Toronto’s medical officer of health is calling on all three levels of government to take action against vaping products, as mounting evidence shows more young people are picking up the vaping habit that has been linked to lung diseases.

Dr. Eileen de Villa’s report on the health effects of vaping products — technically known as aerosolized liquid products — will be tabled at the city’s board of health next week. It recommends, among other things, that the city regulate vaping products the same way as cigarettes. Under existing bylaws, people are prohibited from smoking at such places as public sports fields, playgrounds, bars and restaurants, and near entrances to buildings used by the public.

The report comes at a time when governments and health organizations across the country are dealing with a growing body of evidence that vaping is associated with various pulmonary illnesses. Canadian officials have confirmed at least three such cases in Quebec and one in Ontario, while over 2,000 cases have been identified in the United States, including 47 deaths, according to the report.

“I think that should give rise to some concerns certainly,” said de Villa, noting that beyond the acute lung injuries, vaping can also contribute to other health impacts like the worsening of asthma, coughing, wheezing, and other symptoms of respiratory diseases.

She said studies have shown there was a more than 70 per cent increase in the number of Canadian youth using vaping products from 2017 to 2018, a trend that could threaten efforts to curb tobacco smoking.

“We know, based on the available evidence, that use of e-cigarettes and similar products is strongly associated with subsequent tobacco use amongst youth and young adults,” she said. “We worked very hard in public health sector to address tobacco use, yet it still is a major cause of preventable illness and death.”

The report, which will ultimately head to city council for approval, recommends the federal government prohibit advertising and sales of vaping products in stores and places where minors have access. It asks the federal government to set a limit on nicotine concentration in these products, and also asks the province to prohibit sales of such products in places where young people have access.

“The idea is to try to amend existing provincial and federal legislation so that it better matches up with the restrictions and regulations that apply currently to tobacco products,” said de Villa.

The Ontario government announced earlier in the fall that advertising on vaping products in retail stores and gas stations will become illegal starting next year. According to this regulation, vaping products can only be promoted at vape and cannabis stores where customers are at least 19 years old. The sales of these products at convenience stores would still be allowed.

Mayor John Tory was asked last week in a media scrum outside city hall whether the city should consider banning vaping products, and said the marketing approach of these products needs to be addressed — just as it is done with “other things deemed risky to health” like tobacco.

He said the rules that apply to smoking should be applied when it comes to vaping as well.

Coun. Joe Cressy (Ward 10 Spadina—Fort York), who is also the chair for the city’s board of health, said every level of government needs to be involved and do more in preventing the potential harm that can result from the proliferation of vaping products.

He called for the federal government to implement strict regulations to ban advertising of flavoured vaping products that are targeted at children, to ensure plain packaging and to regulate nicotine content. For the province, the Smoke-Free Ontario Act should be amended to include banning of these flavoured vaping products targeting youth, he said.

“For the city, we are going to proactively implement restrictions on where vaping products can be used,” he said. Those restrictions would prevent people from vaping in outdoor public spaces such as near playgrounds and sports fields, and establishing a nine-metre smoke-free zone at entrances to many indoor places.

This past November the cities of Brampton and Mississauga voted to treat vaping in public spaces like smoking tobacco. Canadian provinces have created a range of regulations against the advertising of vaping products in places where young people are spending time, and many prohibit vaping in or near public places like libraries, school grounds, malls and parks.

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Cressy said establishing effective regulations against vaping products and their consumption is possible, as such restrictions have helped decrease tobacco use among young people over the past 20 years.

“I think it’s fair to say that when e-cigarettes and vaping products emerged, the research was slim on what their effects would be. The more we learn, the worse it gets,” he said, noting these products were originally seen as a novelty but now it’s clear they can cause serious health damage if not properly regulated.

“The longer we wait to act, the more harm will be created.”