fbpx
Select Page
Gov’t and MSA payments

Gov’t and MSA payments

State governments & the MSA

On November 23, 1998, all but 4 states entered into the Master Settlement Agreement with the 4 big tobacco companies.

 

The tobacco companies committed to pay out around $200 billion over twenty years to the state governments… based on annual cigarette sales.

Money.

Vaping has been proven successful at getting smokers off of cigarettes and keeping them off.

If smoking rates drop because of vaping then the states get less money.

(source)   (source)

In the first section of the MSA, this agreement was made “to avoid the further expense, delay , incovenience, burden and uncertainty of continued litigation” by the state against the tobacco industry for expenses occured to Medicaid as a result of smoking.

Unfortunately, the MSA did not make provisions for how the MSA money is to be spent.

(source)

Since the 4 tobacco giants entered an agreement to pay the state though the MSA, other tobacco companies are to be penalized by the state for doing business. So, since vaping helps smokers get off of cigarettes (which would lower MSA payments) the states catigorized vaping as tobacco.

Vaping is no more tobacco than vitamin C is an orange.

(source)

Some of the state governments issued bonds based on the projections for future MSA payments. Unfortunately, they underestimated the rate at which smokers would stop smoking which means the payments were lower than they banked on. Those payments were short to pay the bonds when due.

(source)

MSA backed bonds at risk for default

The S & P securities ratings assessed the immerging vaping industry as reducing the amount of smokers. Therefore they anticipated a drop in cigarette sales and the amount of MSA payouts. This means the governments that issued the bonds would have to find money elsewhere to pay them out when due.

(source)

What went wrong in the USA

What went wrong in the USA

What went wrong in the USA

During the investigation into the cause of EVALI, governments, health-related nonprofits, health authorities, medical professionals, anti-smoking groups and media repeatedly claimed that vaping was injuring people without specifying that the injuries were caused from illegal THC cartridges.

Over and over again, they included nicotine eliquid in their conversations, statements and announcements. A false narrative that blamed tobacco harm reduction (vaping nicotine eliquid) for the lung injuries spread throughout the public and the health community.

(source)

(source)   (source)

(source)   (source)

(source)   (source)

(source)   (source)   (source)   (source)

(source)

(source)   (source)

For over 20 years, RealClearPolicy has been reviewing US domestic policy and analyzes “the most pivotal information on the day’s need-to-know issues”. They reviewed how the CDC handled EVALI in their article titled, Heads Should Roll at CDC after Botched Vaping Investigation.

Filter is a nonprofit, their mission is to …”advocate through journalism for rational and compassionate approaches to drug use, drug policy and human rights”. Their critique of how CDC handled EVALI is titled, Vapes and Lung Disease: The CDC’s Lesson in How Not to Handle an Illness Outbreak.

Expert warnings

Expert warnings

Expert warnings from the UK

Since the 2016 publication of Nicotine Without Smoke, UK health authorities have been promoting vaping as a smoking cessation aid for their citizens.

 

Scientists, health authorities and doctors in the UK issued statements and reports to help people see the deception about the 2019 vaping related lung injuries (EVALI).

(source)

(source)

(source)

(source)

(source)   (source)

Repeated fear provoking narrative

The pervasive message in North America is that we have to ban vaping because their is a ‘youth vaping epidemic’.

In Great Britain, vaping is recognized as a significant harm reduction strategy and is promoted by their public health. Yet, less than 2% of 11-18 year olds vape more than once a week.

WHERE is the youth vaping epidemic in Great Britain?

(source)

Youth experiment with adult activities, this is why 52% vaped “to give it a try”. Cigarette smoke is far more addictive than nicotine vapour and far more harmful. Since smoking tastes gross, perhaps the flavours in eliquid are preventing them from becoming smokers.

(source)

CALL TO ACTION

Australasian Professional Society on Alcohol and other Drugs wrote a referenced paper about EVALI. It is the perfect document to enlighten health professionals about how they have been deceived about tobacco harm reduction.

Canada gov’t THC cartridges

Canada gov’t THC cartridges

Canada gov't THC cartridges

The Canadian federal government controls the sale of cannabis products and taxes the sales.

 

On October 19, 2020, during the EVALI outbreak, THC cartridges were approved for sale. The fact that EVALI was caused by illegal THC cartridges could have an adverse effect on legal THC cartridges sales revenue.

Nicotine eliquid was blamed.

(source)

 

(source)   (source)

(source)   (source)   (source)   (source)

(source)   (source)   (source)

Due to the deception that nicotine vaping was the cause of EVALI, sales of the new cannabis products were not interupted but how many vapers switched back to the most lethal form of nicotine: tobacco cigarettes?

(source)   (source)  (source)  (source)

What went wrong in Canada

What went wrong in Canada

What went wrong in Canada

During the investigation into the cause of EVALI, governments, health-related nonprofits, health authorities, medical professionals, anti-smoking groups and media repeatedly claimed that vaping was injuring people without specifying that the injuries were caused from illegal THC cartridges.

Over and over again, they included nicotine eliquid in their conversations, statements and announcements. A false narrative that blamed tobacco harm reduction (vaping nicotine eliquid) for the lung injuries spread throughout the public and the health community.

(source)   (source)   (source)

(source)   (source)   (source)   (source)

(source)

(source)   (source)   (source)

(source)

(source)   (source)   (source)   (source)

(source)

(source)

(source)

(source)   (source)   (source)

(source)

(source)   (source)

What happened

What happened

What happened

Suddenly, there were hundreds of cases of severe lung injuries in areas around the USA. All the patients had vaped.

Yet, millions of smokers had been vaping nicotine for more than a decade without any cases of these lung injuries.

In August of 2019, the Centers for Disease Control and Prevention (CDC) announced they were investigating an outbreak of lung injuries.

Over 2800 cases were identified, causing 68 deaths in the USA; in Canada there were 19 cases and no deaths.

76% of the patients were under 35 and 66% were male.

(source)

Vaping nicotine eliquid is a harm reduction strategy used by millions of smokers all over the world. Since the injuries only occurred in North America, it was clear the injuries were being caused by something other than standard nicotine eliquid.

(source)

Almost 100% of the injured patients reported using illegal THC cartridges. Despite the evidence, the injury was named EVALI (E-cigarette or Vaping product use-Associated Lung Injury) implying the cause was nicotine eliquid.

(source)

To identify the substance causing the injuries, lung samples from the patients were analyzed. The fat based substances identified as causing the injuries can not be disolved in nicotine eliquid because they would separate in the container.

(source)   (source)

Vaping products used were analyzed

The patients submitted the products they were vaping to help identify the cause of the injuries. Nicotine eliquids contained no unexpected or harmful chemicals but 9 out of 10 illegal THC carts contained vitamin E acetate which is used as a cutting agent.

(source)

(source) 

(source)

(source)

(source)

(source)   (source)

More on what happened

 (source)    (source)

(source)   (source)

 (source)

(source)

(source)

(source)

(source)

(source)   (source)

current context

current context

The current context

The current resistance about tobacco harm reduction is a familiar reaction.

A similar response occurred during the AIDS crisis in the 1980’s.

The rhetoric at that time was that distributing condoms would encourage youth to become promiscuous28.

Canadian Nurses Association harm reduction resources

Stay current in the credible evidence

Tobacco harm reduction hx

The neo-prohibitionist approach to smoking is “Quit smoking or suffer and die from smoking-related diseases.” All innovative products under this precautionary principle are oppressed which supports the tobacco industry by denying the population safer alternatives and supports the pharmaceutical industry by promoting the incidence of smoking-related diseases. About 95% of unaided smoking cessations attempts end in failure and attempts with nicotine replacement therapies (NRTs) have <10% success rate at six months29.

