Electronic cigarettes are being treated like regular cigarettes.

Winnipeg Health RegionWave, November / December 2014

The emergence of electronic cigarettes is raising concern among health officials who say the battery-powered devices may pose health risks.



Commonly known as "vapes," electronic cigarettes are being promoted as a safer alternative to tobacco.

But e-cigarettes are not as innocuous as they seem. In fact, they can be potentially harmful, local health experts say.

Developed and manufactured in China, vapes started to appear on the scene about four years ago.

The device functions much like a cigarette. When a user "puffs" on a vape, it triggers a mechanism that releases a variety of chemicals from a cartridge that are absorbed into the lungs, just like cigarette smoke.

In Canada, it is illegal to buy vapes containing nicotine or to market the devices as a smoking cessation tool.

But e-cigarette cartridges containing nicotine can be imported. Some contain as much or more nicotine than tobacco cigarettes.

Dr. Marcia Anderson DeCoteau, a medical officer of health with the Winnipeg Health Region, says the main problem is that vapes are unregulated.

"Vapes are not regulated so you can't be sure what's in it in terms of the amount of nicotine or other potentially toxic materials," she says. Studies have shown that some vapes contain chemicals known to cause cancer.

Some promoters of vapes have talked up the devices as a potential aid to help people quit smoking. But Anderson DeCoteau says there is not sufficient evidence at this time to suggest that e-cigarettes can help anyone quit their addiction to tobacco.

Moreover, she notes, there are nicotine replacement therapies that are regulated and do have good evidence when used in combination with support from a health-care provider.

Despite the potential health issues, vapes are growing in popularity.

A Canadian survey found that among adult smokers, those who said they had used a vape jumped from four per cent in 2010/11 to 27 per cent in 2013/14. Among smokers, dual use of vapes and cigarettes jumped from 15 per cent in 2012 to 27 per cent in 2013. When it comes to youth who smoke, a study found that those who had ever used e-cigarettes went from 35 in 2012 to 43 per cent in 2013.

Unlike regular tobacco products, e-cigarettes are sold out in the open in stores, often on the counter by the cash register, says Anderson DeCoteau.

A major worry for health officials is that these devices appear to be aimed at attracting young people.

"E-cigarettes come in flavours like bubblegum, watermelon and cola, and they look neat," says Anderson DeCoteau.

And while these flavoured vapes are not supposed to contain nicotine, young people may be tempted to acquire cartridges with nicotine online.

The key issue, says Anderson DeCoteau, is that vapes may undo the de-normalization of smoking, thereby undermining all the progress that has been made in reducing smoking rates.

Concern over the toxic hazards of vapes and the optics of re-normalizing smoking has prompted the Winnipeg Health Region to ban e-cigarettes in the same way it has prohibited the use of other tobacco products in its health-care facilities. The Region has had a smoke-free policy since 2003, in order to protect the health of patients, staff and others.

"We have seen people using e-cigarettes inside our buildings, inside our hospitals," says Anderson DeCoteau. "It became a concern, given the uncertainty about what the e-cigarettes contain. Our smoke-free policy protects everyone indoors and outdoors from second-hand smoke, so we came to the decision to ban these as well."

Banning e-cigarette use indoors and on smoke-free grounds is becoming more widespread in Canada. They have been banned by the Winnipeg School Division and a number of cities, including Vancouver, Red Deer and York. The City of Winnipeg and the Province of Manitoba have not yet banned the products.

While all tobacco products are banned in Region facilities, health-care staff can offer nicotine patches and gum to smokers who are staying in Region hospitals. "We want people to know that we can make them comfortable by treating their nicotine withdrawal symptoms so they can recover smoke-free while in hospital," says Anderson DeCoteau. "We also provide support if they want to quit smoking altogether."

Susie Strachan is a communications advisor with the Winnipeg Health Region.

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Winnpeg Health Region's smoke-free policy