Tobacco/Cannabis Health Alert

"We are not seeing the potential benefits [of e-cigarettes helping adult smokers quit regular cigarette smoking], but we are taking the potential risks [in seeing an increase in teen use of e-cigarettes]."
"Your lungs are much more sensitive than digesting it [vaping cannabis oils] through  your stomach. No one knows what the contaminants are in these oils."
"If you are buying something on the black market, then all bets are off."
David Hammond, chair, Canadian Institutes of Health Research in applied public health, University of Waterloo

A woman smokes a Juul e-cigarette in New York. The company says its product is intended for adults who already smoke and never people who are underage. (Brendan McDermid/Reuters)

In Canada between 35,000 and 45,000 deaths attributed to smoking take place annually, with roughly 30 percent of those deaths occurring from cancer. Recreational drug use in Canada includes the three legal products including tobacco, vaping and cannabis, though regulators have yet to fully comprehend the interplay that the three manifest on public health. Cannabis and vaping, newer to public health concerns than tobacco, are now posing challenges of their own.

Challenges that David Hammond, speaking at the biennial Canadian Cancer Research Conference taking place in Ottawa, addressed in his capacity as chair of Health Research in applied public health. In both the United States and Canada, the sale of e-cigarettes has seen a sharp increase, and a large proportion of that increase reflects new sales to teen users.

The conundrum is that despite the expectations that e-cigarettes having the capacity to aid adult smokers cease the use of regular cigarettes, no parallel increases in e-cigarette use has been realized among that adult smokers' demographic. A strong association exists among  youth, however, between vaping first and then proceeding onward toward smoking cigarettes.

Juul opened its first retail store in Toronto this summer. (Albert Leung/CBC)

Dr. Hammond points out that this disparity might arise given youths' propensity to be attracted to risky behaviour, and once one risk-taking behaviour has been absorbed, the next one beckons. Dr. Hammond earlier in the year had led a study that discovered an increase in vaping by Canadian youth. Among 16- to 19-year olds an 8.4 percent vaping increase was reported in 2017, which had additionally increased to 14.6 percent in the like period, August to September by 2018.

A 15-year-old high school student uses a vaping device. (AP Photo/Steven Senne)

Until recently, teen smoking had been observed to be on the decline. This study pointed out an increase in youth smoking regular cigarettes between 2017 and 2018, from 10.7 percent to 15.5 percent, with vaping seen as introducing youth to regular smoking. This was viewed as the first data to emerge since major tobacco companies launched and advertised e-cigarette brands in Canada in the wake of the adoption of Bill S-5, legalizing e-cigarettes with nicotine in May 2018.

Though admittedly e-cigarettes are viewed as less harmful than smoking -- in particular with cancer risk -- the inescapable fact is that they contain nicotine. E-cigarettes are only useful for regular smokers when an entire switch is made from cigarettes to e-cigarettes. For those who choose to smoke both e-cigarettes and to continue with regular cigarettes, little or no risk reduction results from that combination.

In the United States there  have been close to 2,000 serious cases of lung disease related to vaping cannabis oils, with over 30 deaths, thus far. An estimated 80 percent of the cases of that mysterious lung disease point to vaping cannabis oils, mostly acquired through the black market. The Canadian Cancer Society back in June called on government action immediately, to address the increase in youth vaping.

The Canadian Cancer Society wants Saskatchewan to raise to legal age of purchasing tobacco and vaping products to 21. (Aliaksandr Barouski/Shutterstock)