Snus is an oral tobacco product processed via fermentation which removes the tobacco-specific nitrosamines (the carcinogens found in tobacco). Due to pressure from public health groups, in 1992, the sale of snus was prohibited in the European Union (EU) despite the EU’s acknowledgement that snus is not a carcinogen. Sweden obtained an exemption to allow their smoking citizens a harm reduction option29.  As a result, Sweden has the lowest smoking rates and the lowest rates of lung cancer in the EU. It’s notable that 13% of Swedish men are smokers compared to an average 29% of men in the EU. Further, Sweden has the lowest rate of tobacco-related mortality even though Sweden consumes the same amount of tobacco by weight as other countries29.

This is an example of the efficacy and sensibility of tobacco harm reduction (THR). History also illustrates the oppression of tobacco harm reduction by authority29.

nicotine eliquid didn’t cause lung injuries

The recent outbreak of vaping-related lung injuries were a result of  illegal THC (cannabis) cartridges used in vaping devices30,31,32. Vitamin E acetate has been identified as the primary causative agent33,34.

During the outbreak, misisnformation was spread by media and health authorities. Click the link below and learn more from a letter released by the Australasian Professional Society on Alcohol and other Drugs35.

Outbreak named EVALI

E-cigarette or Vaping Product Use-Associated Lung Injury

People have been vaping in the USA for over 10 years without lung injury outbreaks36. In the summer of 2019, a sudden  outbreak of severe lung injuries occurred in North America, mainly the USA. Over 2800 cases were identified, causing 68 deaths30.

Absence of infection37

Hx of recent vaping

Age of patients (median 23):
15% under 18 years old
37% 18-24 years old
24% 25-34 years old
24% 35+ years old30

Patients presented with a nonproductive cough, shortness of breath, tachycardia, and fever38.

Investigations

Labs and interviews

58 American EVALI patients were interviewed; 91% reported using illegal THC cartridges39. 51 lung fluid samples of lung injured patients tested positive for fat based substances used in THC cartridges: 48 vitamin E acetate, 1 coconut oil, 1 limonene (a “terpene” found in cannabis)40.

EVALI quickly declined

Law enforcement responded

44 websites were seized that were advertising the sale of illegal THC cartridges41. Millions of dollars worth of THC concentrates and cartridges were seized from illegal operations in Wisconsin and Minnesota42, 43.

Commercial nicotine eliquid

Federal regulations

Ingredients in nicotine eliquids have been restricted by Canadian government regulations since May 201844. Lipophilic ingredients are not allowed in commercial nicotine eliquids44. Nicotine eliquid is an aqueous solution and lipids won’t dissolve in it45.

THC cartridges in Canada

Government controlled

THC cartridges were approved for sale in Canada October 19, 2019 during the lung injury outbreak46. Of the 19 Canadian patients with EVALI, 11 reported they only vaped nicotine (many during a time when THC cartridges were illegal)47. Neither toxicology screens nor lung fluid biopsies were performed to confirm patients’ self-reporting47.

Experiment with mice

Vitamin E Acetate aerosols

In this experiment, two controls were used: air and standard eliquid base of propylene glycol/vegetable glycerine blend. Mice exposed to the vitamin E acetate aerosols presented with signs consistent with EVALI48.

Wide-spread misinformation

Discouraged harm reduction

Public Health England, March 2020:

“The mistaken belief that e-cigarettes are more harmful than smoking increased rapidly among UK smokers following the US lung injury outbreak in autumn 2019.”49

Listen to the experts

Quotes from those that have done the research

“The burden of proof

is on the regulatory agency to
demonstrate that the product is unreasonably dangerous for its intended use…electronic cigarette prohibition will do harm to hundreds of thousands
of vapers already using electronic cigarettes in place of tobacco ones – a clear violation of nonmaleficence.”

Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or past mistakes? (2010) Cahn, & Seigel

 

“Current state of knowledge

about chemistry of liquids and
aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable
exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces.”

Peering through the mist: Systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks. (2014) Burstyn.

“Even if there are longterm

vapers, this is not a problem, as long as they quit smoking. The problem is combusted tobacco, not nicotine. At the dosage  used by vapers or users of nicotine gums or patches,  nicotine is not toxic. Long term vaping is not a public health problem; not any more than long term use of nicotine  gums.”

Dr Jean-François Etter

“None of the toxicological

testing conducted in E-cigs has shown that users or bystanders are exposed to harmful levels of toxins or carcinogens. E-cigs eliminate exposure to the smoke toxicants responsible for nearly all smoking-related diseases.”

A fresh look at tobacco harm reduction: The case for the electronic cigarette. (2013) Polosa, Rodu, Caponnetto, Maglia, & Racitti

“The burden of proof

is on the regulatory agency to demonstrate that the product is unreasonably dangerous for its intended use…electronic cigarette prohibition will do harm to hundreds of thousands of vapers already using electronic cigarettes in place of tobacco ones – a clear violation of nonmaleficence.”

Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or past mistakes? (2010) Cahn, & Seigel 

“Even if there are longterm

vapers, this is not a problem, as long as they quit smoking. The problem is combusted tobacco, not nicotine. At the dosage  used by vapers or users of nicotine gums or patches,  nicotine is not toxic. Long term vaping is not a public health problem; not any more than long term use of nicotine  gums.”

Dr Jean-François Etter

“Current state of knowledge

about chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces.”

Peering through the mist: Systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks. (2014) Burstyn.

“None of the toxicological

testing conducted in E-cigs has shown that users or bystanders are exposed to harmful levels of toxins or carcinogens. E-cigs eliminate exposure to the smoke toxicants responsible for nearly all smoking-related diseases.”

A fresh look at tobacco harm reduction: The case for the electronic cigarette. (2013) Polosa, Rodu, Caponnetto, Maglia, & Racitti

Facilitate informed decision making

Your patients’ lives depend on it

In the next section we look at the current false narratives about nicotine vaping and offer evidence to help you make informed decisions.

 

28. Sellers, D., McGraw, S., & McKinlay, J. (1994). Does the promotion and distribution of condoms increase teen sexual activity? Evidence from an HIV prevention program for Latino youth.

29. Institute of Economic Affairs. (2013). Free market solutions in health: The case of nicotine.

30. Centers for Disease Control and prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Updated February 25, 2020.

31. FDA. (2019). Vaping Illness Update: FDA warns public to stop using tetrahydrocannabinol (THC)-containing vaping products and any vaping products obtained off the street.

32. Utah Department of Health. (2019). Vaping-related lung injury, Utah, 2019: Investigation to date updated September 30, 2019.

33. Duffy, B.; Li, L.; Lu, S.; Durocher, L.; Dittmar, M.; Delaney-Baldwin, E.; Panawennage, D.; LeMaster, D.; Navarette, K.; Spink, D. (2019). Analysis of cannabinoid-containing fluids in illicit vaping cartridges recovered from pulmonary injury patients: Identification of vitamin E acetate as a major diluent.

34. Blount, B., Karwowski, M., Shields, P., Morel-Espinosa, M., Valentin-Blasini, L., Gardner, M., Braselton, M., Brosius, C., Caron, K., Chambers, D., Corstvet, J., Cowan, E., et al., (2019). Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI.

