The first time that I heard about vaping as a safer alternative to smoking cigarettes was in 2012. At the time I was Head of the Infectious Diseases division at the University of Ottawa and was conducting research in harm reduction among people who used street drugs. I had established a group of eight community members to be part of an advisory committee for a large prospective cohort project designed to measure the impact of various harm reduction strategies to prevent HIV and Hepatitis C transmission. All were smokers.
Within the first three months we lost two committee members to smoking related diseases – one to severe COPD and one to a heart attack. It occurred to me that smoking would kill far more participants in this cohort study than HIV, Hepatitis C or all other infectious diseases combined, and we were doing nothing about it.
Now smoking cigarettes among people who use other drugs is extremely common – like 95% common. In fact, I have been doing research among people who use drugs for over twenty years and cigarette use is so ubiquitous that it is hardly even considered to be a health issue.
E-cigarettes are the very definition of harm reduction. To make an inherently risky behavior – in this case cigarette smoking - less harmful for people who are unable/unwilling/uninterested/unready to stop that behavior/habit/addiction/pleasure. In 2015, Public Health England came out with a comprehensive review of existing evidence and concluded that e-cigarettes were 95% less harmful than smoking cigarettes. There has been no information that has emerged over the past five years to refute that estimate. How could we not offer a safer way to deliver nicotine to people who are struggling with other drug dependencies, as well as the estimated five million Canadians who smoke cigarettes? How is providing access to a product much safer than cigarettes not a basic right?
The road to promote vaping as an alternative to smoking has faced many challenges over the past decade. In fact, public health leaders, medical associations, political leaders, the media and even the general public have increasingly taken a very negative stance toward vaping. E-cigarettes that were once positioned as a promising public health intervention have been turned into a public health threat. Reasonable dialogue has been drowned out by fear mongering, moral panic and blatant misinformation. The e-cigarette debate provides a fascinating window into substance use, drug policy, public health and our health system in general. This blog is intended to explore and expose the major issues that inform and influence the policies surrounding vaping in Canada. The stakes are high.