Everything is safer than a cigarette
The evolution of Canada’s vaping policies was based on a theory of relativity.
The battery-operated heating devices were novel consumer products that deliver nicotine and other unknown compounds into the lungs.
But instead of being judged in isolation, e-cigarettes have always been measured in relative terms — how safe they are compared to combustible cigarettes.
And because almost every other consumer product is safer than a cigarette, vaping devices came on the market already bearing a healthy halo.
“It is the wrong way to look at it,” said Pisinger, who realized early on the risks of comparing vaping to cigarette smoking.
“We have been so focused on smokers and how to make it easy for smokers to quit, or reduce their harm, that we have forgotten to take care of the rest of the population.”
The emergence of e-cigarettes should not have caught tobacco-control experts by surprise. The tobacco industry has been working on a novel way to offer nicotine to their cigarette customers for decades.
Industry documents released through the courts show tobacco executives imagining an invention that would “act as an acceptable alternative to both cigarettes and quitting.”
“Perhaps we could develop cigarettes that would not have to be lighted with a flame … that would burn without smoke … and that would not leave butts. Ridiculous? Perhaps,” an industry executive wrote in 1976.
All of the early industry prototypes failed in the market. But by 2006, a new version of Chinese-made “nicotine inhalers” began to be imported and sold in the U.S. They simulated the look and feel of a cigarette, but used a battery to create a nicotine vapour.
When those first e-cigarettes appeared in Canada in 2009, Health Canada’s instinct was to slam the door shut.
The agency issued a public warning to Canadians “not to purchase or use electronic smoking products, as these products may pose health risks and have not been fully evaluated for safety, quality and efficacy by Health Canada.”
In the beginning, the U.S. Food and Drug Administration (FDA) also tried to crack down by blocking imports of e-cigarettes, calling them “unapproved drug/device combinations” that would need special health approval and licensing.
But when two U.S. companies sued the government, a district court in D.C. ruled the FDA did not have jurisdiction to regulate e-cigarettes because they were not being marketed as a treatment for nicotine addiction. Instead, the judge determined the marketing was aimed at “encouraging nicotine use.”
The FDA decided not to appeal, and instead drafted legislation to regulate e-cigarettes as tobacco products that need FDA approval. That regulation process is still unfolding.
Although nicotine e-cigarettes remained technically illegal in Canada, small vape shops selling flavoured vaping juices began popping up across the country. Canadians were also able to buy e-cigarettes online.
The first e-cigarettes were advertised in magazines and online as a way for smokers to keep smoking with greater freedom — on airplanes, in bars and other places where cigarettes were banned.
An e-cigarette advertisement published in 2011 asks, “Why Quit?” and urges smokers to use the e-cigarette to “take back your freedom to smoke when and where you want without ash or smell.”
When tobacco prevention researcher Charlotta Pisinger saw that ad she had a flashback to the tobacco industry’s campaign several decades earlier promoting the benefits of switching to “light” cigarettes.
“Suddenly I could see it in the historical perspective,” the researcher said. “And we knew from light cigarettes that it was a public health disaster because they undermined smokers’ wish to quit completely.”
Andrew Pipe, the heart specialist in Ottawa, used the “Why quit?” ad in seminars at medical conferences five years ago to warn about the ways tobacco companies could use e-cigarettes to promote smoking.
He told his audiences it would be an opportunity for the tobacco industry to push back against the social forces that had made smoking increasingly unacceptable in public.
“There was a disinclination to thoughtfully regulate these products,” he said.
The Blu brand, featured in the ad, is now owned by Imperial Brands, which acquired it in 2014, as part of a merger. A spokesperson for Fontem Ventures, a subsidiary of Imperial, said the company can’t speak to the motivations of ads created before the acquisition.
“In regards to this specific advertisement and messaging, this is not the type of language that we would use.”