35. Australasian Professional Society on Alcohol and other Drugs. (2020). Miscommunication about the causes of the US outbreak of lung diseases in vapers by public health authorities and the media.

36. Public Health England. (2019). Vaping and lung disease in the US: PHE’s advice.

37. M. Perrine CG, Pickens CM, Boehmer TK, et al. Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping — United States, 2019. MMWR Morb Mortal Wkly Rep 2019;68:860–864.

38. J. Schier JG, Meiman JG, Layden J, et al. Severe Pulmonary Disease Associated with Electronic-Cigarette–Product Use — Interim Guidance. September 6, 2019 MMWR Morb Mortal Wkly Rep 2019;68:787–790

39. A. Taylor J, Wiens T, Peterson J, et al. Characteristics of E-cigarette, or Vaping, Products Used by Patients with Associated Lung Injury and Products Seized by Law Enforcement — Minnesota, 2018 and 2019. MMWR Morb Mortal Wkly Rep 2019;68:1096-1100.

40. B. Blount, B.C., Karwowski, M.P., Shields, P.G. et al. (2020). Vitamin E acetate in bronchoalveolar-lavage fluid associated with EVALI.

41. C. US Food and Drug Administration. (2019). FDA, DEA seize 44 websites advertising sale of elicit THC cartridges to US consumers as part of Operation Vapor Lock.

42. D. ABC News. (2019). Sheriff details charges against brothers accused of running THC vape ring.

43. E. ABC News. (2019). Minnesota police seize over 75,000 THC vaping cartridges in record bust.

44. Government of Canada. (2018). Tobacco and Vaping Products Act.

45. F. Campagna, D., Amaradio, M.D., Sands, M., & Polosa, R. (2016). Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping.

46. Government of Canada. (2019). Backgrounder: Final regulations on new cannabis products.

47. H. Government of Canada. (2019). Vaping-associated lung illness.

48. K. Bhat, T.A., Kalathil, S.G., Bogner, P.N., Blount, B.C., Goniewicz, M. L., & Thanavala, Y.M. (2020). An animal model of inhaled vitamin E acetate and EVALI-like lung injury.

49. L. Public Health England. (2020.) False fears preventing smokers from using e-cigarettes to quit.

Bioethics

Bioethics

Bioethics

 

Patients are a vulnerable population79.

They trust health professionals with their health, well being and their lives.

They deserve to know all their options.

 

Advocate for utilization of harm reduction

From first year of post-secondary education, health professionals are trained to trust “credible sources” such as health-related nonprofits, health authorities, regulatory bodies and internal information sources in the work place. Health professionals trust that the information that comes from credible sources are unbiased, accurate, and ethical79.

However, in reference to the Syphilis Study at Tuskegee, health professionals are required to think critically and challenge unethical practices80. This study, from 1932 to 1972, recorded the untreated effects of syphilis in 399 males against a control of 201 uninfected men. Subjects were poor and illiterate. They were not informed that they had syphilis, nor were they offered penicillin when it was found to be an effective treatment in 1945. In 1969 the Centers for Disease Control backed by the American Medical Association and the National Medical Association refused to inform the subjects of their infection nor offer treatment despite concerns voiced by citizens. Public outcry ended the study in 197280. Over 40 years, multiple doctors, nurses and other health professionals violated informed decision making and promoted harm.

Health professionals have a responsibility to resist blindly following authority, review the evidence and advocate for harm reduction to promote improved health outcomes79.

Tobacco harm reduction

Compassionate and just approach

Health professionals’ primary bioethic is nonmaleficence; to do no harm. Miscommunication about tobacco harm reduction has compromised health professionals’ ability to promote autonomy in their smoking patients, specifically facilitating informed decision making81. Ensure beneficence by reviewing the credible evidence.

 

Misinformation

Supports continued profits

Public Health England estimates vaping helps at least 18,000 and as high as 57,000 smokers quit each year in the UK82. Not only have pharmaceutical smoking cessation prescriptions dropped more than 50% since vaping has been introduced but current vapers83, and subsequently former smokers, are reporting a decreasing need for their medications for managing their smoking-related diseases84.

Youth vaping epidemic

What about youth smoking?

Why are all the credible sources omitting significant data such as youth smoking rates are plummetting85,86; vaping is a fraction the harm of smoking87; nicotine is less addictive than cigarette smoke84; and smokers are quitting using tobacco harm reduction88? The hysteria over youth experimenting with vaping disregards the reduction in youth smoking uptake. One must look at the  potential reduction in harm if youth are choosing to experiment with vaping instead of smoking due to the significant reduction in health destroying toxins and reduction in addiction potential89.

Long term effects

We know the LT effects of smoking

Unlike with cigarettes, vaping has been developed in an age when science has studied and catalogued thousands of substances and how they effect human health90. Eliquid and vapour have been thoroughly analyzed and the results consistently indicate that vaping is a very small fraction of the harm compared to smoking87.

Bad science

False claims

Omitting significant data is coupled with false claims such as youth smoking rates are inclining91 and vaping causes heart attacks92. These questionable researchers have the audience of the most powerful tobacco control bureaucrats in Canada93. It’s time the health community review the evidence and advocate for the effective utilization of vaping  before these bureaucrats enact oppressive regulations which will destroy the industry that supplies Canadians with tobacco harm reduction94.

Media

Click bait headlines

Mainstream media has been instrumental at spreading false narratives. Is the free press particularly Canada’s publicly funded CBC not responsible to report the facts so Canadians can make informed decisions on issues of public health95?  One must consider that media is significantly funded by the pharmaceutical industry96.

Credible sources

Are they trustworthy?

Health-related nonprofits97, health authorities, regulatory bodies and universal health care agencies have close and often financial relationships with industry that profit from ill-health such as the pharmaceutical, medical supply, and medical equipment industries. These industries fund a large portion of our scientific research, medical schools98, tobacco control conferences99 and so on.

Health-related nonprofits

Revenue contingent on disease

Health professionals trust these agencies as credible sources of information because they have been trained to. It’s time to start questioning sources of information that revenue comes as a result of diseases. These agencies do not have answer to the bioethics of professional codes of ethics that guide the practice of health professionals.

Regulatory bodies

On the bandwagon

Professional regulatory bodies make professional conduct and responsibilities for their members. But do these ethics apply to the agencies as well? The Canadian Nurses Association has been a leader in harm reduction for illicit drug users since 2007100.

Front line workers

The final fail safe

When the system fails, it’s the front line workers that must advocate for appropriate application of science to improve population health outcomes. These health professionals witness the suffering caused from smoking everyday. Will they review the evidence, challenge the opinion of majority and do the right thing?

79. Canadian Nurses Association. (2017). Code of ethics for registered nurses.

80. Centers for Disease Control and Prevention. (2015). U.S. Public Health Service Syphilis Study at Tuskegee.

81. Huang. J. et al. (2019). Changing perceptions of harm of e-cigarette vs cigarette use among adults in 2 US National surveys from 2012 to 2017.

82. Public Health England. (2018). Key questions and findings from our e-cigarette evidence update

83. NHS Digital. (2019). Statistics on smoking, England – 2019.

84. Farsalinos, K. E., Romagna, G., Tsiapras, D., Kyrzopoulos, S., & Voudris, V. (2014). Characteristics, perceived side effects and benefits of electronic cigarette use: A worldwide survey of more than 19,000 consumers.

