Harm reduction

Cigarettes pose serious health risks; the only way to avoid those risks is to not use them. But if a current smoker is deciding between smoking conventional cigarettes and using potentially reduced-risk alternatives like vapour products, they should make the switch. That’s what harm reduction means. 

What do we mean by vapour products?

  • Vapour products are rechargeable, battery-powered devices that heat liquid formulations–e-liquids–to create a vapour which is inhaled. Most e-liquids contain water, propylene glycol and glycerol, flavourings and nicotine, although some e-liquids don’t contain any nicotine.

    Most of the harm associated with smoking is caused by the toxicants in the smoke produced when the tobacco in the cigarette is burned. Because vapour products don’t burn tobacco, the vapour contains substantially lower levels of the toxicants created during the combustion of tobacco.

What does the evidence say?

  • The Canadian Federal Government has recognized vapour products as a harm reduction tool, and Health Canada’s website affirms that “Vaping is less harmful than smoking.” 

    In the UK, Public Health England (the equivalent of Health Canada) estimates that vapour products are at least 95% less harmful than traditional cigarettes.1 As a result of their progressive policies, millions of British smokers have quit.

    A review by the National Academies of Sciences, Engineering and Medicine, a US-based organization of leading researchers which analyzed the results of more than 800 identified peer-reviewed scientific studies and concluded that “while e-cigarettes are not without health risks, they are likely to be far less harmful” than conventional cigarettes.2

    1 McNeill A, Brose LS, Calder R, Bauld L & Robson D (2018). Evidence review of e-cigarettes and heated tobacco products 2018. A report commissioned by Public Health England. London: Public Health England. “Based on current knowledge, stating that vaping is at least 95% less harmful than smoking remains a good way to communicate the large difference in relative risk unambiguously so that more smokers are encouraged to make the switch from smoking to vaping. It should be noted that this does not mean e-cigarettes are safe.”

    2 E-cigarettes: Balancing risks and opportunities, British Medical Association, November 2017.

Successful approaches

  • Promoting nicotine vapour products as a potentially reduced risk-alternative to smoking has proven successful in the UK, New Zealand and France, often with the support of public health authorities.

    Meanwhile, provincial governments in Canada seem determined to move  people away from nicotine-based vapour products, or at least from the legal market for those products. Instead of collaborating toward a cohesive federal policy, the provinces have taken aggressive and divergent action, proposing a complex patchwork of regulation by jurisdiction on an accelerated basis.

Is Canada losing out?

  • Since the reports of vaping-related illness began to emerge, vapour product sales in Canada have dropped by more than 20%. Meanwhile, there is some concern that sales of cigarettes, which had been in double-digit decline in 2019, may start to increase.   

    A product that was introduced as a potentially reduced-harm alternative for adult smokers (with the support of Health Canada) is now on the verge of being regulated to the point where it is no longer viable, forcing people back to combustible cigarettes.

    Rather than fuelling special interest and misinformation campaigns, recent events in the United States should serve as a catalyst to finding a balanced regulatory approach to vapour products that provides adult consumers with the information they need to make an informed decision, enforces restrictions on sales to minors and imposes robust and consistent product standards.

Moving forward

  • We need to have a fact-based discussion around vapour products premised on some very basic questions:

    • Do governments believe in the concept of tobacco harm reduction in the form of vapour products? 
    • How can such products remain accessible and affordable for Canadian adults while preventing youth use?
    • If existing laws are not being enforced, how can we expect new laws to be?
    • How can we approach health issues around vapour products and illness in a factual way?  
    • Why aren’t public health authorities in Canada sharing details about Canadian cases of vaping-related illness? 
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