Please, Health Canada, do not make vapers return to tobacco!

My friend Maria is an enthusiastic vaper. If I go to her office, she usually will have three vapes on the go. Today, it is a Voopoo with strawberry flavour, a Stlth with Grape Apple Ice and a Favostx with banana flavour. If we go to a restaurant, she will excuse herself between every course and go outside to vape. She vapes from early morning to late at night, every day. She keeps a spare vape at home, just in case. Even if she is sick, she keeps on vaping. She would never even consider going on vacation to a country that did not allow her to vape.

Some people would call her a nicotine addict but she refutes the label. She says that she enjoys vaping and that it is not doing her or anyone else any harm. In fact, she says that she has had fewer respiratory illnesses since she switched from smoking, and nicotine helps her concentrate.

As her friend and as a physician, I am pleased to see her vaping because for Maria, the only alternative to vaping is smoking cigarettes. She began with a John Player Special at 14 and rapidly became a pack a day smoker. She tried to quit but was unable to do so. Nicotine patches gave her nightmares and she went manic on Zyban. She discovered vaping in 2010 and stopped smoking completely three weeks later.

* * *

I spent 40 years in the operating room as an anesthesiologist, so I have seen the disease, disability and death caused by smoking. I know that if Maria returned to smoking, she would have a 50 per cent chance of dying. Maybe a sudden death from a heart attack, maybe a slow, drawn-out death from COPD. She might go through surgery and chemotherapy for cancer or she might spend years in a wheelchair after a stroke or amputation before she died. I do not want to see that happen to her.

All vape is tobacco-free. Even the tobacco-flavoured vape only contains artificial tobacco flavour. Vape juice is heated but not burnt so it contains far fewer toxic chemicals than cigarette smoke.  If she continues to vape, the chance of her dying from vaping is less than 1:40. That is why I am happy to see her vaping.

* * *

Maria is convinced that vaping saved her life. She is giving back by running a vape shop in Port Hope, Ont., where she helps other smokers quit by vaping.

I enjoy hanging out with her in her cozy store, overhearing her conversations with customers, smokers who want to quit. She really listens to them, taking the most detailed smoking history, because every answer guides her choice about the most suitable vape to recommend.

She does not just ask how many cigarettes people smoke; she asks how they smoke them. Do they smoke the cigarette down to the butt or not? Do they suck smoke directly into their lungs, or do they hold it in their mouth first?

“So, you like the ‘throat hit’ from smoking? – let’s try you with regular nicotine.”

“You like to take a long, deep drag on your cigarette? A pod system will not give you that, you need a tank.”

* * *

In less than a year, all this may be gone. She may be back to smoking cigarettes. The store may be shuttered. Her clients may have nowhere to go for supplies, advice and support as they try to quit. Why? Who would do such a crazy and destructive thing that will inevitably lead to more deaths from tobacco use? Surprisingly, the answer is Health Canada, the organization that hopes to reduce tobacco use to 5 per cent by 2035. The federal government is planning to ban flavours in vape juice in response to the so-called “epidemic” of teen vaping. The only flavours that will be allowed are tobacco, menthol and mint. Even these flavours will be reformulated to be unpleasant as no sweeteners will be allowed. This will make vaping unattractive to smokers and put adult-only specialty vape stores out of business.

The ban is ill-conceived.

“If Maria returned to smoking, she’d have a 50 per cent chance of dying.”

Teen vaping is not leading to teen smoking, which is declining rapidly.

Teens know that vape is safer than smoking. It is also cheaper, cleaner and more discreet. Teens may experiment with both sources of nicotine but they prefer vaping.

Flavours are only one reason why teens vape. Teens vape for fun, because their friends vape, to do vape tricks and out of curiosity. Few will quit vaping in response to the ban.

Most vapers (83 per cent) are adults, the majority of whom vape as a safer alternative to smoking. The ban will make vaping less attractive and may lead some who have switched to go back to smoking. A weaker ban in San Francisco led to a 30 per cent increase in tobacco use.

The Regulatory Analysis Impact Statement for the ban is full of errors and half-truths:

• It assumes that vaping is 20 per cent as dangerous as smoking. Public Health England and the Royal College of Physicians say that the risk is 5 per cent, four times lower.
• It states that Health Canada has not approved vaping as a way to quit but fails to mention that scientific studies prove vaping is better than conventional nicotine replacement therapy at getting smokers off cigarettes.
• It assumes that adult smokers will find unsweetened tobacco and menthol flavoured vape acceptable but both adults and teens prefer sweet vape with fruit or dessert flavours, and smokers who use non-tobacco flavoured vape are more likely to quit.

Health Canada accepts that this ban will increase adult smoking and notes that there is no scientific consensus on the value of a flavour ban. But it is giving in to political expediency and a need to be seen to be doing something.

Recreational vaping by teens is a problem. Health Canada made vaping legal in 2018 with a ban on  advertising to minors. *But in the US, JUUL and other companies paid “influencers” to promote a vaping lifestyle to young people on social media. Vaping became a popular fad before the government noticed. They are now over-reacting to try to recover.

How can we discourage minors from vaping while allowing adult smokers access to an enjoyable and much safer alternative to smoking? British Columbia, Saskatchewan and Ontario have banned the sale of flavoured vapes in convenience stores and gas stations but permit their sale in adult-only specialty vape stores that would lose their licence if they sold vapes to minors. Health Canada should study this option before rushing in with an ill-conceived national vape flavour ban.

There are 520,640 Canadian vapers over age 20 who, like Maria, are using vaping as a safer alternative to smoking. If you think they should have the right to continue to have an enjoyable and safer alternative to deadly cigarettes, please email hc.pregs.sc@canada.ca and let Health Canada know before the Sept. 2nd deadline. See https://oyston.com/blog/submission/  for details.

*This article was updated to specify that the mentioned social media marketing occurred in the United States.