85. Government of Canada. (2015). Canadian Student Tobacco, Alcohol and Drugs Survey.

86. Government of Canada. (2019). Canadian Student Tobacco, Alcohol and Drugs Survey.

87. Abrams, D. B., Glasser, A. M., Pearson, J. L., Villanti, A. C., Collins, L. K., & Niaura, R. S. (2018). Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives. Annual Review of Public Health.

88. Farsalinos KE, Barbouni A. Association between electronic cigarette use and smoking cessation in the European Union in 2017: analysis of a representative sample of 13 057 Europeans from 28 countries.

89. A Consensus Study Report of the National Academies of Sciences, Engineering and Medicine. (2018). Public Health Consequences of E-cigarettes. Page 33.

90. Canadian Centre for Health and Safety. (2020). Registry of Toxic Effects of Chemical Substances (RTECS).

91. Hammond, D. et al. (2019). Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys.

92. Journal of the American Heart Association. (2020). Retraction to: Electronic Cigarette Use and Myocardial Infarction Among Adults in the US Population Assessment of Tobacco and Health.

93. University of Ottawa Heart Institute. (2020). Top Smoking Cessation Authorities Gather at Ottawa Conference – Day 1. Retreived Feb. 19, 2020 from https://www.ottawaheart.ca/media-release/top-smoking-cessation-authorities-gather-ottawa-conference-day-1.

94. Public Health Agency of Canada (2020). Statement from the Council of Chief Medical Officers of Health on Nicotine Vaping in Canada.\

95. Canadian Broadcast Corporation. (2017). Code of Conduct: Working together: Our values, ethical principles and expected behaviour. Retrieved Feb. 19, 2020 from https://site-cbc.radio-canada.ca/documents/values-ethics/values-ethics/code-conduct-en.pdf

96. Kantar US Insights. (2017). Retrieved Feb 19, 2020 from https://us.kantar.com/business/health/2017/drug-advertising-booms/

97. Women and Health Protection (WHP). (2005). Marching to Different Drummers: Health Advocacy Groups in Canada and Funding from the Pharmaceutical Industry. Retrieved Faeb. 19, 2020 from http://www.whp-apsf.ca/pdf/corpFunding.pdf

98. Canadian Medical Association Journal. (2013). Pharma influence widespread at medical schools: study. Retrieved Fab. 19, 2020 from https://www.cmaj.ca/content/185/13/1121

99. 12th Annual Ottawa Conference State of the Art Clinical Approaches to Smoking Cessation. (2020). Conference program. Page 17. Retrieved Feb. 19, 2020 from https://ottawamodel.ottawaheart.ca/sites/default/files/2020_program_-_web.pdf

100. Canadian Nurses Association. (2020). Harm reduction. Retrieved Feb. 19, 2020 from https://www.cna-aiic.ca/en/policy-advocacy/harm-reduction.

 

 

 

Health professionals

Health professionals

Health professionals

Smoking is the most preventable cause of morbidity and mortality in Canada.1

We invite you to make informed decisions about tobacco harm reduction.

 

Optimal patient care

If you are a health professional, you have chosen a caring profession that entrusts you to advise your patients with accurate information to improve their health outcomes.2 You are trusted by the public, authorities and your colleagues to communicate relevant information and you rely on your sources to provide you with current, unbiased and credible evidence3.

Undoubtedly, you care for and treat patients that are hopelessly addicted to cigarette smoke. As much as you communicate the devastating health effects of smoking and witness the patients’ resulting decline, they are powerless and you are frustrated that they can’t quit4.

If cessation of high risk behaviours (in this case cigarette smoking) is not happening, the next best strategy is harm reduction3. Would you want to know if your current best educated advice for smokers is actually causing great harm? We invite to look at the credible evidence to ensure best practice.

Section 1

Smoking

Before you can understand the relevance of harm reduction you first must understand what is causing harm5. Learn about what goes into cigarettes, the constituents of the smoke, and the social cost.

Section 2

The current context

Since summer of 2019, the media, health-related nonprofits, regulatory agencies and health authorities have been repeating the same congruent narratives about vaping without debate nor deviation. The current discourse about harm reduction omits significant data6.

Section 3

Tobacco harm reduction

Vaping has been thoroughly studied in labs and in real life context. A search on a medical data base resulted in over 22,000 published articles. We take you through the 10 most common myths about vaping and link you to more evidence.

Section 4

Bioethics

In this section we challenge health professionals to apply bioethics to the current context. Health professionals care about their patients’ outcomes and are required to advocate for change when current practice is causing harm3.

1. Health Canada. (2014). Health concerns: Notice of proposed order to amend the schedule to the Tobacco Act.

2. Canadian Nurses Association. (2017). Code of ethics for registered nurses.

3. Canadian Nurses Association. (2018). Harm reduction and substance use: Joint position statement.

4. Centers for Disease Control and Prevention. (2010). A report of the surgeon general: How tobacco smoke causes disease: What it means to you.

5. Canadian Nurses Association. (2017). Harm reduction and illicit substance use: Implications for nursing.

6. Australasian Professional Society on Alcohol and other Drugs. (2020). Miscommunication about the causes of the US outbreak of lung diseases in vapers by public health authorities and the media.

Smoking

Smoking

Smoking

Every year in Canada, smoking causes 18% of all deaths and costs the taxpayers $16 billion7.
Over one million Canadians suffer with smoking-related diseases7,8.

Smoking morbidity and mortality is 100% preventable9.

Diagnose the problem

Cigarette smoke addiction

Cigarettes became mainstream in the early 20th century due to automation which made them economically viable to produce10. Over decades, tobacco company scientists experimented with chemicals to produce the most addictive product in the world10.

Currently, up to 600 ingredients are added to tobacco cigarettes to cause physiological outcomes and enhance the delivery and effects of nicotine11. Ammonium salts increase nicotine bioavailability; menthol acts as a local anaesthetic and cough suppressant12. Eucalyptol and theobromine are bronchial dilators to increase the volume of  smoke inhaled12. Then, lactones reduce the body’s ability to metabolize nicotine; and acetaldehyde mimics monoamine oxidase inhibitors (anti-depressant effect)12.

Cigarettes are more addictive than just nicotine on its own and the most harmful source of nicotine13. When smokers switched to tobacco harm reduction (THR), they reported improvements in chronic diseases14 and general health 15.

At-risk populations

Higher prevalence in vulnerable populations

Those with metal health disorders have double the smoking prevalence of the general population16. For instance, people with schizophrenia have up to 80% prevalence17. Cigarettes are the most harmful source of nicotine18.

While smoking prevalence has significantly declined in the last 50 years, people of lower socio-economic status prevalence has hardly changed19. Considering that a pack of cigarettes in Canada costs up to $20, this expense adversely effects their ability to afford healthy food for themselves and their children.

Smoking rates

15% of Canadians smoke

About 4.6 million Canadians 15 years and older are addicted to cigarette smoke20. It is the most common addiction in Canada21. Toxins in smoke include: carbon monoxide which displaces oxygen on RBC; hydrogen cyanide which paralyses lung cilia; free radicals which cause atherosclerosis22.

7000+ chemicals in smoke

Combustion is a problem

Burning chemical laden cigarettes cause new toxins to form22. Cigarette smoke contains hundreds of known disease causing agents and 69 carcinogens11, 22. Smoking is responsible for 36% of respiratory diseases, 29% of cancers, 14% of cardiovascular diseases, 85% of lung cancer and 87% of COPD23.

100% preventable costs

Death and taxes

Premature deaths caused from smoking leads to 599,390 potential years of life lost24. Tax expenditures include $6.4 billion in direct health care costs and indirect costs includes $6.8 billion for long-term disability24.

