Vaping-related illnesses

In 2019, US media outlets were buzzing with reports of a mysterious “vaping-related illness” sweeping the country. Here in Canada, anti-tobacco lobbyists reacted immediately, pushing provincial governments and federal authorities to adopt stringent vaping regulations. But these new rules disregard solid evidence for vaping as a less harmful alternative to smoking–and ignore the fact that Canadian vaping regulations are miles away from those in the US.

Vaping in Canada

  • A thriving black market

    Vapour products, often called e-cigarettes, have been in the Canadian market for at least a decade. Prior to legalization, the absence of regulation or enforcement helped independent and online retailers take advantage of a thriving illicit market, with vapour products illegally sold in Canadian vape shops or illegally imported from the US. There was no government oversight on how market players operated, what they sold, the quality of their products, or who they sold to.

  • Legalization

    The federal government, understanding the need to balance the tobacco harm reduction potential of vapour products with measures to ensure minors do not have access to these products passed the Tobacco and Vaping Products Act (TVPA) in May of 2018. 

    The TVPA ensures the following:

    • Vapour products cannot be sold or given to anyone under 18 years of age (in some provinces 19 or 21)
    • It is illegal to sell vapour products with confectionary flavours that could be deemed appealing to youth
    • Vapour products that appeal to youth in how they look or work are strictly prohibited
    • Industry reporting, manufacturing standards, product and package labelling (including health warnings) and the permissibility of certain ingredients are subject to federal rules
  • Playing by the rules

    Imperial Tobacco Canada did not begin selling vapour products until the Government of Canada passed legislation that legalized their sale. These devices are primarily intended for adult smokers who choose to quit traditional cigarettes and present a potentially reduced-harm alternative to smoking.

Vaping in the US

  • American vapers get sick

    In late summer 2019, US media began reporting cases of “vaping-related illness.” 

    In April of 2019, the FDA issued a statement about people experiencing a seizure following the use of e-cigarettes. The statement reported 35 cases of such seizures after vaping among “youth or young adult users,” between 2010 and early 2019, with an uptick in seizures over the previous year. The CDC then issued a pre-emptive statement warning people not to vape any products.

    Over the next several months, federal health officials reported many more such cases, triggering a national panic over a mysterious outbreak–and a steady stream of news items speculating on the exact cause. This led US President Donald Trump to propose a vaping ban in the fall of 2019 (which he later reversed due to a public outcry from the vaping community). 

    The US has now reported 2,500 cases of vaping-related illness and 54 deaths. 

    On November 8, the US Centres for Disease Control and Prevention (CDC) reported a “breakthrough,” stating their findings “provide direct evidence of vitamin E acetate at the primary site of injury within the lungs.” As recently as December 21 the CDC was saying that the “vast majority” of cases are tied to vitamin E acetate. This confirms earlier reports suggesting that illnesses in the US are linked to this additive which tends to be mixed with THC vapour products obtained on the black market. Most importantly, it is critical to note that vitamin E acetate is already a prohibited additive for vapour products in Canada.

    Most recently, the CDC removed guidance from its website which previously advised people that “they should consider refraining from using all e-cigarettes or vapour products” if they were concerned about lung illnesses. The CDC now recommends that “people not use THC-containing e-cigarettes or vaping products.”

    Brian King, Chief Science Officer for the CDC’s vaping-related outbreak response, commented: “[r]ecommendations were refined to reflect the best available scientific evidence and to best protect public health. The available science shows that Vitamin E acetate is strongly linked [to the outbreak].”

Hysteria moves north

  • The spillover effect

    The US media coverage naturally spilled over to Canada and became intertwined with the media narrative about youth vaping. Public health lobby groups in Canada demanded immediate action, in spite of Canada’s distinctly different vaping product restrictions.

    We now know that vaping-related illnesses in the U.S. were linked to products containing ingredients such as THC and Vitamin E acetate, which are not used in the vaping products distributed by Imperial Tobacco Canada and manufactured by its parent company British American Tobacco. Vitamin E acetate is a prohibited additive for vapour products in Canada. 

    While there have been 15 cases in Canada that report possible “vaping-related illness”  the only case with any published details in Canada suggests that the origin of the illness may be tied to a black market product that uses an ingredient Health Canada has given directions to not use.  

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