The legalization of cannabis isn’t the only pending policy issue involving what people are smoking. The question of how many people smoke cigarettes and what, exactly, they’re doing to their bodies and minds while they’re doing it is also a serious public health question. At a Sixth Estate panel in Ottawa during National Non-smoking Week, experts explored the effectiveness of vaping as a harm-reduction tool for people trying to quit smoking cigarettes.
“It would be rather naïve to think that all smokers want to stop smoking, and that all smokers are able to stop smoking,” said Dr. Gaston Ostiguy, past director of the Smoking Cessation Clinic at the Montreal Chest Institute. “Even the best clinical studies have a success rate of less than thirty percent abstinence of one year.”
Ostiguy was joined by: David Sweanor, chair of the Advisory Board, Centre for Health Law, Policy & Ethics, University of Ottawa;
Jaye Blancher, director of the Tobacco Harm Reduction Association of Canada; and Sherwin Edwards, president of Vap Select Inc.
The conversation comes at a time when countries around the world are wrestling with the issue of how to regulate vaping, the practice of inhaling vapour through an electronic cigarette. United Kingdom is moving to embrace e-cigarettes, while Brazil, Singapore, and Thailand have moved to prohibit them. In Canada, Bill S-5, the proposed tobacco and vaping products act, is making its way through Parliament. Smoking rates in Canada continue to decline, with 2017 reported figures at 17.7 percent, or just over five million people.
Jaye Blancher, Director of the Tobacco Harm Reduction Association of Canada, said that she had been a smoker since age 12 and was unable to quit by another means until she tried vaping. She quit within five days.
“If there are very restrictive regulations passed, someone who wants to go into a vape store to get their equipment, the owner would not be able to show them how to use the equipment other than saying this is how it turns on,” said Blancher.
She is also concerned about the restriction of flavours, as she doesn’t feel that there has been enough evidence to show that vaping would be a gateway to smoking for youth.
A study released in the United States by the National Academies of Sciences, Engineering and Medicine the same day the panel met found “conclusive evidence” that most e-cigarettes contain numerous chemicals that can be toxic, but at the same time, vaping is far less dangerous than smoking cigarettes. The survey, the most comprehensive analysis of data on vaping to date, also found “substantial” evidence that young people who vape are more likely to try cigarettes, and that there is limited evidence vaping was an effecting tool to help adult smokers quit.
Ostiguy said that while smoking kills, nicotine itself does not, even while it creates dependence and addiction. He also added that Sweden has the lowest lung cancer rate in the world because of the use of the traditional smokeless tobacco product “snus” — a type of wet snuff.
“Despite the controversy, it is clear that e-cigarettes are far less hazardous than tobacco – 95 percent less, says the public health [unit] of the Royal College of Physicians in London,” said Ostiguy. “E-cigarettes can save many thousands of lives.”
David Sweanor, Chair of the advisory board for the Centre for Health Law, Policy and Ethics at the University of Ottawa, said that cigarettes are still killing 100 Canadians a day, and killing 20,000 people a day globally.
“We’ve known for decades that people smoke for the nicotine, but they die from the smoke,” said Sweanor. “If we got our caffeine by smoking tea leaves rather than brewing them, that would be causing the same diseases.”
Sweanor said that treating vaping like smoking treats it like a problem rather than a solution, which stymies the needed innovation to give Canadians the products they need to quit smoking.
“Canadians are spending billions of dollars on cigarettes – they don’t want cigarettes,” said Sweanor. “Create an incentive for ever better innovation to come out with products that are able to get them off cigarettes. We can do that. The opportunity is there.”
“Since 2011, when this industry started to grow and flourish, we heard a lot of fear-mongering and propaganda,” said Edwards. “When we’re looking at regulations, now that the positive science is coming through very rapidly, we should be able to share this positive information to the consumer but BILLS5 will make that illegal. We should be looking to the European market and the United Kingdom for guidance.”
Edwards said Bill S-5 is looking to the American Food and Drug Administration template rather than our Commonwealth partners.
“Here in Canada, we’re going the wrong way – we’re scaring people and stigmatizing vaping,” he said. “To classify it within the Tobacco Act is just wrong.”
Sweanor cautioned against any effort to over-regulate. “We need to move away from that abstinence-only [model],” he said. “It didn’t work for us very well with sex. It didn’t work for us very well with alcohol. It didn’t work for us very well with illicit drugs. It doesn’t work for us with nicotine.”
Vaping opponents were invited to participate, but were not available.