The needless suffering

The human element

The accumulative effects of the toxins deteriorates the smoker’s health22. This adversely effects their families such as when the main earner can no longer work and their children cannot afford a higher education24.

Long term effects

The next generation

If we help grandparents stop smoking, they can enjoy active relationships with their grandchildren. After one year of quitting smoking, patients’ risk of heart attack reduces by 50%; after 10 years, risk of lung cancer is reduced to 50% and risk of coronary heart disease is the same as a never smoker25.

Harm reduction for smokers

Medical autonomy

When patients are unable to cease risky behaviours, the next best intervention is harm reduction such as practising safe sex to avoid HIV26. Health professionals are responsible to promote harm reduction27.

Stay current in the evidence

What you don’t know can harm your patients

Let the scientific findings guide your practice.

 

7. The Conference Board of Canada. (2017). The costs of tobacco use in Canada, 2012.

8. Centres for Disease Control and Prevention. (2014). Fast facts: Diseases and death.

9. Health Canada. (2014). Health concerns: Notice of proposed order to amend the schedule to the Tobacco Act.

10. Institute of Economic Affairs. (2013). Free market solutions in health: The case of nicotine.

11. Rabinoff, M., Caskey, N., Rissling, A., & Park, C. (2007). Pharmacological and Chemical Effects of Cigarette Additives.

12. Europa. (2010). Public Health: Tobacco additives.

13. Laugesen, M. (2013). Nicotine and health.

14. Farsalinos, K. E., Romagna, G., Tsiapras, D., Kyrzopoulos, S., & Voudris, V. (2014). Characteristics, perceived side effects and benefits of electronic cigarette use: A worldwide survey of more than 19,000 consumers.

15. Polosa, R., Rodu, B., Caponnetto, P., Maglia, M., & Raciti, C. (2013). A fresh look at tobacco harm
 reduction: the case for the electronic cigarette.

16. Mental Health and Smoking Partnership. (2017). Statement on Electronic Cigarettes

17. Royal College of Physicians. (2013). Smoking and mental health: A joint report by the Royal College of Physicians and the Royal College of Psychiatrists.

18. Nutt, D. J., Phillips, L. D., Balfour, D., Curran, H. V., Dockrell, M., Foulds, J., Fagerstrom, K., Letlape, K., Milton, A., Polosa, R., Ramsey, J., & Sweanor, D. (2014). Estimating the harms of nicotine-containing products using the MCDA approach.

19. Public Health England. (2015). E-cigarettes: an evidence update A report commissioned by Public Health England.

20. Reid, J., Hammond, D., Tariq, U., Burkhalter, R., Rynard, V.L., & Douglas, O. (2019). Tobacco Use in Canada: Patterns and Trends, 2019 Edition.

21. Public Health Agency Canada. (2014). Tobacco.

22. A Report of the Surgeon General. (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General.

23. Dawkins, L. (2013). Why is it so hard to quit smoking?

24. Conference Board of Canada. (2017). The Costs of Tobacco Use in Canada, 2012.

25. Canadian Cancer Society. (2020). Amazing ways your body bounces back.

26. Canadian Nurses Association. (2017). Harm reduction & illicit substance use: Implications for nursing.

27. Canadian Nurses Association. (2018). Harm reduction and substance use: Joint position statement.

to edit Downloads

to edit Downloads

Downloads

Free printable and digital resources

Our printable resources are based on scientific evidence yet written in a way that’s simple to understand.

Download the PDF’s for quality printing.

Posters


You are being deceived

Most vapers are aware that there is rampant misinformation about vaping. This 18″ x 24″ poster features 9 Shareables that give a base knowledge about vaping as a harm reduction strategy.

It’s all bull sh*t

This poster addresses the current fear-provoking message that tobacco harm reduction (vaping regulated nicotine eliquid) is what is making people sick. The ‘vaping related’ lung injuries are clearly caused from mostly black market cannabis products used in a vape device.

We are VERY concerned that authority and media group these dangerous products with nicotine eliquid. In the interest of public health, it is unethical to (1) not clarify what is making people sick and (2) actively oppress tobacco harm reduction!

The emojis are humour that create receptiveness followed by a command to invite learning. We have two styles for your preference.

Rack cards


 

VAEP info and youth infographics

These were a big hit at an expo so we have made them available here for anyone who wants them!

They feature our youth smoking and vaping infographics for both Canada and the US. The front drives people to our website for self directed learning, creating more support and customers for harm reduction.

Business cards


 

Card with VAEP QR code

This card is an effective and inexpensive way to educate your community about vaping. Print off these business cards and hand them out.

Encouraging education will promote more social support for current smokers to try harm reduction. Make it easy for people to visit our website and learn the truth about vaping!

Get your facts straight business card

We got a request to use one of our Shareables as a business card. So, here it is! This card gives some information to understand that vaping is tobacco harm reduction.

Infographics


8 things you should know about vaping

Utilizing our Shareables, this infographic covers eight key points that illustrate how vaping is a significant harm reduction strategy for current smokers and more.

Youth smoking and vaping

These infographics illustrate the smoking and vaping trends of youth in 2017. The data is expressed in percentages. Graphs are utilized to show frequencies of use and to draw comparisons. We have two colour options (on desktop version) for printer preferences.

Canadian version

This infographic reflects the data collected from Government of Canada’s population surveys. We have used the Canadian Student Tobacco, Alcohol and Drugs Survey (CTADS) for 2014-15 and 2016-17 as well as the Canadian Tobacco Use Monitoring Survey (CTUM): Overview of historical data 1999 to 2012.

American version

This infographic reflects the data collected from U.S. government population surveys. We have used the National Youth Tobacco Surveys from 1999-2017.

Due to inconsistencies in data collection, in the section titled “Difference in Smoking Rates over 2 year Periods (%)”, an average was used for years 2001, 2003, 2005, and 2007.

Papers


Vaping (electronic cigarette use) The Truth

This paper is based on scientific evidence yet written in conversational English. In a short read, it provides the reader with the basic knowledge about vaping as a harm reduction strategy.

This paper has many colourful graphs throughout; side columns of quotes; and fifty-two references listed in the back. The two versions reflect American and Canadian statistics.

Le vapotage (L’utilisation de la cigarette électronique) La vérité

Ce document est basé sur des preuves scientifiques. Dans une courte lecture, vous pouvez apprendre les connaissances de base pour comprendre vaping comme une alternative viable pour le tabagisme. Il fournit au lecteur des informations pour prendre une décision éclairée sur le vapotage en tant que stratégie de réduction des risques.

Nous prévoyons desservir la communauté québécoise. VAEP incorporé en français et en anglais.

CBC correction

The pervasive, fear-provoking, biased misinformation that media continues to publish harms people because they cannot make informed decisions about harm reduction. The CBC produced a series called “Vape FAIL”. Their first article, “The Road to Vaping”, was so jammed packed with misinformation, half-truths and biased perspective that we felt compelled to write a correction. We have added the significant data they omitted, corrected their deceptions and exposed their integrity.

Outlawing Vaping in Public

This paper discusses the social issue of public vaping. It looks at the contexts of current public risks; effective transition to vaping and adolescent experimentation.

A quick read to start critical thinking about society’s role in promoting harm reduction. Smoking is a social issue with very high costs. We should be looking at all the options to reduce the suffering caused from inhaling smoke from burning, chemically laden tobacco.

Vaping vs smoking chart

Harm reduction means to reduce the negative consequences of the things people do. Examples would be seat belts, condoms and helmets.

