If Big Tobacco sells e-cigarettes, they'll 'recruit a whole new generation' of smokers: Public Health Ontario

If Ottawa lets Big Tobacco into the e-cigarette business it would be handing the industry the chance to hook teenagers on nicotine and turn them into lifelong customers, the chief executive officer of Public Health Ontario says.

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"It's desperately difficult for people to give up smoking once they're addicted to nicotine," Dr. Peter Donnelly said. "And my concern is that e-cigarettes and vaping of nicotine-containing mixtures could be a very effective way of recruiting a whole new generation of nicotine-addicted young people who are then very prone to turn to smoking cigarettes."

The federal government announced last month that it would introduce changes to the Tobacco Act in order to regulate the burgeoning e-cigarette and vaping industry.

Right now, e-cigarettes can only legally be sold in Canada without nicotine — and since they're not regulated by Health Canada they can't be marketed as a way to help someone stop smoking.

But what's legal and what's actually happening are not necessarily the same thing.

More than 26 per cent of people who vape reported that their last e-cigarette contained nicotine, while another 19 per cent said they didn't know if their last vape was nicotine-free or not, according to a 2015 study on countrywide tobacco uses and trends by Waterloo's Propel Centre for Population Health Impact.

The study also found that most specialty vaping stores and online e-cigarette shops offer nicotine-laced vaping liquid, much of which is flavoured to taste nothing like tobacco.  

'Who are they targeting?'

It's an issue that Donnelly said the pending regulations need to address in order to balance the needs of an adult population trying to quit smoking, with protectionist measures to keep youth from taking up the habit.

The flavours include everything from bubblegum to maple syrup to mint, something that has been the target of public health officials like Donnelly who argue it's essentially marketing to children.

"I mean who are they targeting?" he said. "I don't know many adults who are going to go for gummy bears."

The public health official said he wants to see regulations that would make it illegal to market e-cigarettes to youth, which he said could include putting limits on what kind of flavours could be sold.

Nascent research surrounding e-cigarettes has found that vaping appeals to young people, Donnelly said, perhaps because it seems like a safer alternative.

Conflicting research

"But cigarettes are an outstandingly dangerous product and the worry is that nicotine-dispensing e-cigarettes and vaping products are very attractive to young people," he said. "If they use them, they're more likely to go on and smoke cigarettes."

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Canada's largest tobacco company, meanwhile, says that it's not interested in getting into the e-cigarette industry to target children. 

"I don't want my kids to smoke," Imperial Tobacco spokesman Eric Gagnon told CBC's the fifth estate. "We support reasonable and evidence-based regulation, especially the ones aimed at keeping tobacco products out of the hands of kids."

Instead, he said, the tobacco industry wants to be able to offer a product that's less harmful to people who are already addicted to smoking, likening it to McDonald's offering a salad on their menu as well.

It's a kind of logic that Dr. Gopal Bhatnagar might understand. 

The cardiovascular surgeon at Trillium Health Centre is also the owner of 180 Smoke, a popular chain of vaping shops, and said he believes he's offering a tool to help smokers quit. 

Combustible tobacco smoking remains the number one preventable cause of disease in our society.- Cardiovascular surgeon and vape store owner, Dr. Gopal Bhatnagar

The issue, however, is that because it's a new product there are few long-term studies measuring its effectiveness. And those that have been done offer conflicting information. 

The medical journal, The Lancet, for example, released a study in January that found people were 28 per cent less likely to quit smoking by using e-cigarettes than by turning to other methods. In March, however, it published another piece, which found that vaping is less harmful to someone than traditional cigarettes.  

So when asked whether it seemed out of character for a health professional to sell an addictive product like nicotine, Dr. Bhatnagar responded that pharmacists also sell nicotine through gums, patches and sprays.

"Combustible tobacco smoking remains the number one preventable cause of disease in our society," he said. "So I feel that anything that can continue to reduce the smoking rates and lessen the harm caused by tobacco is a very positive thing."