Electronic cigarettes: smoke-free, but are they risk-free?

Wednesday, October 21, 2015

Since they were first introduced a few years ago, electronic cigarettes have continued to grow in popularity, among smokers and non-smokers alike, and especially among young people.

What are they?

E-cigarettes are tube-shaped devices that come with a battery, a cartridge filled with a chemical liquid containing nicotine or other substances, and an atomizer that heats the liquid and converts it into mist as the user, or “vaper” as they’re called, inhales.

Are they harmful?

E-cigarette cartridges contain a chemical mixture of nicotine, propylene glycol, vegetable glycerine and other substances, including various flavourings. The quantity of nicotine shown on the packaging isn’t always accurate, and products labelled “nicotine-free” may actually contain nicotine. Because no manufacturing standards apply to electronic cigarettes, the make-up of these liquids isn’t fully disclosed and it varies greatly from product to product. Nicotine and propylene glycol are the most troubling ingredients—nicotine, because it’s highly addictive and may affect the cardiovascular system and blood sugar levels; and propylene glycol, because it may cause lung irritation and aggravate respiratory conditions like bronchitis and asthma. And its long-term effects are still unknown.

Can they really help someone quit smoking?

Some doctors believe electronic cigarettes can help their patients quit smoking. But the Canadian Lung Association advises smokers to avoid electronic cigarettes and opt for proven methods like individual or group counselling, smoking cessation drugs and nicotine replacement therapies.

Is it legal to sell them?

According to Health Canada, electronic products (cigarettes, cigars, cigarillos and pipes) and their nicotine solution cartridges fall under the Food and Drugs Act and require marketing authorization. Until now, none of these products have been granted this authorization. Health Canada, which issued a warning1 in 2009 advising Canadians not to use electronic cigarettes, defines them as a drug, since they can be used to treat nicotine addiction and may contain nicotine, which modifies organic functions in human beings and animals2. That means that selling e-cigarettes (and other similar devices) containing nicotine is illegal until they’ve been declared an approved drug, which could take some time. Until now, Health Canada has been ordering businesses to stop selling nicotine-loaded e-cigarettes. In Canada, retailers are allowed to sell nicotine-free products, as long as they aren’t presented as smoking cessation aids, as it has not yet been shown that they really help smokers quit.

Are vapers considered smokers when they apply for insurance?

The vast majority of insurers consider e-cigarette users to be smokers, regardless of whether the person is a smoker or a vaper.

Should they be prohibited in the workplace?

As we know, smoking is completely prohibited in workplaces in British Columbia, Manitoba, Ontario, Quebec, New Brunswick and Nova Scotia. In some other provinces, a separately ventilated room is allowed. But what about the vapour generated by e-cigarettes? While there are currently no regulations on indoor air quality, some provinces have moved to regulate the use of e-cigarettes. However, Canadian occupational health and safety legislation requires employers to provide a safe and healthy workplace and, therefore, to ensure good air quality. According to the Canadian Centre for Occupational Health and Safety, it’s best to wait until we know more about the short- and long-term effects of e-cigarettes before allowing their use in the workplace.

Another potential danger came up in a report released by the World Health Organization in August 2014. It called for regulations to end the use of e-cigarettes in workplaces and in public, citing evidence that exhaled e-cigarette aerosol increases the concentration of nicotine, particles and certain toxins in the air3. Just one more reason not to use these products.

1. GOVERNMENT OF CANADA. Health Canada Advises Canadians Not to Use Electronic Cigarettes Opens in a new window., March 27, 2009.

2. FORTIER, Julie C., and LACERTE, Guylaine. E-cigarettes in the workplace Opens in a new window., May 27, 2015.

3. CANADIAN CENTRE FOR OCCUPATIONAL HEALTH AND SAFETY. Up in the Air: e-Cigarettes and the Workplace Opens in a new window., Health and Safety Report, vol. 12, issue 8, 2014.