At the same time, an expert says we can’t forget about the ‘old pandemic’ of smoking
Vaping nicotine survived a pandemic — and that’s proof it’s not just a fad, said University of Waterloo public health professor David Hammond.
According to the most recent data from Statistics Canada, released in March 2021, about one in seven young Canadians reported vaping on a regular basis last year — a slight decrease from 2019. By contrast, smoking saw a larger decline from 2019 — the most significant of which was among those aged 20 to 24 — with an overall five per cent drop.
Changes in routine and health concerns contributed to that decline, said Hammond.
On Friday, Health Canada released draft regulations to restrict e-cigarette flavours except for mint, menthol and tobacco. The maximum nicotine concentration will also be lowered to 20 mg/ml, down from 66 mg/ml. The regulations are scheduled to come into force on July 8, and retailers have until July 23 to comply, Health Canada said.
Studies suggest those who vape and smoke are more likely to get diagnosed with COVID-19. In one U.S. survey of more than 4,000 youth, those who vaped were five times more likely to get COVID-19, and those who both vaped and smoked cigarettes were seven times more likely.
Hammond said there’s some evidence that vaping rates in youth are starting to creep back up. At the same time, he cautioned that while officials need to pay attention to vaping, they can’t forget about smoking. According to Health Canada, nearly five million Canadians continue to smoke, and every year about 48,000 Canadians die from tobacco use.
Globally, the World Health Organization says that tobacco kills about eight million people a year, which Hammond pointed out is twice the number of deaths from all of COVID-19 worldwide.
“So while we talk about one pandemic, [smoking] is the old pandemic that hasn’t gone away and has a huge impact on our public health.”
Hammond spoke to White Coat Black Art and The Dose host Dr. Brian Goldman. Here is part of their conversation.
What do we know about what the pandemic has done to rates of smoking and vaping nicotine?
Just like [efforts to] diet or exercise, what we’ve seen is more people trying to quit. We’ve also seen more people struggling to quit and some people actually smoking less. Now, at the end of the day, that means that smoking is actually continuing to go down at about the same rate it was before the pandemic.
There was a lot of media about the excess risk of COVID-19. If you’re a smoker, if you have underlying health problems, there’s no other consumer product or behaviour that contributes more to underlying health problems than smoking.
What we saw was people trying to take action because of the extra risk and concern. But we also know that many adult consumers had a really hard time. If you were working from home, you don’t have the same constraints on your smoking. Some people had more disposable income, which meant that, you know, they had more left over to pay for tobacco. So it really played out differently, again, depending upon people’s situation.
Young people showed a decrease in vaping during the pandemic. Why do you think that is?
You’re not around the same social sources. So kids share cigarettes, they share vapes. It was more difficult to buy vapes in many cases. And so I think it’s a combination of just not having the same sort of incentives, the same cues.
But I will say that the most recent data suggest that we have seen a bit of a rebound effect in 2021. So that’s concerning … and it seems to be quite a sticky behaviour in that it seems to have survived a pandemic.
What does science say about the health effects of vaping more generally?
It depends on who’s using it. So if someone is a long-term, established smoker, we don’t exactly know the relative risk. We know it would be substantially less for vaping compared to smoking in terms of people who never smoked in the first place.
But here’s the problem. Even if you go back to the 1930s and ’40s and ’50s, it took 20 or 30 years for us to identify the link between smoking and lung cancer. Now, that’s about as potent a relative risk as you can imagine. And part of it is the time lag from these chronic diseases, from when people start using the product to when these diseases appear. So it is a bit of a morbid reality that we won’t really know what the risks of vaping are for another 10 or 20 years. We can be confident that they’ll be less than smoking. But really, at this point, there’s no reason for any Canadian to be vaping if they don’t already smoke cigarettes.
How effective is vaping nicotine as a harm reduction strategy to get people to quit smoking?
We have clinical trials out there that do show that it can be an effective method. It’s probably equally or maybe even a touch more effective than some of those gums or the patch. But we also know that there are many smokers who are using the product not to quit. Maybe they use it when they’re at work and they can’t smoke.
So it will be effective for some. But here’s the message that smokers out there need to know. Is it less harmful if you switch to vaping? Yes. Can it help you to quit? Yes. But you must stop smoking because people that vape and smoke at the same time, it actually doesn’t reduce your risk and it might actually increase your risk. So, yes, it can be effective and less harmful, but you must quit to make sure that you achieve that lower risk.
What’s your advice around best practices to anyone who’s looking to quit their nicotine addiction?
The more you try [to quit], the more your likelihood goes up. Use whatever method is most likely to help you. We have telephone quit lines. We have subsidized nicotine replacement therapy, prescription medication. Some smokers try vaping.
Stick with it. It’s one of the most important things that people can do for their health, and we need to do a better job helping consumers. We’re great at warning people away from cigarettes, from convincing kids not to start. We need to support the smokers and consumers out there because we still have four million [plus] of them in Canada and it remains one of the leading causes of death.
CBC Radio – 2021-06-18.
Want More Investigative Content?
