The World Health Organization (WHO) is urging governments to implement tougher rules around electronic cigarettes in a bid to protect public health.
Electronic cigarettes (also known as e-cigarettes) are battery-powered tube-like devices resembling regular tobacco cigarettes but without tobacco, smoke or combustion as part of their process.
The devices contain a refillable cartridge with a nicotine-laced solution and some flavouring material. This “e-liquid” is vapourized forming small droplets that are inhaled into the lungs much the same as the smoke from a conventional/combustible cigarette. Those who use e-cigarettes get a dose of nicotine and experience the same physical sensation as those who smoke tobacco cigarettes.
E-cigarettes are frequently marketed by manufacturers as aids to quit smoking, or as healthier alternatives to tobacco. However, WHO reports there is little evidence to support these claims.
With flavours mimicking candy, fruit or alcohol, experimentation with the popular nicotine-vapour products is rapidly increasing among adolescents. In fact, WHO reports e-cigarette use in this group doubled from 2008 to 2012.
Governments and health professionals are concerned that the growing use of these devices could once again popularize smoking (especially among young people and non-smokers).
Although only a few studies have directly investigated the health effects of e-cigarettes some have concluded that exposure to e-cigarette aerosol can damage health.
It can also be damaging to the health of those exposed to second-hand aerosol. In their report, WHO warns exhaled e-cigarette aerosol is not merely “water vapour” as is often claimed by marketers of this product. The aerosol contains toxins, nicotine and other potentially harmful particles.
For example, when heated and vapourized, propylene glycol (a main ingredient of the “e-liquid”) can form propylene oxide, which is considered possibly carcinogenic to humans by the International Agency for Research on Cancer (IARC). Less serious effects can include throat and mouth irritation, cough, nausea and vomiting. No studies are available on the long-term effects.
WHO says to protect public health e-cigarette regulations should:
Impede e-cigarette promotion to non-smokers and young people;
Minimize the potential health risks to e-cigarette users and nonusers;
Prohibit unproven health claims about e-cigarettes;
Protect existing tobacco control efforts from commercial and other vested interests of the tobacco industry; and
Prohibit the use of e-cigarettes indoors in public and work places.
There is little regulation both federally and provincially that addresses the sale and use of e-cigarettes in Canada. Health Canada last addressed e-cigarettes in 2009, advising consumers not to buy or use the products because the safety of the products had not been proven. The agency also reminded Canadians that no company has been granted authorization under the Food and Drugs Act
to manufacture and sell e-cigarettes containing nicotine. However, e-cigarettes that do not contain nicotine are neither approved nor banned in Canada.
Although nicotine-filled e-cigarettes are officially not permitted for sale in Canada, there has been little or no enforcement allowing for nicotine e-cigarettes to find their way into the country through online purchases from other countries. There are no regulations in Ontario.
The lack of regulation federally and provincially has led some municipal governments to develop their own by-laws on e-cigarette products.
Recently the Toronto City Council voted to treat e-cigarettes like real cigarettes banning their use in city workplaces. This includes parks and Nathan Philips Square where city staff work. As well, the Toronto Board of Health is asking the province to impose an Ontario-wide ban on e-cigarettes wherever smoking is prohibited.
Want to know the health effects of e-cigarettes?
Want more information on the WHO report on electronic cigarettes?
Want to read the Toronto Public Health position statement on e-cigarettes?
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