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June 2023

On April 19, 2023, Quebec media outlets announced that flavored vaping devices would be removed from sales (1). Designated by various names such as electronic cigarettes or “vapes”, these objects are hand-held devices that heat an inhalable solution containing nicotine, a humectant and synthetic volatile compounds (2). In fact, vape retailers would face a prohibition on distributing any vaping products that have flavors other than tobacco. Why has vaping consumption become a public health issue and what factors have led to this ban?


In Quebec, it is estimated that 20% of vapers are young people under the age of 18 (1). Vape’s growing popularity is partly the result of the marketing strategies involved in its sales. Data gathered in the U.S. and Canada suggest a significant increase in the use of nicotine vaping products in recent years, especially among young people (3). Its popularity could be attributable to the attractive designs of the devices, their packaging, and their appealing flavors, such as ‘’peach ice’’ and ‘’daiquiri’’(2). Another element potentially contributing to this trend is the societal perception of the health risks associated with vaping. That is, more than half of regular vape users consider it to be harmless (4). But are these devices as risk-free as one may believe?

Scientific literature suggests that vaping is associated with neurological, pulmonary, and mental health risks, in addition to containing carcinogenic metabolites (@). In 2019, a total of 39 deaths have been associated to vaping in the United States, which could be due, at least in part, to its high amount of vitamin E (2).  Vape devices also contain other hazardous metabolites that are known carcinogens as well as nicotine (4). Unfortunately, nicotine intake can have harmful impacts on neurocognitive functions, especially on youth as their brain is still developing. Vaping as a teenager also leads to an increased risk of smoking later in life (5). Lastly, many health risks associated to vaping remain unknown as its distribution and use are fairly recent (6). In the absence of evidence-based data on the safety of the product in different contexts and different populations, and in an attempt to reduce its use among young people, regulations have been issued.

Even though vaping is associated with increased risks of deleterious health consequences, could it be a safer alternative to smoking or assist in smoking cessation? Data shows that vaping increases tobacco consumption among minors (5). On the other hand, the data is not as conclusive when it comes to the adult population (6). It doesn’t seem impossible that vaping may aid in smoking reduction or cessation in specific therapeutic contexts. However, given the lack of data on vape’s efficacy in this context and its safety, individuals who live with nicotine dependence are encouraged to seek out other therapeutic modalities such as pharmacological treatments, nicotine replacement products as well as medical or psychosocial interventions (3, 7). Only further studies will determine whether vaping can become a new tool that may be included in strategies for smoking cessation.


Find more information here to get help on smoking cessation strategies.


Sabrina Bijou (she/her/elle)

References

  1. QMI A. Vapotage: Québec interdit les saveurs tvanouvelles.ca: TVA Nouvelles; 2023 [Available from: https://www.tvanouvelles.ca/2023/04/19/vapotage-quebec-interdira-les-saveurs-et-les-aromes-autres-que-ceux-du-tabac.
  2. Dinardo P, Rome ES. Vaping: The new wave of nicotine addiction. Cleveland Clinic Journal of Medicine. 2019;86(12):789-98.
  3. Hammond D, Reid JL, Burkhalter R, O’Connor RJ, Goniewicz ML, Wackowski OA, Thrasher JF, Hitchman SC. Trends in e-cigarette brands, devices and the nicotine profile of products used by youth in England, Canada and the USA: 2017-2019. Tob Control. 2023 Jan;32(1):19-29. doi: 10.1136/tobaccocontrol-2020-056371.
  4. Bernat D, Gasquet N, Wilson KO, Porter L, Choi K. Electronic Cigarette Harm and Benefit Perceptions and Use Among Youth. American Journal of Preventive Medicine. 2018;55(3):361-7.
  5. Levy DT, Warner KE, Cummings KM, Hammond D, Kuo C, Fong GT, et al. Examining the relationship of vaping to smoking initiation among US youth and young adults: a reality check. Tobacco Control. 2019;28(6):629-35.
  6. Wang RJ, Bhadriraju S, Glantz SA. E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis. American Journal of Public Health. 2021;111(2):230-46.
  7. Soule EK, Plunk AD, Harrell PT, Hayes RB, Edwards KC. Longitudinal Analysis of Associations Between Reasons for Electronic Cigarette Use and Change in Smoking Status Among Adults in the Population Assessment of Tobacco and Health Study. Nicotine and Tobacco Research. 2020;22(5):663-71.