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.

Section 5

Vaping Advocacy and Education Project Inc.

Since 2016, VAEP, our Canadian nonprofit, has been reviewing the evidence and producing open source learning tools to facilitate informed decision making about tobacco harm reduction. In this section, we link you to more of our resources to your further knowledge.

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.

Tobacco harm reduction

Tobacco harm reduction

Tobacco harm reduction

Smokers who aren’t willing or simply cannot quit smoking face a future of pain and suffering50.

As health professionals, you have a responsibility to help these people with the best available strategies to improve health outcomes51.

 

Learn how smokers are made

The biggest myth: there isn’t enough evidence

Health professionals are busy people, working long shifts in high stress environments. We understand that research is the last thing you want to do on your days off. VAEP was developed to make learning about tobacco harm reduction easy for health professionals and the public.

This image is a screen shot from a medical data base. The search results for “e-cigarettes or vaping or vape or electronic delivery systems” provided over 22,000 published articles on vaping.

Myth 2

We don’t know if vaping is less harmful than smoking

The multiple-criteria decision analysis (MCDA) is a decision-making tool that takes into account multiple factors and enables comparison of related subjects. Twelve experts compared sources of nicotine using 14 criteria of harm. Cigarettes are the most harmful source of nicotine at 100%. Vaping was assessed at less than 5% the harm52.

Myth 3

Second hand vapour is dangerous

Over 9000 observations of the constituents of vapour were compared to universally recognized workplace exposure standards known as Threshold Limit Values (TLVs). All constituents were valued at <1% TLV, except two constituents acrolein amd formaldehyde were <5%53. It’s important to note  that acrolein and formaldehyde are normal constituents of exhaled breath54.

Myth 4

Nicotine causes disease

Nicotine is an addictive mild stimulant. It elevates mood, stimulates cognitive function and increases energy55. It’s physiological effects and therefore addictive effects are similar to caffeine56. It is not a carcinogen and without the adjunct chemicals, nicotine presents as less additive than cigarette smoke55. Nicotine is so safe you don’t need a prescription or to be age of majority to buy nicotine patches, gums etc.

Further

The Royal College of Physicians (RCP)

RCP has been an authority in medicine for 500 years. ‘Nicotine without Smoke’, released by RCP in 2016, is a 200+ page report investigating the scientific research on vaping. Some of their key recommendations: “… the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco…in the interests of public health it is important to promote the use of e-cigarettes57…”

Myth 5

Vaping is a gateway to smoking

During the last 6 years, vaping has been mainstream in Canadian society58. This is the first generation of youth that have experimented with vaping58. It is normal adolescent behavour to experiment with adult taboos59. 20% of youth have tried vaping in the last 30 days60. If vaping was a gateway to smoking we would observe an increase in youth smoking prevalence. As per the biennual Canadian Student Tobacco and Drug Survey, grade 12 smoking prevalence has decreased 63% in the last 6 years58,60.

Further

The Canadian Institute for Substance Use Research

at the University of Victoria released in January 2017 ‘Clearing the Air: a systematic review of the harms and benefits of e-cigarettes and vapour devices’61. Tim Stockwell, an investigator on this review, stated: “The public has been misled about the risks of e-cigarettes. Many people think they are as dangerous as smoking tobacco but the evidence shows this is completely false62.”

Myth 6

Flavours are to attract youth

Considering that one in four Canadians are obese, and that alcohol comes in thousands of flavours we can deduce that adults like flavours63. This is why nicotine gum, lozenges and sprays come in flavours64. When smokers are detoxing off the 7000 chemicals found in cigarette smoke and transitioning to just pharmaceutical grade nicotine, pleasing flavours encourage continuation of harm reduction65. Further, the novelty of flavours encourages the continued compliance with vaping65.

Myth 7

Vaping’s ineffective for cessation

Considering that Canadian public health officials have utilized millions of our tax dollars to only oppress tobacco harm reduction by disseminating fear-based narratives about vaping66, the vaping industry has been driven solely by consumer demand; smokers’ demand for an alternative that reduces harm67. If vaping was ineffective it would not exist. From 2015 to 2017, the preferred smoking cessation method for Canadian smokers was vaping at 32% vs 24% with patches and 16% with gum68. In the United Kingdom, 54% of successful smoking cessation attempts were with vaping69.

Further

Controlled clinical trials

In 2014, smokers that did NOT want to quit smoking were given eliquid and vape pens (which aren’t as effective at nicotine delivery as the current devices). At 2 months,  34% of the subjects reported smoking cessation. eCO levels decreased significantly and continine (nicotine metabolite) remained the same. At six months, 21% remained exsmokers compared to 6% cessation with patches70.

