Should the Canadian Federal Government impose a minimum six-month ban on all flavored vaping products, with the exception of tobacco and menthol flavors, in order to give Health Canada and experts time to determine if the flavorings are a health risk to users? Such a drastic measure could result in even more serious, unintended consequences. Habitual vape users could potentially turn to unsafe alternatives to current flavors designed for e-cigarettes. Former smokers, who have developed a taste for flavored e-cigarettes, could be lured back to smoking traditional cigarettes, where flavoring options such as ITSA flavor cards or flavor drops are legal, and sold as smoking accessories. The tobacco and e-cigarette industries would quickly fill this sudden void in the market with new, and possibly more injurious products, while managing to circumvent the ban legally. Finally, a ban on flavorings will likely create an entirely new underground market for people determined to continue using flavorings in their e-cigarettes.
What Exactly are Vapes?
Vapes are hand-held, battery-operated, electronic cigarettes. Vapes do not burn tobacco like traditional cigarettes. They vaporize a minute amount of liquid mixture known as e-juice, through a small heating chamber located in the middle of the device. Hence the nicknames vapes and vaping. E-cigarettes are also known as e-cigs, mods, box mods, and juuls. The largest manufacturers of e-cigarette brands are MarkTen (owned by Altria, a tobacco company), Vuse, and Juul [NCBI, 2016]. “Modern e-cigarettes were patented in 2003 by Chinese inventor, Hon Lik” [LiveScience, 2013]. Their original purpose, according to the inventor, was to help smokers quit the habit, by delivering nicotine in the form of a vaper, instead of inhaling smoke from chemical-laden tobacco. “A 2013 study in the journal Tobacco Control found that the harmful chemicals in e-cigarettes occurred at levels 9 to 450 times lower than in regular cigarette smoke” [Livescience, 2013]. Traditional tobacco cigarettes not only contain nicotine, but thousands of other damaging chemicals such as tar, carbon monoxide, methanol, acetone, and ammonia [Irish Cancer Society, 2019]. However, e-cigarettes only contain a few ingredients, primarily water, nicotine, flavorings (which are optional), and propylene glycol, which when heated, creates a smoke-like vapor, mimicking the sensation of inhaling real cigarette smoke [U.S Food and Drug Administration, 2019].
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Vaping satisfies a smoker’s nicotine cravings, without the use of added chemicals, making it, in theory, safer for a smoker. In the world of e-cigarettes, the flavoring options are practically endless. An article written by Meghan Neal in 2014 for the online news site Vice, lists the variety of flavorings that vape industries manufacture. According to Neal and her research team, over 7,700 flavors have been created since 2014, and that number continues to grow. It is believed that “flavors make e-juice pods more customizable”, meaning that e-cigarettes and the vaping experience originally designed to help smokers quit the habit, are appealing to a new generation of users. Her research team “discovered fruity flavors were most common, (offered by 84 percent of brands) followed by 'dessert/candy' (80 percent), alcohol/drinks (77 percent), and then snacks/meals (25 percent)” [Neal, 2014].
The benefit to having flavorings for e-cigarettes, is to help smokers slowly wean off the taste of tobacco in a traditional cigarette. According to a 2009 WebMD article by Ben Hendrick smoking dulls taste buds making food less palatable. “The taste buds on smokers’ tongues were found to be flatter than the buds on the tongues of the nonsmokers, the researchers say, there was no difference in the numbers of taste buds between the two groups” [WebMD, 2009]. However, with vaping, which uses no tobacco, smokers regain healthier taste buds over time, making the taste of tobacco unappealing. This can help traditional smokers to wean off tobacco yet still satisfy their need for nicotine as well as their need to physically complete the action of holding a cigarette flavorings can assist in making vapes taste more appealing and drive smokers further away from smoking tobacco and going back to cigarettes. The physical shape of the device itself also helps smokers to transition more easily from traditional cigarettes. The hand to mouth action required to draw in the vaporized liquid in most e-cigarettes and vapes mimics the hand to mouth action of a smoker puffing on a traditional cigarette. Inhaling and exhaling the vapor, which also contains nicotine is more emotionally gratifying than using a patch or chewing a piece of nicotine gum to break the habit.
As beneficial as vapes seem to be for smokers, there is considerable controversy about this product due to a recent spate of injuries and deaths in the United States. A Cnet news article posted on October 17th, 2019 says there are now 33 vaping-related deaths in the U.S, and over 1,000 injuries. Cnet also claims that flavorings such as birthday cake and bubble gum and Juul’s colorful advertising is attracting a younger audience, and is believed to be responsible for increased vape use among highschool students. One particular case that has drawn the attention of the public, is an investigation into Juul on September 25, 2019 in San Joaquin County, California when a minor was hospitalized and lapsed into a coma after smoking a juul. The District Attorney of San Joaquin County, Tori Verber Salazar said the minor had “the lungs of a 70 year old man” [Cnet, 2019].
Why Support A Temporary Ban?
Vaping and juuling have become a global concern in recent years. A number of countries such as the U.K, India, and numerous states in the U.S, have already banned either flavored vaping, nicotine vapes, or the act and sales of vaping altogether. Canada’s young adults and teenagers are also attracted to vaping and are encouraged by their peers and advertising to pick up the habit, causing a spike in the popularity of vaping and juuling. In a survey conducted in 2017 and 2018 by David Hammond (a health professor at the University of Waterloo), teenagers aged 16-19 were asked if they vaped. In 2017 about 8.4 percent of teenagers confessed to vaping, in 2018, that number increased to 14.6 percent. Teenagers in 2018 who also admitted to smoking in the last month was 74 percent. [CBC, 2019]. Canada wants to keep pace with other countries which have already taken the bold step of banning vaping products. CBC also reports that most of today’s vaping in Canada is done by smokers trying to quit, but that the attraction of vaping is drawing a younger audience. One of the attractions of e-cigarettes is that they are not banned in public spaces where cigarettes are. 'They're so small and discreet and these new devices don't create the huge clouds that the previous devices did — people can use them anywhere, all the time.' Proponents undoubtedly hope that a ban on flavorings, even a temporary ban, will help deter use by underage vapers.