To understand if a new thing will reduce harm; it must first be compared to the thing it is replacing. This chart makes a direct comparison of vaping to smoking in several areas: ingredients, what’s inhaled, bystanders, addiction, health effects and costs.

Slide shows


 

The Facts in Five Minutes

This is a five minute slide show explaining the basics of vaping, complete with narrative. It is designed to fit into the presentation time allowed by a committee or city council.

The information is based on ‘Vaping, the Truth’ and we HIGHLY recommend  you study this paper and the slideshow prior to your presentation to ensure your knowledge base!

It features an additional 16 slides that provide more information on vaping to expand the audience’s knowledge. Use these to add to the presentation if the time allotment is more than 5 minutes or to answer questions or if more information is requested.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

to edit slide shows

Downloads

slide shows

Our learning resources are based on scientific evidence yet written in a way that’s simple to understand.

We aim to help people learn about vaping from a harm reduction perspective.

Slide shows


 

The Facts in Five Minutes

This is a five minute slide show explaining the basics of vaping, complete with narrative. It is designed to fit into the presentation time allowed by a committee or city council.

The information is based on ‘Vaping, the Truth’ and we HIGHLY recommend  you study this paper and the slideshow prior to your presentation to ensure your knowledge base!

It features an additional 16 slides that provide more information on vaping to expand the audience’s knowledge. Use these to add to the presentation if the time allotment is more than 5 minutes or to answer questions or if more information is requested.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

to edit papers

Downloads

papers

Our learning resources are based on scientific evidence yet written in a way that’s simple to understand.

We aim to help people learn about vaping from a harm reduction perspective.

Papers


Vaping (electronic cigarette use) The Truth

This paper is based on scientific evidence yet written in conversational English. In a short read, it provides the reader with the basic knowledge about vaping as a harm reduction strategy. It has many colourful graphs throughout; side columns of quotes; and fifty-two references listed in the back. The two versions reflect American and Canadian statistics.

This paper was copyrighted in 2015 and clearly illustrates the harm reduction application of vaping. How many smokers have been diagnosed with chronic smoking-related diseases in the last 5 years because they didn’t know they had a harm reduction strategy?

Le vapotage (L’utilisation de la cigarette électronique) La vérité

Ce document est basé sur des preuves scientifiques. Dans une courte lecture, vous pouvez apprendre les connaissances de base pour comprendre vaping comme une alternative viable pour le tabagisme. Il fournit au lecteur des informations pour prendre une décision éclairée sur le vapotage en tant que stratégie de réduction des risques.

Nous prévoyons desservir la communauté québécoise. VAEP incorporé en français et en anglais.

CBC correction

The pervasive, fear-provoking, biased misinformation that media continues to publish harms people because they cannot make informed decisions about harm reduction. The CBC produced a series called “Vape FAIL”. Their first article, “The Road to Vaping”, was so jammed packed with misinformation, half-truths and biased perspective that we felt compelled to write a correction. We have added the significant data they omitted, corrected their deceptions and exposed their integrity.

Outlawing Vaping in Public

This paper discusses the social issue of public vaping. It looks at the contexts of current public risks; effective transition to vaping and adolescent experimentation.

A quick read to start critical thinking about society’s role in promoting harm reduction. Smoking is a social issue with very high costs. We should be looking at all the options to reduce the suffering caused from inhaling smoke from burning, chemically laden tobacco.

Vaping vs smoking chart

Harm reduction means to reduce the negative consequences of the things people do. Examples would be seat belts, condoms and helmets.

To understand if a new thing will reduce harm; it must first be compared to the thing it is replacing. This chart makes a direct comparison of vaping to smoking in several areas: ingredients, what’s inhaled, bystanders, addiction, health effects and costs.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

to edit infographics

Downloads

infographics

Our learning resources are based on scientific evidence yet written in a way that’s simple to understand.

We aim to help people learn about vaping from a harm reduction perspective.

Infographics


8 things you should know about vaping

Utilizing our Shareables, this infographic covers eight key points that illustrate how vaping is a significant harm reduction strategy for current smokers and more.

Youth smoking and vaping

These infographics illustrate the smoking and vaping trends of youth in 2017. The data is expressed in percentages. Graphs are utilized to show frequencies of use and to draw comparisons. We have two colour options for printer preferences.

Canadian version

This infographic reflects the data collected from Government of Canada’s population surveys. We have used the Canadian Student Tobacco, Alcohol and Drugs Survey (CTADS) for 2014-15 and 2016-17 as well as the Canadian Tobacco Use Monitoring Survey (CTUM): Overview of historical data 1999 to 2012.

American version

This infographic reflects the data collected from U.S. government population surveys. We have used the National Youth Tobacco Surveys from 1999-2017.

Due to inconsistencies in data collection, in the section titled “Difference in Smoking Rates over 2 year Periods (%)”, an average was used for years 2001, 2003, 2005, and 2007.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

to edit business cards

Downloads

business cards

Our learning resources are based on scientific evidence yet written in a way that’s simple to understand.

We aim to help people learn about vaping from a harm reduction perspective.

Business cards


 

Card with VAEP QR code

This card is an effective and inexpensive way to educate your community about vaping. Print off these business cards and hand them out.

Encouraging education will promote more social support for current smokers to try harm reduction. Make it easy for people to visit our website and learn the truth about vaping!

Get your facts straight business card

We got a request to use one of our Shareables as a business card. So, here it is! This card gives some information to understand that vaping is tobacco harm reduction.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

to edit Rack cards

Downloads

rack cards

Our learning resources are based on scientific evidence yet written in a way that’s simple to understand.

We aim to help people learn about vaping from a harm reduction perspective.

Rack cards


 

VAEP info and youth infographics

These were a big hit at an expo so we have made them available here for anyone who wants them!

They feature our youth smoking and vaping infographics for both Canada and the US. The front drives people to our website for self directed learning, creating more support and customers for harm reduction.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

to edit Posters

Downloads

posters

Our learning resources are based on scientific evidence yet written in a way that’s simple to understand.

We aim to help people learn about vaping from a harm reduction perspective.

Posters


You are being deceived

Most vapers are aware that there is rampant misinformation about vaping. This 18″ x 24″ poster features 9 Shareables that give a base knowledge about vaping as a harm reduction strategy.

It’s all bull sh*t

This poster addresses the current fear-provoking message that tobacco harm reduction (vaping regulated nicotine eliquid) is what is making people sick. The ‘vaping related’ lung injuries are clearly caused from mostly black market cannabis products used in a vape device.

We are VERY concerned that authority and media group these dangerous products with nicotine eliquid. In the interest of public health, it is unethical to (1) not clarify what is making people sick and (2) actively oppress tobacco harm reduction!

The emojis are humour that create receptiveness followed by a command to invite learning. We have two styles for your preference.

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

Harm reduction

Adolescents and Adult Activities

The making of smokers

Harm reduction

VAEP is run by health professionals.

We are required to promote harm reduction that is based on credible evidence instead of ideology, personal beliefs, or misconceptions.  23

we would like to suggest a compassionate strategy to address the youth vaping issue.

When youth have difficulty coping with their stressors, some will seek to escape reality with drug use as evidence by 40% or grade 10-12 students have participated in high risk alcohol consumption in the last year.9 This type of behaviour indicates the youth may benefit from resources that can help them cope such as support groups or anger management courses.

