In 2016, Queens University held as part of its 175th anniversary celebrations an international summit to discuss and debate an "endgame" for tobacco usage in Canada.
The Tobacco Endgame for Canada Summit concluded with a call for the creation of a tobacco endgame strategy for the country. Experts envisioned a Canada in which smokers make up less than five per cent of the population by 2035.
Fast forward to May 2018. The federal government releases its tobacco control strategy, and while it can be commended for its welcomed elements, experts in smoking cessation condemn it overall.
So what happened?
“The strategy as revealed was a source of great disappointment to many in the health community who had anticipated a robust, imaginative approach to addressing Canada’s leading cause of preventable disease, disability and death,” said Dr. Andrew Pipe, who recently presented at the University of Ottawa Heart Institute’s 11th Annual Ottawa Conference: State of the Art Clinical Approaches to Smoking Cessation. Dr. Pipe is one of Canada’s foremost experts in smoking cessation.
The emergence of a highly sophisticated nicotine delivery device like JUUL, accompanied by a lavish advertising strategy and an explosion in teenage nicotine use and addiction has revealed the deficiencies in the strategy and the shortcomings of a misplaced optimism about being able to divert smokers to e-devices.
- Dr. Andrew Pipe, University of Ottawa Heart Institute
According to Pipe, there is a lack of enforceable legislation to regulate how vapes, e-cigarettes and other e-devices are advertised to non-smokers, specifically among Canada’s youth. Teenagers across the country are using these devices in the classroom and many students are reporting they are refusing to use school bathrooms since they are dominated by the presence of vapers.
In at least one high school in Ontario, the teenage vaping epidemic has forced a principal to remove the doors to the public washrooms in an effort to deter students from vaping.
“The emergence of a highly sophisticated nicotine delivery device like JUUL, accompanied by a lavish advertising strategy and an explosion in teenage nicotine use and addiction has revealed the deficiencies in the strategy and the shortcomings of a misplaced optimism about being able to divert smokers to e-devices,” Dr. Pipe said.
In its original report, the Summit of 2016 made clear that electronic cigarettes and other e-devices had potential to help smokers manage their nicotine addiction, and could potentially form part of the government’s tobacco control strategy so long as “policies are put in place to prevent them from becoming a problem for non-smokers, or for deterring cessation.”
The language found in Bill S-5 which outlines vaping provisions is described by Dr. Pipe as being far too passive, bland and “very difficult to enforce.”
It’s as if we failed to learn anything from our experience in battling and regulating the tobacco industry over the past 20 to 30 years, Dr. Pipe said. “The development of sophisticated nicotine delivery by tobacco companies or new entities heavily supported by tobacco-company investment portends a whole new generation of nicotine addicts and continuing challenges for the health community. Once again the tobacco industry is laughing all the way to the bank – and continuing to escape any robust regulation.”
Dr. Pipe suggested the government’s thinking was likely based around an idea that to help people quit smoking, health officials should want people to know that products like JUUL and Vype are potential answers to their problems – that these highly addictive, highly efficient nicotine delivering devices are somehow helpful, and thus do not require the same regulations as tobacco products. This thinking, Dr. Pipe said is an example of the federal government’s “naivety in the extreme.”
It’s like the Australian cane toad all over again.
At the turn of the century and in the years that followed, sugar cane became a huge industry in Australia and in many parts of the world. One of the biggest problems then for Australian industry was the cane beetle, a native parasite which devoured vast quantities of sugar cane and buried its larvae beneath the soil where traditional pesticides couldn’t solve them.
The solution then by the Australian government was to introduce a foreign species to the ecosystem to hunt and kill the beetles. At first it seemed a practical and logical solution to a pressing issue. The cane toad was deemed a better option than traditional pesticides despite having itself toxic venom-secreting glands in its skin, making it highly poisonous – and dangerous to the country’s native animals. With no natural predators of its own, and with opportunistic breeding behaviour, the cane toads quickly amassed in huge quantities on highways and roads, and created a host of unanticipated consequences for Australia which still exist today.
“The publicity of vaping devices now permitted has led to a massive increase in their use by non-smoker adolescents with a resulting increase in the number of addicted teenagers - many of whom are anticipated to begin using conventional cigarettes. Unanticipated consequences to be sure!”
Vapes and other e-devices, Dr. Pipe said, are the cane toad to tobacco’s beetle.
According to Dr. Pipe, what we need now is simple:
“We need to support and encourage the Minister of Health to re-invigorate the tobacco control strategy. We need to support and encourage the Minister of Health to adopt an emboldened approach to the regulation of e-devices and their marketing and we need to recognize the implications of any delay in these matters.”