CALGARY—Canadian health officials are grappling with potential risks associated with vaping in the midst of hundreds of reports of illnesses in the U.S. that have been linked to e-cigarettes.

The Alberta government announced a review of provincial tobacco and smoking legislation Wednesday, with vaping as a key focus for new regulation. No confirmed cases of severe vaping-related illness have been reported in Alberta so far, but officials are watching for problems.

As public health officials and governments mull the future of vaping laws, here’s what you need to know about e-cigarettes.

How is vaping different from smoking cigarettes?

Vaping involves inhaling an aerosol produced when liquid inside a battery powered e-cigarette or vape pen is heated. The liquid usually includes nicotine and solvents like propylene glycol and vegetable glycerin, and it can also be flavoured. Vapes can also be used to inhale cannabis products. Smoking a cigarette involves inhaling burning tobacco, which produces tar that poses additional health risks.

But Dr. Dilini Vethanayagam, a respirologist and associate professor at the University of Alberta, says any inhalant can pose a risk to your lungs, and vaping can’t be considered risk-free.

“We’re not supposed to have oil anywhere near our alveoli,” she said, referring to the small air sacs in our lungs.

The risks of cigarette smoking are well established, since they’ve been studied for decades. But there isn’t the same well of data for vaping, especially for people who are regular, long-term users. Health Canada says the potential long-term risks of vaping are still unknown.

David Hammond, a professor at the University of Waterloo’s School of Public Health, has extensively studied tobacco control and e-cigarettes.

“We’ve had trouble holding two facts in our mind ... (vaping) is much less harmful than smoking, but it’s still harmful,” he said.

“People need to remember that this is inhaling chemicals into your lungs, which, if you’re an adult smoker, is going to be less than the 7,000 chemicals from smoking (cigarettes),” Hammond said. However, he noted that teens who have never smoked and start to vape might be at an increased risk.)

What are the health concerns that come along with vaping?

Besides the uncertainties about the consequences of long-term e-cigarette use, U.S. health authorities are currently trying to get to the bottom of a spate of acute cases of lung injuries associated with vaping, including some deaths. Nearly all the cases are linked to vaping marijuana oil.

Health Canada issued an advisory last week for Canadians to watch for symptoms like coughing, chest pain or shortness of breath if they use e-cigarettes. A person in Quebec was diagnosed with the first Canadian case of a severe vaping-related breathing illness in September.

Why are people getting sick?

Some U.S. researchers suspect the cause is vitamin E acetate, which has been used as a thickener in vaping cartridges from the black market. Inhaling the oily droplets can trigger pneumonia.

Canadian and U.S. health authorities have warned consumers not to buy vaping products off the street, but no single cause has been singled out so far.

Jason Alksne, the owner of Vaporstorm Calgary, said there’s a big difference between e-liquid that comes from a retail store like his and products from illicit markets.

“You’ve got this whole thing with illicit, illegal, black-market drugs that people are screwing onto their vapes,” he said. “It’s misuse of something that was specifically designed to help people quit (cigarettes).”

Can vaping help people stop smoking?

Alksne was a smoker for 13 years, and had tried to quit multiple times before he tried e-cigarettes. It worked, and he says he’s been vaping regularly for about a decade.

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He maintains that it’s an important tool to help people stop smoking cigarettes.

Vethanayagam, however, said she’s alarmed when she sees patients who don’t know that there are health risks that come with vaping.

“It’s a whole different ball game, what you’re seeing now. They’re not using it to get off cigarettes. They’re using it as another recreational drug,” she said.

“We need patient education. That takes time and resources, which we have very little of in the clinics right now.”

Alksne says it’s important that any future regulation focuses on evidence and science.

Are there other public-health concerns around vaping?

Hammond said there needs to be a better balance between promoting vaping as a smoking cessation tool and making sure young people are informed about the risks.

“Our smoking, nicotine market has been going down for decades except in the last couple years and that’s entirely attributable to vaping,” he said.

Teens have been trying e-cigarettes for years, but Hammond said there’s cause for concern when recent data indicates teen vaping rates in Canada have increased substantially.

“Kids experimenting with things is not new. What’s worrisome is when kids start to use those on a daily or near-daily basis,” Hammond said.

“We now have a product that is a highly effective nicotine delivery device. We are seeing vaping dependence.”

Vaping devices like Juul, which entered the Canadian market last year, are now widely available in convenience stores. They have a high nicotine content, and experts say they’re increasingly popular among teens.

Vethanayagam said she’s alarmed to see the products advertised so openly, and Hammond said there needs to be a more thoughtful approach to regulating the way they’re sold.

“I would suggest that selling them in corner stores right next to the slushie machine in candy flavours with ads and really nice, modern tech-y devices — anybody who turns around and says, ‘I can’t believe kids are interested in doing that’ when these provide an addictive drug, I don’t understand that,” Hammond said.

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