26 August 2021

Submitted by: Christopher Edward Lalonde

To whom it may concern:

Please find attached my submission in response to Order Amending Schedule 2 and 3 to the Tobacco and Vaping Products Act (Flavours) as published in Canada Gazette Part I, Vol. 155, No. 25 on June 19th, 2021.

My submission is in support of Option 1: Baseline scenario (no further restriction on flavoured vaping products).

Perceived or actual conflicts of interest with the tobacco industry: Before outlining my specific concerns with the content of the Order, I am disclosing that I act as an unpaid academic advisor to Rights4Vapers.

“Rights 4 Vapers is a movement dedicated to advancing evidence-based regulations on vaping. We are an informal collection of committed volunteers who believe that vapers deserve to make an informed choice. We are guided by unpaid academic advisors.”

I have never received any compensation from the vaping or tobacco industry. My opinions are my own.

I am Professor of Psychology at the University of Victoria. For the past 30 years my research has concerned youth health and wellbeing.

I also smoked for 42 years. When I began my university studies, ashtrays were provided in classrooms. Times have changed, but I kept smoking. Short of Varenicline and hypnosis, I tried every other method multiple times (patches, gum, inhaler, etc.). Nothing worked. By my early 50s I was smoking 30 cigarettes a day. In 2013, I began researching vaping (I’m a researcher, it’s what I do). I decided to give vaping a try. I drove to my local vape shop and purchased a “starter kit.” I assembled and filled the device in the parking lot, took a puff and realized “I think this is going to work!” I haven’t had a tobacco cigarette since I drove away from that shop at 2:30pm on February 16, 2013.

After all my failed attempts, my wife and children were astonished. My health has improved immeasurably. I no longer wheeze in my sleep or cough when I wake. So, I have not only a professional interest in tobacco harm reduction for youth and adults, but a personal stake in the debate about the future of vaping in Canada.

I want to focus on just two of the opening paragraphs in the Executive Summary of the The Regulatory Impact Analysis Statement (RIAS) and the evidence used by Health Canada to support these statements.

Issues: There has been a rapid increase in youth vaping in Canada. Young persons are being exposed to vaping product-related harms, including those related to nicotine exposure, which can result in a dependence on nicotine and an increased risk of tobacco use. Health Canada has identified the availability of a variety of desirable flavours, despite the current restrictions, as one of the factors that has contributed to the rapid rise in youth vaping.

Description: The proposed Order Amending Schedules 2 and 3 to the Tobacco and Vaping Products Act (Flavours) and the proposed Standards for Vaping Products’ Sensory Attributes Regulations (the proposal) would implement a complementary, three-pronged approach to restricting flavoured vaping products. First, it would further restrict the promotion of flavours in vaping products to tobacco, mint, menthol and a combination of mint and menthol (mint/menthol), including through indications or illustrations on packaging. Second, it would prohibit all sugars and sweeteners as well as most flavouring ingredients, with limited exceptions to impart tobacco and mint/menthol flavours. Third, it would prescribe sensory attributes standards to prevent a sensory perception other than one that is typical of tobacco or mint/menthol.

There has been a rapid increase in youth vaping in Canada.

The data used to support this claim are seriously out of date. Even if one considers “past 30-day use” a useful indicator—which it clearly is not—the “rapid increase” disappears when one considers more recent data from the 2020 CTNS survey. Rather than an increase to 29.4%, the 2020 rates fell from 15.1 to 14.4%.

Young persons are being exposed to vaping product-related harms, including those related to nicotine exposure…

I have searched the RAIS in vain for actual evidence of actual “vaping product-related harms.” What appears instead are phrases such as “potentially harmful” and “may have a negative impact on health” rather than definitive statements of actual harm. The references to the harms of nicotine itself reduce to a handful of rodent studies (adolescent rats shouldn’t vape). But let’s imagine that there are harms and that these harms are somehow specifically focused on youth and magically occur only when they use vaping products rather than tobacco cigarettes or NRT. The simple solution would be to enforce existing legislation meant to prevent youth access to both cigarettes and vaping devices. We don’t need full-scale prohibition and another war on drugs.

Health Canada claims that the morbidity and mortality rate from vaping is 20%:

To estimate the potential adverse health effects of vaping, the model assumes the mortality and morbidity risks associated with vaping are 20% of the mortality and morbidity impacts of cigarettes. This assumption was developed in consultation with members of an expert panel composed of five academics in tobacco control who were previously consulted on exploratory work related to a nicotine standard.

This estimate is wildly different from any other in the extant literature (see Public Health England and the Royal College of Physicians). No evidence is offered, no publicly accessible reference is given. In fact, the “five academics in tobacco control” are all psychologists with no evident training in either medicine or epidemiology. In scientific terms, this amounts to “overheard down at the pub.”

… can result in a dependence on nicotine and an increased risk of tobacco use

And so, we come to the dreaded “gateway effect.” If vaping led to cigarette smoking, where are all the new smokers? Smoking rates (particularly among youth) continue to fall faster than ever before. According to 2020 CTNS data, smoking rates among 15- 19-year-olds are at 3.1%. If this is a gateway, it seems to be operating in reverse—away from smoking. Correlation does not equal causation. Every undergraduate understands that.

the availability of a variety of desirable flavours, despite the current restrictions, as one of the factors that has contributed to the rapid rise in youth vaping

Let’s grant, for the moment, that the (non-existent) rapid rise in youth vaping is somehow attributable to “the availability of a variety of desirable flavours.” How should Health Canada respond? How would eliminating essentially all flavours reduce youth (but not adult) vaping? It won’t, of course, and Heath Canada openly acknowledges that it will create a completely unregulated black market.

Turning to the “three-pronged approach.” First, if Health Canada fully subscribes to the gateway theory, I simply fail to see how restricting vape flavours to tobacco and menthol would accomplish anything other than training youth to find tobacco cigarettes appealing.

Second, it is not at all clear how reformulating existing tobacco and menthol flavours would preserve current user experience. As a seasoned vaper, I can tell you that there is NO e-liquid that mimics the taste of the tobacco cigarette (and that’s a good thing).

Finally, it seems that the notion that Health Canada can “prevent a sensory perception other than one that is typical of tobacco or mint/menthol” is plainly preposterous. Does Health Canada plan to hire a team of vaping sommeliers to vet ‘sensory perceptions? Or simply prohibit anything that vapers find tolerable or pleasant? Either way, it opens the door to black markets and DIY flavouring—both of which threaten Canadian’s health.

In closing, I find it particularly repugnant that Heath Canada—the government agency charged with “helping Canadians maintain and improve their health”—is seemingly comfortable with trading the health of Canadians for an anticipated “increase in tobacco sales [that] will mitigate their losses from reduced vape sales.” If the best we can hope for from this legislation is higher taxes, a vibrant black market, more smoking, less switching, and the death of a viable alternative to tobacco, then mission accomplished.

If we want to help Canadians “maintain and improve their health” we can do much better than this.

Sincerely,

Christopher Edward Lalonde, PhD