Opinion

Ontario's forthcoming vaping rules will be a roadblock to proven harm-reduction

The indoor vaping ban will effectively prevent consenting adult cigarette smokers from trying e-cigarettes in a vape shop. To some, this might seem like no big deal. But this testing phase is a key part of successful cigarette cessation.

In order for people to successfully transition from smoking to vaping, they need a space to try out products

The indoor vaping ban will effectively prevent consenting adult cigarette smokers from trying e-cigarettes in a vape shop. To some, this might seem like no big deal. But this testing phase is a key part of successful cigarette cessation. (Doug Husby/CBC)

With little fanfare late last month, the Ontario government under Premier Kathleen Wynne moved ahead with regulations that will have a profound impact on the ability for adult smokers to switch to electronic cigarettes. When the new regulations come into force — which the government just announced will happen on July 1 — they will paradoxically erect roadblocks to the province's goal of creating a smoke-free Ontario.

One of the most troubling aspects of the new rules is a ban on using e-cigarettes indoors, including in adult-only vape shops. This makes no sense. Users need to be able to properly try out products. Yet the indoor vaping ban will effectively prevent consenting adult cigarette smokers from testing out e-cigarettes in a vape shop.

To some, this might seem like no big deal. But in order for people to successfully transition from smoking to vaping, they need a lot of information. Vape shop employees need to be able to show people how to use the devices, and customers need to be able to sample the various devices and flavours in order to find something that will satiate their cravings. Otherwise, people tend to give up and go back to cigarette smoking.

Little to no second-hand risk

The rationale for this ban is based on the notion that second-hand vapour is harmful to others, but there is basically no evidence to prove that is true. Indeed, there is now a body of peer-reviewed research confirming that there is little to no risk to the second-hand vapour produced by e-cigarettes.

In 2013, for example, doctors from the Roswell Park Cancer Center in Buffalo, N.Y., published a study on second-hand vaping in the journal Nicotine & Tobacco Research. They found that the second-hand nicotine exposure from e-cigarettes was 10 times lower than from regular cigarettes. Moreover, unlike with tobacco cigarettes, e-cigarettes do not produce any carbon monoxide, which can be very harmful to bystanders.

In 2016, a literature review looking at the research on second-hand vapour that had been conducted over the preceding 10 years was published in Public Health Research and Practice. No attempt was made to exclude older, flawed studies that used e-cigarettes with unsafe coil designs (which have now phased out), studies in which e-cigarettes were improperly run dry (resulting in the combustion of the wick) and studies that used low-quality and potentially contaminated e-liquids. Despite these major limitations, which bias the review against e-cigarettes, the authors concluded that, "the risk from being passively exposed to EC (e-cigarette) vapour is likely to be less than the risk from passive exposure to CC (conventional cigarette) smoke."

Furthermore, a 2015 study published in the International Journal of Drug Policy found that the average nicotine residue left by tobacco cigarettes was 150 times greater than what was left by e-cigarettes. That means that in order for a child, for example, to be exposed to the same amount of nicotine that's produced by a single tobacco cigarette, he or she would have to lick over 5,000 square feet of surface in a room after someone vaped in it. In the end, the study concluded that there is "no significant difference in the amount of nicotine in homes of e-cigarette users and non-users."

A proven harm-reduction tool

But by classifying e-cigarettes as akin combustible tobacco cigarettes, the Ontario government is basically ignoring this evidence. It's even more contradictory because the government has fully supported and funded safe injection sites for intravenous drug users, but is, at the same time, making it more difficult for smokers to access and try out e-cigarettes, which are a safe, proven harm-reduction tool.

Other provinces have taken more liberal approaches: In B.C., vape shop employees can show customers how to use the devices, though only two devices can be in use in a store at one time. Alberta and Saskatchewan do not have laws dealing with e-cigarettes, so vaping is allowed within vape shops. Manitoba allows vaping within vape shops, but not in other places where tobacco is prohibited.

In Ontario meanwhile, where politicians openly muse about allowing cannabis lounges, the government is in the process of enacting hypocritical regulations that will make it harder for cigarette smokers to quit. We need smart policies that will help Ontarians transition away from tobacco, instead of a whole host of new cumbersome regulations.

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.

About the Author

Akbar Khan

Dr. Akbar Khan is the founder and medical director of Medicor Cancer Centres, an integrated cancer treatment facility in Toronto, and the Canadian Vaping Association’s chief medical expert.