Health committee  Right now, the composition of the e-liquid and the levels of toxic substances, or contaminants, in an e-cigarette are significantly lower than what is found in a regular cigarette. From a public health standpoint, there is something people often forget. The issue of dose-response factors into every type of illness, unless the cause is immunological.

Health committee  You are reinforcing just how important proper regulations are. I, however, disagree with the figures put forward by the Canadian Cancer Society. From a methodology perspective, respondents were asked whether they had ever tried e-cigarettes. Everyone here today probably has children.

Health committee  There are two basic, principal issues. If you look at even the third edition of the American guidelines on how to treat smoking addiction, there are two basic principles: pharmacotherapy and counselling Very often, if people really want to stop smoking and have made many attempts in the past and have had lots of difficulty stopping, you should use these two approaches.

Health committee  It should be regulated in terms that the concentration of nicotine is well marked on the bottle. You've heard stories that people were selling e-liquid pretending that it contained 15 milligrams or 18 milligrams of nicotine, while as a matter of fact it was almost down to zero.

Health committee  If you do provide nicotine in childproof bottles, you cannot even get your nicotine solution with a syringe because it's like a dropper. Children will have extreme difficulty to get intoxicated with nicotine. Christopher Columbus brought nicotine to Europe in 1492, so it is a product that has been on the market a long time.

Health committee  It doesn't cause cancer, never caused cancer, I never saw any cancer related to the use of nicotine by itself, and it doesn't cause any pulmonary problems. The cardiologists tell us that the use of nicotine could slightly increase the heart rate and slightly increase the blood pressure.

Health committee  If we look at the experience of tobacco cigarettes, we should at least apply the same rules for e-cigarette in terms of selling e-cigarettes to people under the age of 18. But you know as well as I do that it hasn't always been that successful and that easy to apply. But again, if you select a certain number of reliable shops and then you make sure that these people don't sell any products to minors....

Health committee  If you talk to almost any clinician like the ones who have been writing these books, if you think of the experiences of Dr. West and Dr. John Britton in England, they have much more experience with e-cigarettes than we do. I could tell you some success stories. I have a patient with emphysema and he could hardly walk a block without stopping.

Health committee  Yes, or harm reduction, both.

Health committee  Yes. Again, we need to have some retrospective long-term studies to show that using the electronic cigarette does not lead to a relapse to tobacco. We don't have any evidence for this, and if we look at the European literature, the European experience, it hasn't been so.

Health committee  No. I think Poland is probably the only country that has reported such a thing. But if you look at the French experience, the Scandinavian experience, the British experience, which is extremely well documented, this hasn't been their experience.

Health committee  Again, when you see a smoker, of course you evaluate him and you ask him how many cigarettes he smokes. To give you a proper idea of the number of cigarettes he smokes, we measure his alveolar CO. If somebody comes out of the clinic with CO of 12 ppm or 18 ppm he will not be given the same concentration as somebody who comes in with 45 ppm CO in his alveolar air.

Health committee  Well, of course, in our experience we use it to help people to stop smoking and for harm reduction. But again, tobacco cigarettes have been on the market for years and no new government has ever been able to ban the sale of these cigarettes. I think that nobody thinks it's going to be possible.

Health committee  There have been some studies, and this is also our experience, that for some people the ritual of smoking, the blowing out of some vapour, is very important for them. Yesterday I had a patient who had a cerebral haemorrhage. She had neurosurgical surgery. She walks with a cane.

Health committee  There is an important point I would like to make about that. Not medicalizing e-cigarettes is critical. It's hard enough for a patient to get an appointment with their doctor. So I think it would be a mistake to force people to go to their doctors to get a prescription for an e-cigarette.