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Canada vs. E-cigarettes

Canada vs. E-cigarettes illustration.

Canada bans electronic cigarettes in the interest of public safety while tobacco kills more than 100 Canadians daily

BY LAURA CONZO BRADY
Editor, eCigs HQ

Friday, November 9th, 2012

..how many Canadians will die of tobacco-related diseases before Health Canada comes to its senses?”

Laura Conzo Brady
Editor, eCigs HQ

Despite their unprecedented success as a nicotine replacement therapy, e-cigarettes have been subjected to prohibitive regulations from a number of governments — notably Canada — which has banned the importation and sale of electronic smoking products that contain nicotine. The ban is based on the opinion that the “new” technology’s risks and benefits have yet to be adequately studied by the medical community and Health Canada regulators. Meanwhile, more than 100 Canadians die from tobacco-related diseases every single day.1

Laws prohibiting the sale and use of electronic smoking products are currently generating heated debate across the globe. On one side of the argument are e-cigarette advocates who view the technology as the most effective solution to the problem of tobacco-related disease.2 On the other side of the argument are the anti-electronic cigarettes activists, consisting mainly of government health agencies, anti-smoking advocates, the pharmaceutical lobby, and the tobacco lobby.3 Despite their known benefits as a nicotine replacement therapy and smoking cessation aid, they argue that electronic smoking technologies may pose profound, long-term health risks.4

Canada bans first, asks questions later

In 2009, Health Canada authorities issued a ban on the sale, advertising and importation of e-cigarettes containing nicotine. According to information provided on the health.gov.ca website, these products are banned in Canada on grounds that they may pose health risks, since there is little research to verify their long-term health effects. As per a Health Canada press release,5 the ban applies to all electric smoking products including electronic cigars, cigarettes, cigarillos, pipes, and cartridges for nicotine solutions as well as related products.

While this article focuses on the Canadian ban, to better understand the underlying health and legal issues, it may be useful to examine the components of an e-cigarette as well as the device’s invention and subsequent rise in popularity worldwide.

How do e-cigarettes work?

While electronic cigarettes resemble real cigarettes and may provide users with the same nicotine ‘kick’ as tobacco cigarettes, they are fundamentally different. An electronic cigarette, commonly referred to as e-cigarette or e-cig, is actually an electric inhaler device that vaporizes nicotine-infused glycerin, polyethylene glycol, or propylene glycol-based solvent into an aerosol mist. The inhalation/exhalation of vapor simulates the act of tobacco smoking and accounts for the e-cigarette’s popularity as a nicotine replacement therapy and smoking cessation aid. As tobacco users switch to electronic in ever-greater numbers, the technology has continued to gain acceptance as the leading alternative to tobacco cigarettes.

An e-cigarette is essentially composed of three parts: A cartridge that serves as the reservoir for the nicotine-infused liquid and acts as the mouthpiece, an atomizer that vaporizes the solution, and a battery that powers the atomizer. The essential components are each described briefly below:

While nicotine in its pure form is highly addictive, it is actually one of the most benign elements of tobacco.”

Laura Conzo Brady, eCigs HQ Editor

Cartridge: It consists of a small plastic container that serves as the mouth piece and liquid reservoir. It utilizes openings on both ends to allow the flow of liquid to the atomizer and movement of vapor from the atomizer to the mouth piece. Most manufactures insert a sponge or other wadding to keep the liquid in place, but there are larger, advanced models that use a refillable tank to store the liquid, which is linked to the atomizer via separate tubing. While some cartridges are refillable, most are disposable and discarded once the supply “e-juice” liquid has been exhausted.

Atomizer: This component contains a miniature heating element that vaporizes the liquid. The atomizer is centrally located between the cartridge and battery. It is common for the atomizer to burn out or wear out due to sediment accumulation, but it can be replaced in some models. In most new cigarette-style designs, a non-replaceable atomizer is integrated into the disposable cartridge. This advance integrating the cartridge and atomizer into a single screw-on component is often referred to as a cartomizer, while some manufacturers prefer to call it a cartridge. Whatever the name, this design change substantially simplifies electronic smoking by limiting the device to two parts — a rechargeable battery and a disposable cartomizer.

Battery: Most models are equipped with a portable lithium ion cigarette-style rechargeable battery and utilize an electronic airflow sensor to enable the activation heating the flavor and generally nicotine-infused liquid by drawing breath through the mouthpiece. E-cig batteries are commonly charged via an AC outlet, USB port or car adaptor. One popular manufacturer, Green Smoke presently markets a hard-wired e-cigarette that does not require a battery and draws power directly from a USB port, AC wall outlet or an automobile’s DC cigarette lighter socket.

E-juice: This term refers to the liquid found in the e-cig cartridges and cartomizers. Typically, the solution consists of vegetable glycerin and/or propylene glycol and/or polyethylene glycol blended with flavors and nicotine. The liquid is commonly sold in prefilled disposable cartridges, but also marketed separately for electronic smoking devices that provide refillable cartridges or reservoirs. The act of refilling a cartridge or reservoir is commonly known as “dripping.” While there are no current standards for nicotine concentrations in e-cigarettes, most manufacturers market their pre-filled cartridges in a variety of concentrations as a percentage by volume as well as an assortment of flavors. In addition, nicotine-free e-juice (legal in Canada) is widely available. The availability of various nicotine levels is crucial as it allows smokers to select a concentration that best matches their tobacco habit, and provides the option to utilize cartridges in sequentially lower concentrations in order to reduce and potentially eliminate their physical addiction to nicotine. E-juice flavors vary from one manufacturer to the next and range from tobacco and menthol to flavors like vanilla, coffee, chocolate and various fruits. The fruit flavors have become a point of controversy in many locales as anti-smoking activists insist they make smoking more appealing to minors. If the same logic were applied to alcohol — peppermint schnapps, peach brandy, and numerous flavored alcoholic beverages would be subject to bans as well.

Who invented e-cigarettes?

According to World Health Organization (WHO) reports, the first electronic cigarette was developed in China by Hon Lik in 2000. Lik was an inventor, pharmacist and heavy smoker. It is reported that this innovation was borne out of frustrations after his father, also a heavy smoker, died after a prolonged struggle with lung cancer. Subsequently, this innovation laid the foundation for modern electronic cigarettes models. The product was first introduced into the Chinese market in 2004 and was marketed as a tobacco replacement and as a smoking cessation aid. The company Lik worked for, Golden Dragon Holdings, later changed its name to Ruyan (Chinese for ‘like smoke’), which began exporting the devices in 2006 after securing an international patent the same year.6

In practice, e-cigarettes containing nicotine provide tobacco users with their best opportunity to quit smoking…”

Laura Conzo Brady, eCigs HQ Editor
Can smokers buy e-cigarettes in Canada?

The short answer is, “yes.”

Despite Health Canada’s ban on the sale and importation of e-cigarettes containing nicotine, market analysis indicates that these products have gained unprecedented popularity amongst Canadian smokers courtesy of loopholes in the regulatory system. Health Canada does not have the authority to prohibit the sale or importation of electronic cigarettes that do not contain nicotine. So Canadians may legally purchase e-cigarettes and accessories online, but not cartomizers, cartridges or e-juice containing nicotine. Studies have shown that the illusion of smoking created by e-cigs is often enough to satisfy psychological cigarette cravings. However nicotine-free e-juice cannot help smokers overcome the physiological dependence associated with nicotine addiction.

As a result of the increased demand for e-cigarettes, and despite the ban, numerous vendors continue to stock the products in defiance of the Health Canada regulations. Nevertheless, the government has been vigilant in their efforts to fully implement the ban. This has resulted in frequent supply disruptions for local vendors and has driven many Canadian e-smokers to the web, where they may order supplies from the U.S. and other e-cig-friendly jurisdictions. However, it is not uncommon for electronic cigarette shipments to be intercepted and confiscated at the border. Despite the threat of seizure, many e-cig manufacturers continue to ship the banned products to Canada.

Are e-cigarettes safe?

The short answer is, “yes.”

As pointed out by health experts the world over, the main source of harm caused by tobacco products is from inhaling the carcinogen-laden smoke produced as a result of tobacco combustion. There is no combustion with an electronic cigarette. The e-juice is heated and vaporized. As no carcinogenic smoke is produced, any potential harm would be contained in the nicotine-infused vapor.7

While nicotine in its pure form is highly addictive, it is actually one of the most benign elements of tobacco. A number of overzealous government entities have gone so far as to label it toxic, but that is a controversial assessment at best and a disingenuous conclusion at worst.8

In practice, e-cigarettes containing nicotine provide tobacco users with their best opportunity to quit smoking, offering a more appealing and less costly option than expensive nicotine patches, gums and inhalers. It is the opinion of a growing number of health experts that the benefits of e-cigarettes outweigh any potential disadvantages associated with the products.9

Preliminary studies and research findings on the benefits and risks associated with the product have been generally positive. Findings from a 2010 study published in the Journal of Public Health Policy indicate e-cigs are less harmful when compared to tobacco cigarettes since nothing is combusted. These findings were later verified by researchers from the Canadian non-profit organization, TobaccoHarmReduction.org, which added that “electronic cigarettes are the tobacco harm reduction phenomenon of the year.”10

However, studies conducted by FDA on two brands, Smoking Everywhere and NJOY, revealed that trace amounts of tobacco-specific nitrosamines (TSNAs) were found in the e-juice of half of samples analyzed. Trace amounts of diethylene glycol (DEG) were also found in one sample.11 The FDA then used this limited and biased study to offer an advisory warning, which has been used as the basis for government restrictions.12

In August of 2012, the Canadian Agency for Drugs and Technologies in Health (CADTH) produced a compilation of 10 studies entitled, Electronic Cigarettes: A Review of the Clinical Evidence and Safety,13 which sought to assess the effectiveness of e-cigarettes as a smoking cessation device while evaluating their safety. The overwhelming majority of studies utilized were supportive of electronic smoking technologies. However, CADTH included the much-maligned FDA study and seemed to employ it as the basis for their summary analysis, which included:

Given the limitations of the current low-quality evidence, the safety, efficacy and utility of e-cigarettes remain to be determined.”

Electronic Cigarettes: A Review of the Clinical Evidence and Safety
Canadian Agency for Drugs and Technologies in Health


 

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