Sweeping actions like Nova Scotia’s recent move to ban flavoured vaping products are alarmist and could hurt smoking cessation efforts, a group of U.S. researchers argues.
The province’s ban announced Dec. 5 was sparked by a spike in the number of Nova Scotian teens who vape and their preference for flavoured products.
Amy Fairchild, dean of the Ohio State University College of Public Health, said there are better ways to address teen vaping, such as raising the legal age for vaping and beefing up enforcement of those restrictions.
“Instead of bans, the place to start is with a uniform tobacco 21 policy,” Fairchild said in a recent phone interview. “Youth shouldn’t be able to purchase either vaping products or tobacco products until they’re age 21.”
Fairchild is the lead author of a paper published Thursday in the journal Science, which raises concerns that vaping bans could take away an important smoking-cessation tool. The authors include two other university deans of health.
Besides youth vaping, the spike in e-cigarette use has been linked to lung illnesses and deaths in the United States, the authors said.
“We recognize that that’s alarming and that it demands action but we’re concerned that in the rush to action policy-makers aren’t carefully weighing the considerable and complex evidence base that needs to be informing decision-making,” Fairchild said.
She pointed to studies that conclude vaping is a valuable tool for smokers trying to quit.
One study published in the February New England Journal of Medicine found that e-cigarettes were nearly twice as effective as conventional nicotine replacement products like patches and gum.
"In the rush to action policy-makers aren’t carefully weighing the considerable and complex evidence base that needs to be informing decision-making."
- Amy Fairchild, dean of the Ohio State University College of Public Health
The researchers worked with 886 participants in the United Kingdom in the randomized trial. They found the one-year abstinence rate was 18 per cent in the e-cigarette group, as compared with 9.9 per cent in the nicotine-replacement group.
“There are multiple strong observational and randomized control trials and that have been well-conducted and that are consistently pointing in the same direction,” that vaping is an effective tobacco-cessation tool, Fairchild said.
But a Nova Scotia addictions researcher argues the U.K. study cannot be taken as an argument that vaping is an effective tobacco cessation tool.
In a recent interview, Mohammed Al-Hamdani, who strongly supports bans of flavoured vaping products, zeroed in on the 18 per cent in the e-cigarette group who abstained from tobacco for a year. Of those people, about 80 per cent continued to use nicotine-based vaping products. On the other hand, only nine per cent of the people who used conventional smoke and gum cessation tools continued to use nicotine replacement therapy.
“E-cigarettes perpetuate nicotine addiction and nicotine replacement therapy allows people to go to a step-down fashion where eventually most of them quit nicotine replacement therapy,” said Al-Hamdani, who is executive director of Smoke-Free Nova Scotia.
He said there is evidence that vaping is a gateway activity toward tobacco use. A Smoke-Free Nova Scotia survey found 14.6 per cent of vapers aged 16 to 24 also use tobacco. And a study by U.S. researcher Kaitlyn Berry found youths who start vaping may be at greater risk of subsequently initiating cigarette smoking.
As for the doubts raised by the U.S. researchers about the effectiveness of flavour bans, Al-Hamdani said the Smoke-Free Nova Scotia study found 95.8 per cent of youth aged 16 to 18 who vape said they prefer flavoured vape juice over unflavoured vape juice.
As well, almost 50 per cent of youth surveyed said they would quit if flavours weren't available.
Health Minister Randy Delorey told reporters at the flavour ban announcement Dec. 5 that "we're well aware of the harms created for adults and others who are legally able to purchase vaped products. They'll still have access to purchase products but the flavours will not be part of the products that are available for legal sale in Nova Scotia."
The flavour ban will leave only bland and tobacco vaping juices available in Nova Scotia.
Delorey said more restrictions through legislation on vaping regulations will be introduced this spring but didn't specify what those changes could include.
Smoke-Free Nova Scotia, the Canadian Cancer Society and the Nova Scotia Lung Association all want the legal age to be raised to 21 and there have also been calls to dramatically increase taxes on vaping products.
Fairchild said she and the other Science paper writers aren't out to downplay the health risks of vaping but argue governments should place more emphasis on reducing tobacco smoking rates.
"There is no question that e-cigarettes are not safe (but) there is a pretty strong consensus that they are safer than tobacco product."
RELATED:
