found nearly 40 per cent of 16- to 19-year-old Canadians have tried e-cigarettes, and nearly one in 10 said they vape weekly.
Another study, published this month in the journal JAMA Pediatrics, found that young people are attracted to e-cigarettes because of the cutesy flavours – birthday cake, bubblegum, vanilla and other dessert-like confections.
E-cigarettes, for the uninitiated, are handheld electronic devices that mimic smoking by using heat to vapourize a flavoured liquid that contains nicotine salts, which is then pulled into the lungs. They are as addictive as tobacco cigarettes but, because they don’t involve the combustion of tobacco leaf, they produce far fewer dangerous compounds.
And therein lies the other side of the story: Vaping is a legitimate harm-reduction tool for people who are already addicted to nicotine. An oft-cited British study found that it is 95 per cent less harmful than smoking tobacco. Health Canada says e-cigarettes are a safer choice than regular cigarettes.
E-cigarette manufacturers argue they need to be able to offer attractively flavoured liquids to lure adult smokers away from cigarettes.
They also say people will turn to the black market for unregulated products if theirs are banned. The continuing health scare in the United States, where 42 people have died and almost 2,200 have injured their lungs, appears to be related to illicit vaping products containing vitamin E acetate and THC, the psychoactive ingredient in cannabis.
So what to do? The answer lies in the intentions of the e-cigarette industry. It is becoming clear that one of its goals is to create new nicotine users, and not just attract tobacco smokers who might benefit from switching to a safer delivery system.
Let’s be honest: The market for a product designed solely to reduce the health risks associated with nicotine addiction would be small, and have limited growth potential.
But the industry is booming. The American company Juul, which makes the world’s most popular e-cigarettes, had US$2-billion in sales last year. Its product was not designed to be a medical prophylactic; it was designed to be a cool device that provides a big nicotine hit.
An investigation by The Globe and Mail found that vaping companies, some with ties to tobacco firms, have been ignoring the Tobacco and Vaping Products Act limits on how they can sell their products. Health Canada says its inspectors seized 60,000 non-compliant products from stores between July and October.
As well, companies like Juul and Vype are promoting their wares on social media with the help of influencers – people with a following who are paid to use a product. That appears to be lifestyle advertising, which is illegal under the Tobacco and Vaping Products Act. Worse, even if the online advertising is targeted at adults, teens can easily find it.
Last week, British Columbia responded with proposals to dramatically increase the provincial sales tax on vaping products, limit their nicotine content, ban advertising in places frequented by youths and cut back on kiddie-flavoured products. Other provinces are cracking down, too.
But as with tobacco, the regulation of the manufacture, sale, labelling and promotion of vaping products falls to Health Canada. If its rules are being ignored, it should toughen the consequences and make it painful for vaping companies to hook new users on nicotine.
Nicotine-addicted adults will still be able to find e-cigs. For them, it can be a tool for harm reduction. But for everyone else, vaping has become a vehicle for harm multiplication.