Clearing the Air on e-Cigarettes

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May 2 2013

A recent article in the Globe and Mail asked whether electronic cigarettes could save lives in battle against tobacco smoke.  On the face of it, the issue of  e-cigarette availability in Canada is peppered with tough questions.  Are e-cigarettes another smoking cessation tool or are they just about harm reduction for those who can't kick the habit?  Is vaporizing and inhaling nicotine with a side of propylene glycol instead burning tobacco and inhaling thousands of toxic and carcinogenic chemicals a great way to reduce the risk of cancer and heart disease or just a dangerous work-around for addicts who miss smoking indoors?  Finally, would the legal availability of electronic cigarettes save lives or just slow down Canada's increasingly successful war against tobacco?Man smoking an e-cigarette

Frankly, none of those questions are easily answered.  As someone old enough to remember smoking sections on airplanes and professional athletes shilling for tobacco companies, I guess I'm in the damn-the-torpedos school of smoking cessation advocates.  If we can go from roughly half the population smoking tobacco to less than one in five in the space of one generation, I say let's keep the pedal-to-the-metal and work towards a smoke-free Canada.  But I guess that's the reformed smoker talking.  Perhaps a little harm reduction along the way could save a few lives on the road to smoke-free valhalla.  

One piece in this debate that baffles me, however, is the whole notion that Health Canada has "banned" e-cigarettes precipitously.  That's not my understanding.  In 2009, Health Canada issued an advisory warning against the use of electronic cigarettes "as these products may pose health risks and have not been fully evaluated for safety, quality and efficacy by Health Canada."  The advisory notes that no such product had received an authorization for sale under either the Natural Health Products Regulations or the Medical Devices Regulations.  As a result, there was no way to ensure either safety or effetiveness of e-cigarettes on the market.  For example, the United States Food and Drug Administration found that some e-cigarettes actually contained diethylene glycol, which is highly toxic to humans, instead of propylene glycol, which is more benign.  There are good reasons why we, as a society, regulate health products such as these.

To me, the notable thing about this story is not that Health Canada has "banned" e-cigarettes, because they haven't.  The interesting issue is that none of the marketers has obtained a product license for one of these products.  In that context. what do you think?