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High Nicotine Concentrations Lead to Higher Youth Vaping Rates in Canada

Hamilton, ON, May 07, 2020 (GLOBE NEWSWIRE) -- A recent article published by CBC, “Vaping among Canadian teens doubles in 2 years, new research shows” explores the findings of a study conducted by Dr. David Hammond at the University of Waterloo. Dr. Hammond’s study concluded that youth vaping rates have doubled over the past 2 years, while youth vaping rates have remained unchanged in the UK. The Canadian Vaping Association (CVA) agrees with many of the points made in this article but feels it necessary to clarify some misconceptions.

The CVA has repeatedly called for the federal government to limit nicotine concentrations to 20 milligrams per millilitre. The rise in youth vaping rates here in Canada directly correlates to the entrance of Big Tobacco vape brands, such as Juul and Vype. The vape products distributed by these brands have nicotine concentrations of 57 - 59 milligrams per millilitre, making them highly addictive, and the devices are very easily concealed. The UK has not seen a rise in youth vaping as a result of the nicotine limit that had been established in the European Union prior to the entrance of tobacco owned high nicotine vape brands; this nicotine limit meant that the high nicotine vape products distributed by companies like Juul and Vype were never able to enter the market in the UK. The CVA believes it is imperative that the Canadian government implement similar regulations in order to curb youth vaping in Canada.

Cunningham, a spokesperson for the Canadian Cancer Society, expressed the need for the federal government to enforce stricter advertising regulations and flavour limitations. The CVA has consistently supported a ban on national brand advertising. However, Cunningham’s comment is misinformed as advertising vapour products outside of an adult-only environment is already prohibited in Canada. Further regulations against vaping advertisements are not necessary as strict regulations are already in place; what is important is ensuring that the existing regulations are consistently enforced. We are aligned with all health advocates, including the Canadian Cancer Society, that all legislation should ban advertising, restrict the sale of vape products to adult restricted environments and cap nicotine levels to 20 milligrams per millilitre to address youth uptake. We again ask Mr. Cunningham and all other health advocates to collaborate with the vaping industry so that together we can assist the government in designing regulations that both protect our youth and support the unprecedented harm reduction opportunity vaping offers 5 million Canadian smokers.

The idea that flavoured vaping products contribute to youth vaping is a common misconception that has been discredited by the Centers of Decease Control and Prevention (CDC). According to the CDC report “Tobacco Product Use and Associated Factors Among Middle and Highschool Students”, only 22.3 percent of young people indicated that they vape “because e-cigarettes are available in flavours, such as mint, candy, fruit or chocolate.” The most common reason for use among youth was, “I was curious about them.”

A study conducted by the American Cancer Society concluded that, despite Juul removing all flavours other than mint, menthol and tobacco from store shelves, youth did not quit vaping and instead switched to mint or tobacco flavours.

Flavour restrictions have proven to be ineffective in curbing youth uptake and outright flavour bans are incredibly harmful to public health. Both British Columbia and Ontario, however, provide great examples of effective legislation surrounding the distribution of flavours. By restricting the sale of flavoured nicotine products to adult-only specialty vape shops throughout Ontario, youth are unable to access the sales channels, yet adult smokers still have access to the products they require.

The crucial role that flavours play in an adult smoker’s transition from combustible tobacco is documented in many medical journals. Most notably, the study published by the British Medical Journal (BMJ) concluded that if flavours were removed from vaping products there would be an 8.3 percent increase in tobacco use among adults. The New England Journal of Medicine has also concluded through a controlled trial that e-cigarettes are twice as effective as any other cessation method.

The CVA agrees with the experts, including Dr. Hammond, that nicotine concentrations need to be addressed by the federal government and advertising restrictions need consistent enforcement in order to protect our youth. "This phenomenon was probably driven by Juul and the type of product and nicotine concentration in Juul," Hammond said. "We've seen increases in the use of Juul and Juul-like products among kids to the same extent in Canada as the U.S., so that's why we think that that probably is the main reason that explains why England has not seen the same increases".

It has become apparent throughout numerous countries in the European Union that limiting nicotine concentrations is effective in both minimizing youth uptake and limiting the impact of Big Tobacco owned vape products. It has been reported that e-cigarette giant Juul, acting on low sales, is removing its products from Austria, Belgium, Portugal, France, and Spain by the end of the 2020.  Conversely, Juul’s voluntary removal of flavours from their high nicotine North American products had no impact on their sales. 

Time and again, the data supports that banning flavours has no effect on youth vaping and only harms adult smokers looking to vape products for harm reduction. Nicotine strength, not flavours, is the difference between those markets that have high youth uptake versus those who don’t. Effective public policy cannot ignore the evidence; our government must embrace the facts in order to develop successful regulation.

Darryl Tempest
The Canadian Vaping Association