Health Canada’s review of its tobacco and vaping legislation focuses only on reducing youth vaping. It shows no awareness of the links between smoking and vaping, between adults and adolescents, and the case for harm reduction at all ages
This blog takes a critical look at Canada’s ongoing review of its tobacco and vaping legislation. Health Canada produced a discussion document to inform the review, posed twenty-two questions and invited comments. Responses from me and David Sweanor are set out below.
Health Canada is trying to ban almost all vaping liquid flavours. This is on top of measures to limit nicotine strengths and marketing. It is the nearest they can get to a prohibition without actually having to prohibit the most promising low-risk rival to cigarettes. The likely effects are obvious: more smoking. But in a bizarre twisting of reality and evidence, Health Canada finds that making vaping less attractive relative to smoking will… um … reduce smoking. And that’s how it justifies the measure. We respond with a counter-analysis.
In June 2019, an influential and well-respected research group published a paper in the BMJ showing both a sharp rise in youth vaping in Canada between 2017 and 2018 – mirroring the rise in the United States. But the truly shocking finding was that there had also been a sharp rise in youth smoking (not seen in the United States).
Starting from well before publication, the paper had a strong negative influence on Canada’s approach to tobacco harm reduction, causing a reversal from a promising and insightful pro-public health approach to making ad hoc responses to a mounting moral panic. Yet it turns out the smoking figures were wrong – a consequence of a flawed weighting procedure.
By July 2020, a correction had been issued in the BMJ noting that with revised weighting, smoking had, in fact, fallen. But, absurdly, the correction was buried in a statistical supplement and the published paper still states, inaccurately, that youth smoking increased in its results and conclusion. The discussion section of the paper continues to discuss an increase in smoking that never happened. Given the political salience of this paper, a proper correction or retraction and resubmission is essential.