Myth 8

Approved cessation methods are effective

Prior to vaping, only 2.5% of smokers quit long term even though 52% attempted cessation annually71,72. They had a 4% success rate with cold turkey; 8% success with nicotine replacement therapy (NRT) such as patches or gum; if adjunct counselling was added, success can reach 16%71,73. Smoking cessation methods currently approved by Health Canada have an 84% failure rate at best! Of those successful ‘quitters’ 80% relapsed in the first month74. Psychoactives have adverse effects such as suicidal ideation, violent outbursts, depression and psychotic episodes75.

Myth 9

Vaping is ineffective for smoking cessation

A significant aspect of smoking is the ritualistic behaviour of bringing a smoke to the mouth; tasting the smoke with a drag; feeling sensations in the throat and lungs with a full inhale; and observing the visible exhale76. The behaviour is repeated 240 times a day for a pack-a-day76 smoker; 87,600 times a year! This physical ritual is coupled with an immediate increase in serum chemicals61.  Further, smokers are proficient at maintaining therapeutic nicotine serum levels through inhalation77. Vaping uniquely satisfies this ritual and provides nicotine through the same route76.

Myth 10

Dual user isn’t quitting smoking

Utilizing vaping to transition from the most addictive product in Canada to nicotine-free is a process consisting of 4 stages61. The first stage is dual use which is when the smoker becomes familiar with how to use their vaping device to achieve therapeutic nicotine serum levels61. This may include trying different devices and eliquids to find what is right for them78. Stage two is smoking cessation and continued vaping61. Invariably, after a few months to adjust to the decrease of serum chemicals, vapers decrease their nicotine dose and some then titrate off of nicotine completely61.

Listen to the experts

Quotes from those that have done the research

“The most important

toxins in cigarette smoke are missing – those that remain are orders of magnitude lower.”

Dr. Konstantinos Farsalinos

“Vapers should

 be more concerned of the air they breathe in polluted cities rather than their vaping!”

Dr. Riccardo Polosa

“Saying e-cigs

 are 95% safer is not a medical claim, it’s a truth.”

Professor Hajek

“People smoke

 for nicotine but they die from the tar.”

Professor Michael Russell, 1976

Dr. Konstaninos Farsalinos

“The most important toxins in cigarette smoke are missing – those that remain are orders of magnitude lower.”

Dr. Riccardo Palosa

“Vapers should be more concerned of the air they breathe in polluted cities rather than their vaping!”

Professor Hajek

“Sayong ecigs are 95% safer is not a medical claim, it’s a truth.”

Professor Michael Russell, 1976

 ” People smoke for nicotine but they die from the tar.”

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

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

52. 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.

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

54. Filipiak, W., Ruzsanyi, V., Mochalski, P., Filipiak, A., Bajtarevic, A., Ager1, C., Denz1, H., Hilbe W., Jamnig, H., Hackl, M., Dzien, A., & Amann, A. (2012). Dependence of exhaled breath composition on exogenous factors, smoking habits and exposure to air pollutants.

55. Laugesen, M. (2013). Nicotine and health. New York, NY: American Council on Science and Health.

56. Royal Society for Public Health. (2015). Nicotine “no more harmful than caffeine”.

57. Royal College of Physicians. (2016). Nicotine without smoke: Tobacco harm reduction: A report by the Tobacco Advisory Group of the Royal College of Physicians.

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

59. Jackson, C. A.,  Henderson, M., Frank, J. W., Haw, S. J. (2012). An overview of prevention of multiple risk behaviour in adolescence and young adulthood.

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

61. O’Leary, R., MacDonald, M., Stockwell, T., & Reist, D. (2017). Clearing the Air: A systematic review on the harms and benefits of e-cigarettes and vapour devices. Victoria, BC: Centre for Addictions Research of BC.

62. University of Victoria: UVic News. (2107). Clearing the air around e-cigarettes. Retrieved Feb. 19, 2020 from https://www.uvic.ca/news/topics/2017+e-cigarettes-carbc-macdonald-stockwell+media-release

63. Statistics Canada. (2017). Canadian Health Measures Survey.

64. Aslani, A., & Rafiei, S. (2012). Design, formulation and evaluation of nicotine chewing gum.

65. Russell, C., McKeganey, N., Dickson, T., & Nides, M. (2018). Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA.

66. Government of Canada. (2019). The risks of vaping.

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

68. Government of Canada. (2017) Canadian Tobacco, Alcohol and Drugs Survey (CTADS).

69. Farsalinos, K., Polosa, R., Cibella, C., & Niaura, R. (2019). Is e-cigarette use associated with coronary heart disease and myocardial infarction? Insights from the 2016 and 2017 National Health Interview Surveys.

70. Adriaens, K., Van Gucht, D., Declerck, P., & Baeyens, F. (2014). Effectiveness of the electronic 
cigarette: An eight-week Flemish study with six-month follow-up on smoking reduction, 
craving and experienced benefits and complaints.