Why Oppose A Temporary Ban?
Detractors of a ban believe that research can be easily carried out without the removal of products from the market. There are over 15,000 different vape products manufactured worldwide. The devices have evolved and the use of nicotine salts to deliver higher concentrations of the substance being vaped to the brain make it truly difficult to single out any one component and determine the exact cause of vaping-related deaths and injuries that are so worrisome to Canada and other countries. A six-month ban on flavorings alone so that Health Canada can conduct targeted research on flavorings ignores the possibility that other products are the real culprit.
Regular vape users will simply find other legal flavoring alternatives which could prove even more detrimental to their health. Former smokers may well find that having the option of either tobacco or menthol flavored vapes is very reminiscent of traditional cigarettes and may prefer to go back to smoking tobacco.
Tobacco and vape manufacturers will take action to secure their sales and find legal ways to circumvent the ban. Even more troubling, illicit manufacturers and vendors will rush to fill demand with products of questionable quality.
So, to Ban or not to Ban? There is no Question
A temporary nation- wide ban on e-cigarette flavorings for research purposes is unnecessary. Humans have been smoking tobacco cigarettes for over 2,000 years and yet when health-related research on traditional cigarettes began in the mid 20th century, the products were never banned. What makes vaping so different?
Vape flavorings have become a scapegoat in the reported vaping-related injuries and deaths. However, there is more to the story. According to USAToday, many younger people are mixing their vape juice with THC (tetrahydrocannabinol) oil extracted from marijuana, or other contaminated products found through underground markets. “THC stimulates cells in the brain to release dopamine, creating euphoria, according to NIDA (National Institute on Drug Abuse). It also interferes with how information is processed in the hippocampus, which is part of the brain responsible for forming new memories” [LiveScience, 2017]. “Some of the recent serious cases of lung problems involved vaping of marijuana oil that had likely been contaminated. Along with the health risks of this contamination, there is additional potential that teens will ingest an extremely high level of THC, which is harmful to their developing brains, which could lead to cognition loss and even psychosis” [ibid]. If the ban is actually meant to deter young adults from vaping, it will have the opposite effect. All of this evidence points to the fact that the of vaping isn’t the true problem. It is the fact that young adults are lacing their vapes with harmful chemicals that seem to be causing the issue.
Having a temporary sales ban on flavored products won’t necessarily stop vaping companies from creating flavoring. Instead, most companies will create a new product that will apply to the rules of the ban, and still be sold for vape or cigarette use. For example, back in October of 2017, Canada put out a nation-wide ban on the sale and use of menthol flavored tobacco. Not so long after this ban, tobacco companies came out with a new product known as ITSA flavor cards. ITSA flavor cards are advertised as a small thin package that comes in twelve different flavors that allows you to flavor dry foods. The ITSA flavor card ad website gives very broad instructions on how to use their product. “Step one: Drop your flavor card into ______. Step two: Give the card some time to infuse your product with flavor - the longer, the stronger. Step 3 Enjoy your new higher flavored product” [ITSA advertisement]. These broad instructions leave vapers plenty of liberty to use the flavor cards for their vapes and cigarettes, making it look like it was their idea and not the company’s. Another component that makes ITSA flavor cards an obvious hidden vape product is that fact that when you go to purchase them, you can’t find them in any grocery store (which is where you would expect to find flavor cards meant to flavor dry foods) but actually in smoke and vape shops for a very low price. BC Smoke Shop for instance sells ITSA flavor cards for $1.75, Toronto Hemp Company sells them for $2.95, and just 10 minutes away from the University of Ottawa is another smoke shop called Head HQ, that sells ITSA flavor cards for $3.49. One might think that the Canadian government or even the FDA would see the true goal behind the ITSA flavor cards, but according to an article written by the Ontario Convenience Stores Association (OCSA), “It is the Ministry of Health and Long-Term Cares (MOHLTC) view that the ITSA flavour card does not violate the prohibition on promotion in section 3.1(3) of the Smoke-Free Ontario Act (SFOA) as it is not marketed by its packaging or labeling as a flavour card for tobacco” [OCSA, 2017]. Regardless of a temporary sales ban or not, companies will continue to create products like ITSA flavorings and go without consequences.
Although companies will continue to make different flavoring products if a ban were to occur, vapers are still going to make a desperate attempt to purchase flavorings, even if that means going to the black market. If flavorings were to be temporarily banned, a whole new underground market could be opened up for flavorings with marijuana, or laced with even more dangerous products. With legalization of cannabis in Canada since 2018, the “black market has gone down in selling marijuana by 21%” [BNN, 2019]. Although marijuana continues to be sold illicitly here and there, there is still a void in the market that needs to be filled. Most underground markets are already selling THC oil cartridges for vapes, but being able to sell flavoring could just increase their business. An article from the Star Journal, a news site for Illinois, states that THC oil products that are being sold in the black market is the true cause of vape-related deaths. Vape shop owner Scott Walk says that “Vaping has been around for over 15 years and there was no single respiratory illness, but now, because of the insane popularity of illegal, illicit, black-market THC products, this is happening now.” Both Walk and his co-manager Zach Magon say that “THC cartridges are an illegal product”, vape shops are not allowed to sell them, meaning that young adults are purchasing this oil from black market, and potentially are suffering the consequences with health problems.
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