Safety of ‘vaping’ at issue
VAPING IS GAINING IN POPULARITY, but critics fear they will erode anti-smoking gains
Critics call it an unregulated drug delivery system. Fans say it’s better than smoking the real thing. At issue is the popular e-cigarette, which produces wisps of vapour that are odourless and smoke-free. But just how safe is vaping? Charlie Fidelman reports.
People are doing it on the métro, bus and plane, often without getting as much as a first glance from passengers. The batteryoperated, cigarette-shaped electronic device may have a glowing tip at its “burning end” but produces wisps of vapours that are odourless and smoke-free.
A proliferation of storefront shops, sometimes only a block apart, devoted strictly to e-cigs and their many flavours and accessories, attests to the growing popularity of the device as an alternative to smoking. Its selling point is in its supposed health benefits, especially when compared to the traditional cigarette.
But how safe is vaping? There are stories of e-cigarettes blowing up in people’s faces and of children getting poisoned.
Critics call it an unregulated drug delivery system, while fans — backed by some doctors — say it’s much better for one’s health than smoking the real thing. Only last month, a group of 53 leading medical experts warned the World Health Organization that applying nicotine restrictions to low risk products such as e-cigarettes would put at risk a great opportunity to cut disease and death due to smoking.
At issue is a tobacco product — nicotine. Health Canada classifies nicotine as a drug that is not authorized for sale except in a nicotine patch, chewing gum or lozenge. Some argue that for youth, ecig is a gateway device toward nicotine addiction.
While the United States is eyeing regulations, Health Canada has taken a waitand-see approach since it issued a warning in 2009 that e-cigs with nicotine may pose health risks and have not been fully evaluated for safety, quality and efficacy.
“To date, no electronic cigarettes with nicotine or health claims have been authorized by Health Canada,” a spokesperson for the department said in an email. “This means that currently, the advertisement and sale of electronic cigarette products, including e-liquid, that contain nicotine and/or have health claims is non-compliant with the Food and Drugs Act, and is there- fore illegal.”
A Université de Montréal study commissioned by the Cancer Society of Canada, Quebec branch, found that two-thirds of electronic cigarettes labelled as “nicotinefree” actually contained the drug.
“Consumers are certainly entitled to accurate information,” said Rob Cunningham, the Society senior policy analyst. The Society is calling for government regulations and a moratorium on sales and advertising to minors, likely attracted by the candy flavours.
The Society fears that the booming e-cigarette trade — analysts estimate the industry had worldwide sales of about $3 billion in 2013 — will erode anti-smoking gains.
“We don’t want kids to get addicted to nicotine through e-cigarettes and we don’t want to normalize smoking through e-cigarettes,” Cunningham said.
The Society has the backing of the Quebec public health agency. Its May 2013 status report on electronic cigarettes warned of some contaminants and that concentrations of nicotine vary greatly from one cartridge to another, as well as among manufacturers of “e-juice.” The agency deplored the absence of quality control standards in the face of manufacturing and vaporization inconsistencies.
Without regulation, anyone can sell anything and that’s worrisome “because we have to trust the people who sell it,” said cardiologist Martin Juneau, chief of prevention at the Montreal Heart Institute.
Inhaling nothing would be best, however Juneau, one of four Canadian doctors to sign the WHO letter extolling the benefits of e-cigarettes, says he has no problem telling his cardiac surgery patients who are also hard-core smokers to visit vape shops and clubs. Many subsequently quit their pack-a-day habit, he added.
“It’s certainly safer,” he said. “What causes cancer is the 4,000 chemical products in the cigarettes. Not the nicotine.”
Canada is out of step with many European countries that have approved e-cigs, he added. “We don’t have the luxury of waiting another 10 years for efficacy studies. Five million people a year die of smoking-related diseases.
“My colleagues in France say they have patients vaping for five years and no signal of increase in any kind of disease,” he said, while the United Kingdom Royal College of Physicians has issued a statement to its members to recommend it as an alternative to traditional smoking.
Meanwhile, in vape clubs, customers sitting on bean bags strewn on the floor can try an array of 160 taste options, from traditional smoke to pink bubble gum, from red wine to a strawberry-peach-honeydew flavour infusion.
The device uses a low-heat element to vaporize a propylene glycol liquid that is identical to fog machines used in rock concerts, said Kate Ackerman, director of the Electronic Cigarette Trade Association of Canada.
The association was formed two years ago after running into issues with government regulations, said Ackerman, who runs a vape shop in Alberta. Health Canada provides for a nicotine exemption on its Drug Prescription List, for chewing gum and inhalers “delivering four milligrams or less of nicotine per dosage unit,” the list says.
For Ackerman, the issue is clear.
“It’s a recreational product. Definitely not a drug delivery device,” she said. “It’s odourless and safe, in terms of second hand smoke — there is none.”
Incidentally, every dedicated store has an internal policy not to sell to children, she said. E-juice containers do come with labels, she noted.
“You don’t give your child a bottle of bleach to play with in your living room,” she said.
For those who smoke two or more packs of tobacco cigarettes a day, “this can’t be worse,” said Julien-Pierre Maltais, manager of the StDenis St. Vaporus shop. As for the devices that blow up, that’s a technical glitch of the lithium battery, he said, same as in iPhones, which have also been known to explode.
Maltais, 24, who switched to vaping three years ago, said he saw benefits add up in his wallet. A pack-a-day habit costs about $11.50 for the tobacco variety and about $2 for the e-version.
“There’s no combustion,” said Maltais in explaining why vape users are reluctant to call it smoking.