The e-cig divide

To vape or not to vape // Photo courtesy of
To vape or not to vape // Photo courtesy of

At an estimated $1.7 billion in US sales, electronic cigarettes are one of the fastest growing markets for smoking cessation in North America. But their popularity growth may soon hit a major obstacle in Edmonton.

E-cigarettes are electronic devices that offer metred doses of liquid mist to its users. While the earliest e-cigarette can be traced back to the early ’60s, they’ve quickly gained popularity since hitting the US market in 2006. In Edmonton, there’s currently no regulation limiting the use of e-cigarettes in public, but a group of University of Alberta students is hoping to change that.

The Student Advocates for Public Health (SAPH), 11 graduate students from the U of A’s School of Public Health, is asking Edmonton city council to regulate e-cigarettes under the city’s smoking ban, just like typical cigarettes. E-cigarette users would be forced to smoke only in designated areas, just like tobacco users.

“We’re not against e-cigarettes. We want to be cautious, and we believe in the precautionary principle,” SAPH member Tharsini Sivananthajothy says. “If it’s a proven harm-reduction tool, then we’ll be supportive of it. But right now there has been no conclusive evidence. All the studies out there have been six months or one-year clinical trials, and for these types of medications or harm-reduction tools, you need a long cohort study.”

But support for more regulation isn’t universal among experts. Carl V Phillips, the chief scientific officer at The Consumer Advocates for Smoke-free Alternatives Association, researched methods of tobacco harm reduction as an associate professor at the U of A from 2005 – 2010, including publishing the first-ever survey of e-cigarette users.

Through his research, he’s found that e-cigarettes are far less harmful than smoking tobacco, and its negative effects are too small to measure. Phillips also points out that the difference in environmental impact is even greater, as the risk of e-cigarettes is held only to the smokers themselves, unlike conventional cigarettes.

“They don’t know what they’re talking about,” Phillips says about SAPH. “There is a lack of long-term research on every single new product on the store shelves. That does not lead us to ban indoor use of them all. Instead we assess—based on the enormous knowledge we have about environmental exposures—whether there is worrisome hazard.”

The Edmonton Public and Catholic School Boards have already banned e-cigarette use in their spaces, and SAPH is hoping the university and the city will follow suit. Stemming from what the group sees as a lack of long-term research on the health effects of e-cigarettes, SAPH wants better regulation to prevent exposure to any potential health risks and cut down the risk of making smoking look normalized in society to youth who could use flavoured e-cigarettes and take up smoking tobacco later on.

“The main concern of ours with regards to e-cigarettes is the modelling that’s associated with e-cigarettes,” Sivananthajothy says. “We worked so hard for smoking to be socially unacceptable in public spaces. There’s designated smoking areas and young children, when they see people smoking e-cigarettes, they won’t know the difference between which one is a cigarette and one is an e-cigarette. So it could promote uptake of smoking behaviours in the future.”

Even though e-cigarette use has risen for kids, there’s little research connecting e-cigarette use to picking up regular cigarettes later.

“It is a mind-bogglingly stupid conclusion,” Phillips says. “They are just spouting the propaganda of anti-tobacco extremists.

“Very few kids see a lot of adults smoking cannabis, and yet more kids use cannabis than tobacco,” he continues. “Moreover, there is not the slightest reason to believe that vaping (by kids or adults) causes any of them to take up smoking. There is literally no evidence of this ever happening and there are good reasons to believe it would not happen.”

Phillips believes the biggest missing piece of research on e-cigarettes is simply how to convince smokers to switch to them. He says that switch could be as good for their health as quitting completely.

City council is looking for more evidence about the potential harm of e-cigarettes before they come to a final decision on whether to include them under normal smoking regulations. Little is known about the long-term negative effects, if any, e-cigarettes have on people’s health, but SAPH is encouraged that a discussion of the merits of e-cigarettes can now begin on city council.

“Up until now, there was no conversation about e-cigarettes, whether they were harmful or beneficial or anything,” Sivananthajothy says. “So we’re really glad that conversation is happening at a policy level.”

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