71. Nides, M., Leischow, S.J., Bhatter, M., & Simmons, M. (2014). Nicotine blood levels and short-term smoking reduction with an electronic nicotine delivery system.

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

73. Shahab, L., Brose, L.S., & West R. (2013). Novel delivery systems for nicotine replacement therapy as an aid to smoking cessation and for harm reduction: Rationale, and evidence for advantages over existing systems.

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

75. Institute for Safe Medication Practices. (2008). QuarterWatch Report: Strong Safety Signal Seen for Chantix (Varenicline).

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

77. Farsalinos, K., Spyrou, A., Tsimopoulou, K. et al. Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices.

78. Farsalinos, K., Spyrou, A., Stefopoulos, C. et al. Nicotine absorption from electronic cigarette use: comparison between experienced consumers (vapers) and naïve users (smokers).

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.

VAEP

VAEP

Just vaping education

VAEP is a Canadian nonprofit dedicated to helping people learn about vaping as a harm reduction strategy.
We review the scientific evidence and provided free learning resources that are easy to understand.

Our vision: make the truth about vaping common knowledge throughout the general population.

Vaping Advocacy and Education Project (VAEP)

Our project was founded in April 2016 by Kellie Ann while she was working as a registered nurse in a rural hospital. After many failed attempts to stop a 30 year smoking addiction, she, like millions of other smokers, finally achieved cessation with vaping in 2013. With the research skills acquired in her Bachelor of Science in Nursing (dist.), Context Based Learning program she reviewed the credible evidence on vaping through a medical data base. She acquired a strong knowledge base of cigarette addiction, traditional smoking cessation methods, tobacco harm reduction history and the efficacy of vaping for cessation and reduction.

As a frontline nurse, Kellie Ann became aware that the public and her colleagues are misinformed about tobacco harm reduction. In 2015, she copyrighted the paper: “Vaping (electronic cigarette use), the Truth” which clearly illustrates the harm reduction potential of vaping. Kellie Ann has remained smoke-free and invested thousands of hours interpreting findings from credible evidence and designing learning resources that are ease to understand.

External resources

further your vaping knowledge

We have carefully selected credible sources of vaping information from the best experts in the world. Learn from the experts in science, smoking, policy and tobacco harm reduction.

 Lung injuries

Questionable reporting

After 15 years and millions of smokers transitioning to tobacco harm reduction without serious adverse effects, an outbreak of “vaping-related” lung injuries occurred in the USA. Harm reduction was blamed.   

CDC deceived the public

Media spread it around

Health professionals have been trained to trust health regulatory bodies without question. Recent history shows us this may be a problem.  

Health related nonprofits

Questionable credibility

Health professionals, authority and media rely on unbiased, benevolent recommendations from specialized nonprofits. Recent history suggests they are not following bioethics. 

 The current narrative

Rampant misinformation

The information circulating about tobacco harm reduction is leaving out significant data such as: youth smoking rates are plummetting; vaping is a fraction the harm of smoking; vaping is the most effective cessation strategy ever conceived; and nicotine does not cause disease. 

Flavours are THE essential aspect

Fear rhetoric is working

Media, particularly the CBC, are trusted to report the truth so the population can make informed decisions. They have continuously spread fear-based misinformation about tobacco harm reduction.  

Harm reduction for smokers

Gov’t are shutting it down

Pressure from the misinformed public and health community have resulted in the federal government authorizing the provinces place restrictions on harm reduction.  

Learning Resources

Further your knowledge

These resources are designed to teach the average person but provide the references required by health professionials. Utilize these sections to educate your patients and to find more credible evidence.

Downloads

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...

Youth

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...

VAEP Shareables

VAEP Shareables instantly engage the reader and help them quickly learn accurate information about vaping. Each Shareable teaches one key concept about vaping using graphics, colour and text. The reference for the information is provided on the bottom of each one. The...

Downloads

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...

Youth

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 Every contribution ensures we can continue providing quality...

VAEP Shareables

VAEP Shareables instantly engage the reader and help them quickly learn accurate information about vaping. Each Shareable teaches one key concept about vaping using graphics, colour and text. The reference for the information is provided on the bottom of each one. The information in VAEP Shareables are from studies, reports, surveys and other credible sources. We have also referenced mainstream...

Downloads

Downloads

Downloads

VAEP makes it easy to understand vaping science

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.

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.

Downloads

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.

Downloads

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.

Downloads

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.

Downloads

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.

Downloads

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.

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.

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.

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.

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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.

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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

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The making of smokers

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.

