Final thoughts

There is a common theme throughout the debate over e-cigarette regulation: uncertainty.

Ultimately, good legislation requires accepted scientific consensus. For e-cigarette regulation in Canada, it seems that the government is waiting for studies to determine health effects of vaping and the effectiveness of the e-cigarette as a smoking cessation tool.

There is very little research on e-cigarettes and what does exist is conflicting, or at least it is questioning the hypothesis that e-cigarettes are safe. Some research states that e-cigarette vapour may be harmful and have negative health effects for the smoker.

Other research indicates the exact opposite. Some may hesitate to draw conclusions from such conflicting opinions, but potential conflicts are the norm for scientific research.

Consider asbestos. There was a time when asbestos was used in almost all major building constructions. Today, it is known and accepted that exposure to asbestos increases the likelihood of lung cancer and other lung diseases.

Yet how to explain a 40-year study, conducted by McGill researchers that downplayed the dangers of asbestos? Simply put, there is enough evidence disputing the results of this study that it should not be taken as fact until the results can be reproduced elsewhere.

This is the nature of scientific research. Not all results will be identical. Some studies can produce directly conflicting results but with enough research a consensus can be formed. As McGill researcher Caroline Franck says, one study will not dictate a regulatory framework. It takes many studies with repeatable results. This is the reason why it is so important for more research to be done on e-cigarettes.

David Sweanor worked to reduce the harmful and hazardous effects of tobacco for years. He witnessed governments restrict access to nicotine replacement treatments by over medicalizing the industry, making it less accessible than toxic tobacco cigarettes.

“The safer the nicotine product the more heavily we regulated it, and the deadliest products got a free-ride,” he said.

Right now, the e-cigarette industry is vulnerable. This general lack of knowledge means tobacco companies, pharmaceutical companies or other stakeholders can say whatever they like about the product. There just isn’t enough evidence to dispute any reasonable claims.

In this respect, the federal government has failed Canadian citizens. Aside from banning the use of nicotine-containing e-cigarettes, it has turned turned a blind eye to the industry. Health Canada should have recognized the void of research on e-cigarettes and filled the gap by funding or undertaking new studies.

As a result, Canadians are ill-informed of the dangers or benefits of e-cigarettes

By banning nicotine-containing e-cigarettes, Health Canada is sending the message that they must be harmful, which is a problem if it proves to be a beneficial public health tool. Since tobacco cigarettes (containing nicotine) are legal, and nicotine-containing e-cigarettes are illegal, current laws are playing directly into the hands of both tobacco and pharmaceutical companies, who don’t want competition from e-cigarettes.

Despite the lack of e-cigarette research, anecdotal evidence suggests e-cigarettes can help some smokers quit tobacco cigarettes. In some cases they may be more helpful than currently accepted alternatives to cigarettes.

By banning nicotine-containing e-cigarettes altogether, Health Canada leaves smokers with three choices: continue smoking, try a method to stop like gum or patches or illegally purchase or import nicotine e-liquid.

The jury is still out on e-cigarettes, but the verdict is in on tobacco cigarettes. They are the number one cause of premature death in Canada. The ban on nicotine e-cigarettes is depriving the public of a potentially life-saving tool.

It is not reasonable to consider nicotine-free e-cigarettes a smoking cessation tool as the users would then essentially be trying to quit their nicotine addiction cold turkey.

Are e-cigarettes completely safe? That cannot be answered without more research. But they are not as dangerous as tobacco cigarettes and the second-hand vapour as toxic as second-hand smoke.

Whether e-cigarettes should be regulated as a medical device or a consumer product is open for debate, but at this point they are not regulated at all. Despite the prohibition, vapers like Michael Hampartzoumian, Ghulam Hasnain and Adey Bailey have little trouble finding nicotine e-liquid.

As these products are illegal, there is no standard that they must meet. Some, like the Electronic Cigarette Trade Association of Canada, have proposed an industry standard for product testing. At the very least, the federal government should mandate a similar standard to ensure the quality and safety of the products. This is especially important considering the exponential increase in e-liquid flavours and brands.

Provincial regulation of e-cigarettes has been harsh (where it has been applied), but bans on youth purchasing or smoking e-cigarettes are an important step. Nicotine has been shown to affect brain development of adolescents. It is also an addictive drug, much like caffeine.

Ultimately, given the lack of research, e-cigarettes should be presented as a smoking cessation device and at the very least a smoking alternative.

Regulating e-cigarettes as a health product would limit the availability of the product so much that it could not compete with tobacco products.

If for the time being e-cigarettes are marketed as a healthier method of smoking, technically they would not be marketed to non-smokers. That should reduce the risk of e-cigarettes becoming a gateway drug to attract new smokers to tobacco cigarettes.

Ultimately, e-cigarette use should not be as restricted as cigarette use. On this topic, most provincial and municipal legislation has been too harsh and almost unrealistic. Proper legislation, at this point, should give smokers an incentive to use e-cigarettes over tobacco cigarettes.

Since it’s unknown whether second-hand vapour is completely safe, vaping should still be banned indoors and in vehicles. But perhaps there could be some sort of middle ground between vaping and smoking. For instance, maybe vaping could be legal on patios while cigarette smoking is not, or as Bhatnagar suggests, having a room for vapers only.

The federal government has to lead the way on this topic.

More funding, more studies and more clarity are needed for sound legislation–and there is yet to be any of this. Health Canada should commission further studies so Canadians are no longer caught between wait-and-see and safer-than-sorry. The focus should be on keeping Canadians healthy.