'Bad news on all fronts'

At this point, tobacco industry projections still emphasize traditional cigarette sales as the core of their business.

"Cigarette sales around the world have been quite stable and I don't think that those will be going down anytime soon," said Annalise Mathers, of the Ontario Tobacco Research Unit at the University of Toronto.

Industry documents reveal that rather than switching completely to vaping, many smokers are using both e-cigarettes and combustible cigarettes.

It's also becoming clear that many vapers are new to the nicotine habit.

"E-cigarettes and reduced-risk products are kind of seen as a nice complement to maintain that core business, which is nicotine," Mathers said. "Keeping people addicted to nicotine."

At the same time, an entirely new generation of teenage nicotine addiction is taking hold.



Kid-friendly flavours such as mint and mango have been part of the appeal of vaping for teens. ( Scott Olson/Getty Images)

Kid-friendly flavours such as mint and mango have been part of the appeal of vaping for teens. ( Scott Olson/Getty Images)

University of Waterloo professor David Hammond tracks youth vaping trends through a survey of thousands of teenagers in Canada, the U.S. and U.K.



Last year, his research picked up the first signs of a vaping surge in Canada following JUUL's arrival. This year, the numbers have gone up again.

"Vaping has almost doubled again among youth," he said. "What we're seeing is more frequent vaping. We're seeing more and more ... that they feel they're addicted to vaping.

"So, essentially, it's bad news on all fronts in terms of youth."

Add to that the continued lack of evidence that vaping helps smokers quit.

"There are three or four good review studies that show that these things are 85 to 95 per cent ineffective," said Andrew Pipe, the heart specialist in Ottawa. "And that's generally not appreciated."

CBC News asked Health Canada for a chance to interview the minister or a department official about the agency's vaping policy, but no interview was granted.



On Nov. 21, shortly after she was sworn in as Canada's new health minister, Patty Hajdu was asked by reporters what she planned to do about youth vaping.

"I will say, as the mother of two now grown boys, I can imagine the stress this is giving to parents all across Canada," she said.

"So, we have to do more. I'll be speaking with stakeholders. I'll be speaking with my colleagues about what stronger actions we can take to protect young people from the effects of vaping but also the effects of advertising that tries to convince them that this is a healthier choice."

Some public health experts fear that encouraging vaping might set back progress made in recent decades in reducing smoking rates (Gleb Garanich/Reuters) Post image on Pinterest: Some public health experts fear that encouraging vaping might set back progress made in recent decades in reducing smoking rates (Gleb Garanich/Reuters)

Some public health experts fear that encouraging vaping might set back progress made in recent decades in reducing smoking rates (Gleb Garanich/Reuters)

For Charlotta Pisinger, the Danish researcher, all of the commotion about vaping has obscured the fact that smokers already had the tools to help shed their nicotine dependency. Smoking rates have fallen dramatically over the past several decades.



In 1965, about half of the population smoked. Fifty years later, the smoking rate in Canada was down to about 15 per cent.

She is concerned that encouraging smokers to vape assumes that they can never be fully free of nicotine.

"Is risk reduction the aim? Isn't our aim to get smokers to breathe clean air?"

Pipe has some even darker fears.

"My biggest fear is that we are going to go back to a time where we see a significant, if not a majority of the population dependent on nicotine as was the case with cigarettes in the '50s and '60s," he said.

"Are we going to see history repeat itself?"