When it comes to substance use, teens find the abstinence only approach to be unhelpful, yet they find a harm reduction approach to be supportive.26 Instead of the fear-based abstinence-only narrative, perhaps a more beneficial strategy would be a program that provides these youth with resources to cope with their stressors and prevent addiction.

A description of an online youth resource centre targeting youth that are 'JUULING'.

A small percent of youth are ‘ JUULing” to achieve a ‘heady’. A heady is the adverse effects of too much nicotine such as a head rush, nausea and rapid heart rate.  Not all youth are pushing through these unpleasant effects to achieve the head rush and that is what separates those that are at risk of addiction and those that aren’t. In nursing, we would call this a ‘teachable moment’: an opportunity to identify a problem and offer solutions.

Instead of spending millions of tax dollars on fear-provoking advertising that scares smokers away from vaping, perhaps a better investment would be an online interactive program that connects the troubled teen with resources to over come their stressors by building new skills or accessing support.

For example: Suzy is a 14 year old female who loves to socialize. Her parents are going through a divorce and she is having difficulty coping with it. Suzy  has tried JUULing and liked the heady sensation. She wants to try it again because it took her out of her emotional pain for a while.

A website could be built that targets these youth with a lead in relating to JUULing. It would take the youth through a series of qualifying questions to match them with the right resources. So, with Suzy, this program could connect her to resources such as an online video conferencing support group for teens whose families are going through a divorce.

A proactive approach could interrupt the use of drugs to cope with life; it could prevent future addicts.

A proactive approach could help the 5.3 million Canadian smokers instead of deterring them from harm reduction with fear-provoking advertising.

How many smokers have been diagnosed with irreversible diseases as a result of continuing to smoke because they did not know they had an alternative?

Our Founding member accessed a medical data base in 2014 and read hundreds of published articles on vaping. This paper was the result of that research and was copyrighted in 2015.

In a 15 minutes, the reader will gain a comprehensive understanding of vaping as a harm reduction strategy for current smokers. This paper is written in conversational English and cites 52 references. It comes in American, Canadian French and English and  versions.

What this illustrates is that the evidence has been available for at least 5 years.

If someone you care about smokes, please send them to our website.

Making a

smoker

What about

vaping?

Youth and

vaping

The current

narrative

Updated 01FEB2020

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

Current narrative

Adolescents and Adult Activities

The making of smokers

The current narrative

Well intentioned warnings from trusted health authorities may be giving the wrong message to age groups with full cognitive reasoning.

How many smokers have walked through these doors and have been dissuaded from considering harm reduction?

 

 

 

 

 

 

 

 

 

 

“Vaping nicotine can alter teen brain development.”

– Health Canada

This study was done on rats.

It would be unethical to give nicotine to teens and then test their brains.

Considering the difference in brain structure, a more accurate message would be to specify ‘rat’ brain. 11

The dose was 2mg/kg/d of nicotine.

serious adverse effects from nicotine present at 1mg/kg depending on tolerance. (2)

These rats were given the equivalent of 136 mg of nicotine per day through a 24 hour IV to a 150 pound person. 11

 

There are over 7000 chemicals in smoke. (5)

Most of the harmful chemicals found in tobacco smoke are eliminated with vaping. (2)

 Nicotine is a mild stimulant much like caffeine and does not cause disease. 6

To quote the study:

"Although the precise fraction of those [effects] attributable specifically to nicotine has not been precisely quantified." (25)

On one occasion in this study, smokeless tobacco was used as a data source, the rest were all about tobacco smoke. It is literally impossible to determine if any of the health effects on the developing fetus or adolescents who smoke are caused from nicotine.

“Vaping can cause lung damage.”

– Health Canada

Is this the right message for smokers?

The 5.3 million smokers in Canada have a right to know that vaping is a 95% safer alternative. (9) (36)

Yet, these alarming messages hardly illustrate the significant harm reduction strategy!

Where is the evidence?

Health Canada provides no references for this public announcment on their website or literature.

To quote the only statement associated with this public announcement: “Vaping can expose you to harmful chemicals like formaldehyde and acrolein, and metals and contaminants like nickel, tin and aluminum. You don’t want any of these in your lungs!” 37

Health Canada has some positive messages for smokers.

Find more quotes from health experts on our Shareables page.

Harm

reduction

Making a

smoker

What about

vaping?

Youth and

vaping

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

Youth and Vaping

Adolescents and Adult Activities

The making of smokers

Youth and vaping

“Every 10 minutes, two Canadian teenagers start smoking cigarettes; one of them will lose her life because of it.” -Health Canada (22)

View the full infographic of the following Shareables and other free printable materials on our Downloads page!

VAEP does not condone youth using any product intended for adults.

“…nurses have a responsibility to provide non-judgmental care to individuals and families affected by substance use, regardless of setting, income, age, gender identity, ethnicity or other socio-demographic characteristics.” 23

Vaping exists today because of the demand from smokers who want a harm reduction option. However, the evidence suggests that vaping seems to be having an unintended consequence which is that vaping may be interrupting the uptake of youth smoking. Vaping may be preventing the next generation of smokers.

The adolescent brain is more susceptible to addiction than the adult brain.

Studies have shown that because of the development in the brain during adolescent years, teens are more susceptible to continue impulsive behaviours and develop dependence than adults. 24, 12, 25

Research has also shown that teens are less receptive the the abstinence-only approach and find a harm reduction approach more helpful. 26

We have made some suggestions for an approach that may be more beneficial to this age group than the current fear-provoking narrative in our Harm Reduction section at the end of this page.

Grade twelve smokers are the next adult smokers.

A 35% drop in grade 12 smoking rates is very significant!

If vaping was a gateway to smoking, we would see an increase in the smoking rates. Instead the youth smoking rates are dropping. This suggests that vaping may be reducing the uptake of smoking in youth.

In 2017, 11% of grade 7-12 students had one puff or more 30 days and 1.2% vaped daily.

In 2015, 17.7% grades 6-12 students had at least one puff from a vape. In 2017, 22.8% grade 7-12 students had at least one puff from a vape; an increase of 28.8% in two years. 9, 27

35% of grade 10-12 students have ever smoked and 33% have ever vaped. (27)

Is there a smoking epidemic?

This graph shows a 16 year history of current smoking rates of 15-19 year olds over a 16 year period.

Within 3 years of vaping being introduced, the smoking rate decreased at a level not seen in 14 years!  9, 27, 28, 29

In Great Britain, vaping is recognized as a significant harm reduction strategy and is promoted by Public Health England. (30)

Yet, less than 2% of 11-18 year olds vape more than once a week. 31

This indicates that promoting harm reduction and allowing it to be attractive to smokers such as allowing all sorts of flavours (adults like flavours) does not create increased usage among youth.

'Public Health Consequences of E-Cigarettes' from the national Academies of Sciences, Engineering and Medicine (32)

This quote illustrates the potential not only for current smokers but to prevent the next generation of smokers. 32

The graph illustrates the significant drop in American youth smoking rates since vaping has been introduced in the USA. 33

A small percentage of never smokers are abusing nicotine salts eliquids, mainly with pod devices such as JUUL. (34)

‘Nicotine salts’ are nicotine with additives that lower the pH level to crate a faster absorption rate than just pure nicotine. 35 This process is part of tobacco cigarette production and the rapid absorption of nicotine into the blood is what the smoker is accustomed to. 8

Nicotine  salts eliquids are an alternative for the current smoker, usually a heavy smoker, when pure nicotine is not enough to transition off of tobacco smoke.