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APSAD paper

APSAD paper

Australasian Professional Society on Alcohol and other Drugs

Miscommunication about the causes of the US outbreak of lung diseases in vapers by public health authorities and the media

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Educate health professionals

Educate health professionals

Call to Action

Teach health professionals

about vaping-related lung injuries

Jan. 2020, Australasian Professional Society on Alcohol and other Drugs releases:

 

“Miscommunication about the causes of the US outbreak of lung diseases in vapers by public health authorities and the media”.

EVERY health professional who reads this will have full comprehension on the truth about what is causing vaping related lung injuries, how the CDC has deceived the public about it and that they have been getting a false narrative.

This credible paper is a short read consisting of only 2 pages yet cites 32 references.

Here is the paper, just print it off.

Now, write VAEPworld.com on the back.

All you have to do now is give it to the receptionist or practitioner at health professional offices.

Because vaping is a hot topic right now and this is a short, credible paper, it will probably get passed around the staff room. Since you wrote VAEPworld.com on the back, you have helped them learn more PLUS given them somewhere to send their patients for infomation on tobacco harm reduction! This means YOU have made all the difference in the world!

 

Suggestions for places to drop it off:

  • pharmacies

  • emergency rooms

  • hospital admissions

  • walk in clinics

  • dentist offices

  • community/public health clinics

  • doctor’s offices

  • mental health centers

  • harm reduction clinics

  • optomatrist offices

  • labs

  • physiotherapy offices

  • chiropracter offices

  • naturopathy offices

 

If we work together we can overcome the current lies.

Push back against the war on vaping by giving health professionals the chance to learn.

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Basic vaping info

Basic vaping information

These are the facts on vaping

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

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

VAEP Shareables are images utilizing graphics, colour and text to quickly teach people about vaping. Click the Shareable to enlarge and save to your phone or harddrive. Share through text, email and social media.

Smoking

Smoking is the most preventable cause of disease and death in North America. Once hooked, smokers have a very small success rate at quitting.

Tobacco harm reduction

Everyday we practice harm reduction such as using a seat belt to prevent injury. We still take a risk by getting into a vehicle but we lower the chances of negative outcomes.

Smoking cessation

If smokers quit, they stop inhaling all of the chemicals that will give them diseases. Cigarettes are the most harmful source of nicotine.

Nicotine

Nicotine is so safe that anyone, including a minor, can purchase nicotine products at the drug store.

Outcomes

There is plenty of data on what happens to a smoker when they switch to vaping.

Shareables collections

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Youth Shareables

Shareables on youth

The FULL story on youth and vaping

VAEP Shareables are images utilizing graphics, colour and text to quickly teach people about vaping. Click the Shareable to enlarge and save to your phone or harddrive. Share through text, email and social media.

Youth and vaping

The most pervasive tactic to turn the public against harm reduction is to use children. Fear-based false narratives omit important information, convey information out of context and manipulate our desire to protect children with inflammatory and misleading comments. Please go to our Adolescents and Adult Activities page to look at this subject in depth.

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EVALI

Vaping and lung injuries (EVALI)

In 2019, a sudden outbreak of severe lung injuries, some causing death, occurred in North America, mainly the USA. The lung injury was named EVALI (e-cigarette or vaping product use-associated lung injury) by the Center of Disease Control and Prevention (CDC).

Vitamin E acetate was identified as the additive in illegal THC cartridges that caused the injuries. Health-related authority and nonprofits as well as mainstream media conflated two distinctively different activities: THC cartridge vaping and nicotine eliquid vaping. The result was a misinformed public and health community.

Two travesties occurred. First, failing to adequately warn cannabis users caused unnecessary injury. Second, implying that eliquid was causing lung injuries drove thousands of vapers back to the most lethal form of nicotine: tobacco cigarettes.

Section 1

What happened

Explore the events of the outbreak: the investigation, identifying the cause and how it was resolved.

Section 2

What went wrong

Health-related nonprofits and authority utilized media to spread fear about vaping. Their narrative omitted that EVALI was not caused from nicotine eliquid. 

Section 3

Government & THC cartridges revenue

Health Canada approved the sale of THC cartridges during the outbreak. Their position on the lung injuries contradicts the science and data from the USA.

Section 4

Ethical experts tried to warn you

The UK reviewed the science on vaping around 2014: before the false narratives got to them. They stand alone in being fully informed on and benefiting their citizens with tobacco harm reduction.

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Anti-harm reduction

Anti-harm reduction advocates

People and agencies are spreading misinformation about vaping

VAEP Shareables are images utilizing graphics, colour and text to quickly teach people about vaping. Click the Shareable to enlarge and save to your phone or harddrive. Share through text, email and social media.

Anti-harm reduction advocates

There are many health professionals, health-related nonprofits, politicians and health authorities that are repeating the false narratives. Their recommendations clearly indicate a demand to make tobacco harm reduction unattractive to smokers by banning flavours, taxing vaping, banning nicotine levels that help heavy smokers, and other strategies.

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