Less than a year after it passed controversial legislation allowing vaping companies to directly advertise to the public, the Ontario government wants the federal government to crack down on such advertising to reduce vaping by youth.

In apparent contradiction with its own legislation, Ontario signed on to a joint submission from all 13 provinces and territories strongly recommending “immediate regulatory measures to reduce youth uptake of vaping products, including the role advertising has on influencing youth and non-users of tobacco products” as part of those federal consultations on potential measures to reduce the impact of vaping product advertising on youth and non-users.

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The pressure from provinces and others asking the federal government to regulate vaping products to reduce the impact on youth comes as the U.S. Centres for Disease Control is investigating more than 300 cases of lung illness, including one death, linked to vaping. On Friday, the CDC warned people not to use vaping products bought on the street and not to modify either nicotine- or cannabis-based e-cigarettes.

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In Canada, meanwhile, there have been growing advertising campaigns by vaping companies and retail advertising as the federal government consults on proposed regulations to crack down on advertising that makes vaping more appealing to the young.

Last year, against the advice of health advocates, Ontario passed regulations as part of the province’s cannabis law that would allow companies to directly market vaping products to the public, making way for an explosion of display advertising in convenience stores around the province. Other provinces, including British Columbia and Quebec, have banned such advertising.

Robert Schwartz, executive director of the Ontario Tobacco Research Unit and professor at the University of Toronto’s Dalla Lana School of Public Health, says Ontario is “speaking out of two sides of its mouth” by allowing promotion in convenience stores and at the same time signing a letter demanding that the federal government regulate e-cigarette marketing and promotion to align with the advertising approach taken to tobacco products.

A spokesman for the Ontario Ministry of Health said Ontario is supportive of strengthening tobacco control across Canada and preventing youth uptake of vaping products.

Spokesman David Jensen said the promotion of vaping products allowed in convenience and other stores must comply with federal laws that ban any promotion or advertising that may appeal to young people. Jensen said the province will continue to monitor the evidence and will take appropriate action “as information on vaping continues to grow”.

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The letter on behalf of the provincial and territorial members of the Tobacco Control Liaison Committee notes that there has been an “alarming increase” in youth vaping rates, which “compels action on many fronts before the magnitude of the problem grows. Of note, all jurisdictions are receiving numerous reports from school administrators on widespread use of JUUL type vaping devices in schools, the difficulties in preventing this practice and the generally held belief by students and parents that vaping is relatively harmless.”

The letter, written on Manitoba Health, Seniors and Active Living letterhead on behalf of the provincial and territorial tobacco control liaison committee, recommends limits on advertising and warnings on those ads. It also wants restrictions in retail settings — something the Ontario government allows.

“Restricting the display of vaping products will create a nationally consistent approach in the retail environment, which industry is generally in favour of, and would close gaps where provincial legislation is lacking in this regard.”

Schwartz notes that current federal regulations aredifficult to enforce, given that they refer to advertising or selling vaping products that appeal to youth. “The challenge is, what does that mean? Much of what is on the market now appeals to youth.” He cites colours and flavours of vaping products, as well as locations of stores. JUUL opened a store on Queen Street West in Toronto that Schwartz says looks like an Apple store, with a location and design that appeals to youth.

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Schwartz said research shows a clear link between exposure to advertising and promotion and e-cigarette use. And research done by the Ontario Tobacco Research Unit shows that exposure to advertising is extremely high in Ontario. “Just about everybody is exposed.”

Rates of vaping, especially among youth who have never smoked, are increasing in Ontario and elsewhere, causing concern for school officials and others. In Ottawa, several high schools have taken the doors off washrooms in order to monitor vaping in the school. Data from 2017 showed that 65 per cent of people vaping in Canada were current smokers, 20 per cent were former smokers and 15 per cent had never smoked.

Vaping companies and others argue that vaping represents harm reduction and can help smokers move from cigarettes. That is an important role, say public health advocates.

A spokesperson for JUUL Labs Canada said it shares common goals with Health Canada when it comes to vaping, “. . . preventing youth from initiating on nicotine while continuing to move adult smokers to less harmful nicotine products like vaping. We don’t want anyone who doesn’t smoke, or already use nicotine, to use JUUL products. We do not want youth using the product.”

The company says it has called for a complete ban on social-media advertising for vaping products.

Schwartz agrees that helping smokers switch to e-cigarettes is a good thing, but the prospect of young people who have never smoked becoming addicted to nicotine is a reason for alarm. And that is happening.

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“It is a horrible thing. We have enough evidence to invoke the cautionary principle on this.”

Even before cases of lung illness began showing up among e-cigarette users in the U.S., Schwartz noted there was evidence of harm done from vaping, including that it negatively affects the lining of the respiratory system and that young people who vape cough and wheeze at twice the rate of non-users.

In the meantime, he said, tens of thousands of young people are becoming addicted to nicotine as a result of vaping, despite claims that the companies are aiming their products to help smokers quit. Schwartz says flavours that are attractive to teens and the packaging both draw young users.

Schwartz said both levels of government need to take steps to limit harm to young people from vaping. He also said Ontario’s schools, which are dealing with the fallout from spiking vaping rates among students, should hold myth busting sessions on vaping, including explaining that the product is not just water vapour but aerosol and that there are potential harms.

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