A very small percentage of youth that have never smoked are abusing nicotine salts to achieve a ‘heady’. A heady is the physiological experience of too much nicotine such as a head rush, nausea or racing heart rate.

When youth have difficulty coping with their stressors, some will seek to escape reality with drug use as evidence by 40% or grade 10-12 students have participated in high risk alcohol consumption in the last year. 9 This type of behaviour indicates the youth may benefit from resources that can help them cope such as support groups or anger management courses.

When it comes to substance use, teens find the abstinence only approach to be unhelpful, yet they find a harm reduction approach to be supportive. 26 Instead of the fear-based abstinence-only narrative, perhaps a more beneficial strategy would be a program that provides these youth with resources to cope with their stressors and prevent addiction.

More info on vaping.

Visit our Shareables collections to learn more.

The current

narrative

Making a

smoker

What about

vaping?

Harm

reduction

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

What about vaping?

Adolescents and Adult Activities

The making of smokers

What about vaping?

On this website, we reference nicotine vaping products purchased in specialty vape shops when used as intended.

 

Vaping nicotine based eliquids is 95% reduction in harm compared to smoking. 20 Vaping is less addictive than smoking because it has a fraction of the ingredients found in tobacco cigarettes. 3

Learn how vaping compares to smoking in this two minute video.

This 30 second video explains the  epidemic that is related to vaping.

We don't know the long-term effects of vaping but we do know the long-term effects of smoking. (14)

The electronic cigarette was patented in 2004 15 and has been mainstream for about 5-10 years, depending on the country. To date, millions of smokers have switched to vaping. 16 There has never been a case of serious adverse effects from vaping nicotine based products from a specialty vape shop when used as intended.

Unlike with cigarettes, vaping has been developed in an age when science has studied and catalogued thousands of substances and how they effect human health. Eliquid and vapour have been thoroughly analyzed and the results consistently indicate that vaping is a very small fraction of the harm compared to smoking. 17

Over 9000 observations on the constituents of vapor were compared to universally recognized workplace exposure standards; and all (except 2 were less than <5%) were less than 1% of Threshold Limit Values. 18

 

Smoking is the most common addiction in North America. (19) (20)

Half of smokers try to quit every year; yet only 5% quit of those quit attempts achieve long term success.  21, 9 Vaping may be a better solution for smokers because it is inhaled like smoke is and replaces the ritualistic component of smoking addiction.

The Royal College of Physicians reviewed the science on vaping & wrote an 111 page report. (17)

In April 2016, they released the report, Nicotine without Smoke: “…the likely 
harm to health and society 
of e-cigarettes at about 5% 
of the burden caused by 
tobacco smoking.” 17

"People smoke for nicotine but they die from tar." -M. Russell

WHO prioritized the nine most toxic chemicals found in tobacco smoke for reduction. Vaping significantly reduces or eliminates these toxic chemicals! 6

We have more info on vaping as a harm reduction strategy for current smokers.

Visit our Shareables and our Downloads pages.

Youth and

vaping

Making a

smoker

The current

narrative

Harm

reduction

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

Making a smoker

Adolescents and Adult Activities

The making of smokers

Making a smoker

Chemicals are added to tobacco cigarettes to make them more addictive. 3, 4

Scientists employed by tobacco companies created the modern cigarette. When a tobacco cigarette is burned, the smoke contains over 7,000 chemicals; at least 250 of which cause harm and 69 cause cancer. 5

examples of chemicals and what they do
  • Some strange ingredients can be added to cigarette tobacco such as smoke flavour, furfuryl mercaptan, snakeroot oil and 6-Acetoxydihydrotheaspirane.

  • Ammonia salts lower the pH of the smoke which increases the amount of nicotine absorbed into the bloodstream (increased bioavailibility).

  • Menthol numbs the lungs to suppress coughing (local anesthetic).

  • Eucalyptol and theobromine chemically stretch the lungs (bronchial dilators) to help deliver more smoke into the lungs.

  • Lactones reduce the body’s ability to get rid of nicotine.

  • Acetaldehyde acts as an antidepressant in the brain (MOA inhibitor). 3

Nicotine is up to 3x less addictive than tobacco smoke Shareable.

The bar graph (on the Shareable) shows the percentage of people that were able to stop using different sources of nicotine: cigarettes, smokeless tobacco and nicotine gum. Each volunteer was given placebo medications and after 6 months reported whether they quit using the nicotine source.

The graph shows that the people that were on nicotine gum (which is just nicotine) had the easiest time quitting because 36% were able to quit. The people that were smoking had the hardest time quitting because only 10% quit. This indicates that cigarette smoke is up to three times more addictive than just nicotine on its own. 6

Experimenting with adult activities is a normal part of adolescent development.7

“Adolescence is defined by characteristic behaviors that include high levels of risk taking, exploration, novelty and sensation seeking, social interaction and play behaviors.” 8

It is not uncommon for teenagers to experiment with adult taboos such as sex, alcohol and smoking (9).

During adolescents, the brain starts to  build adult connections that make different parts of the brain work together more efficiently. The last part to develop is the frontal lobe that controls judgment and insight and this is why teens take more risks than adults and why addiction often starts in youth. 7

Teens are different than adults in that they are more susceptible to peer pressure and they are “sensation-seeking”; they do things that give a rush such as driving a car fast or eating Tide Pods. 10 Therefore, teenagers are the age group that typically tries smoking 7 and why “virtually all cigarette smoking begins before 18 years of age…” 11

The more cigarettes a person smokes, the more likely they are to become a smoker. 6

The key factor to creating a smoker is to get the tobacco smoke into the person. 6 Addiction is a loss of ‘autonomy’; autonomy means to act independently of something. So, someone who is addicted to tobacco smoke has difficulty functioning without cigarettes. 12

The Hooked On Nicotine Checklist (HONC) Scale is an assessment tool used to determine if someone is addicted to smoking.

The more ‘yes’ answers to these questions, the more a person is addicted to tobacco smoke:

1. Have you ever tried to quit, but couldn’t?

2. Do you smoke now because it is really hard to quit?

3. Have you ever felt like you were addicted to tobacco?

4. Do you ever have strong cravings to smoke?

5. Have you ever felt like you really needed a cigarette?

6. Is it hard to keep from smoking in places where you are not supposed to?

When you haven’t used tobacco for a while … OR When you tried to stop smoking …

7. did you find it hard to concentrate because you couldn’t smoke?

8. did you feel more irritable because you couldn’t smoke?

9. did you feel a strong need or urge to smoke?

10. did you feel nervous, restless or anxious because you couldn’t smoke? 13

Loss of Autonomy Shareable

This graph shows at least one answer of ‘yes’ on the HONC scale by the number of cigarettes smoked.

  • After only one to two cigarettes, 25% have lost some autonomy!

  • At 20 cigarettes (a pack of cigarettes), half are reporting signs of addiction.

  • At 100 cigarettes (4-5 packs) 94% are becoming life-long smokers. 6

What about

vaping?

Youth and

vaping

The current

narrative

Harm

reduction

Make a difference

Every contribution ensures we can

continue providing quality learning materials.

to edit Downloads

Youth

Adolescents and Adult Activities

Youth and nicotine

Over 90% of smokers start before they are 20 years old. 1

Considering that every year, only 2.5% of smokers quit long term 2, smokers are very profitable for those corporations that make tobacco cigarettes and treat smoking related diseases.

Making a

smoker

What about

vaping?

Youth and

vaping

The current

narrative

Harm

reduction

Make a difference

Every contribution ensures we can

continue providing quality learning materials.