Studies examining e-cigarette vapour typically end after six months, which has limited clinicians’ understanding of long-term health effects.Nam Y. Huh
Vapes or e-cigarettes should be a last line of defence for people looking to quit smoking, according to new Canadian guidelines.
The Canadian Task Force on Preventive Health Care released recommendations Monday for methods to help people stop smoking cigarettes. It advises doctors to ask patients whether they smoke and to develop personalized cessation plans that include counselling, prescription drugs and nicotine-replacement therapies.
The task force said that unanswered questions about the health risks of vapes, and their effectiveness as a tool to stop smoking, prompted it to make a conditional recommendation against vaping, meaning that it should be used only as a last measure.
E-cigarette vapour contains some of the same carcinogens as cigarettes, but studies typically end after six months, which has limited clinicians’ understanding of its long-term health effects.
The task force recommended other nicotine replacements, such as patches or gum, which are designed to satisfy smokers’ cravings and lead to abstinence. The panel also recommended group therapy and the use of medications that block nicotine cravings.
Studies show vapes end up sustaining users’ nicotine addiction in the long term. Eddy Lang, a member of the task force and an emergency-room physician in Calgary, said vapes should be used only as a last resort.
“It should not be your first-line, go-to approach because there are things around that work so much better,” Dr. Lang said. “Why waste your time on e-cigarettes when there are other things around that work better?”
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The popularity of vaping, particularly among young people, has become a growing concern. In a Statistics Canada survey in 2022, 30 per cent of 15- to 19-year-olds said they’d tried vaping, compared with just 10 per cent who’d tried smoking cigarettes. Vape use was highest among youth and young adults, another Canadian study found in 2021.
Fruity flavours and sleek packaging turned what was initially marketed as a less harmful alternative to cigarettes into a nicotine craze. No e-cigarette has been approved for smoking cessation in Canada since they arrived on the market in the early 2000s.
Vaping products are designed to deliver the maximum amount of nicotine to users, according to the guidelines. Four years ago, Canada capped the concentration of nicotine permitted in vaping products to curb young people becoming addicted to them.
Nicotine itself has harmful health effects and is extremely addictive, said Christopher Labos, a cardiologist who was not involved in creating the guidelines. Despite decades of decline in the popularity of smoking, it remains the leading cause of preventable death in Canada, increasing the risk of heart attack, stroke and lung cancer, among other diseases.
Dr. Labos, an associate with the Office for Science and Society at McGill University, lauded the latest guidelines for encouraging doctors to ask their patients about their smoking habits.
“For those of us who are still seeing patients, you can’t raise every single issue, but honestly, if there was one thing that you were going to bring up as an ancillary topic to the main visit, smoking cessation is probably one of the most effective things,” Dr. Labos said.
“It really does seem to nudge people, and it’s probably the best simple thing you can do for their health.”