Health committee  If it's a yes or no answer, it would be no, if she hasn't done anything else.

Health committee  The consumption of combustible tobacco.

Health committee  Alcohol.

Health committee  If your question was about e-cigarettes that contain nicotine, they tend to be available in the U.S. and Europe as well. Some jurisdictions are beginning to.... The only ones that don't allow it are Australia and Canada. They are the two ones where e-cigarettes are available as long as they don't continue nicotine.

Health committee  In general, tobacco is not put into it. It's actually nicotine that is extracted, so the other compounds and chemicals in tobacco are not there. There's a look at whether there should be a 18 mg limit or not, but again, that rationale behind that is still being debated. The regulatory framework in the FDA is beginning to look at this, but I'm not aware of others that are setting limits per se.

Health committee  Thank you very much for that question, Ms. Fry. When you look at regulations, I think history has taught us that people do use substances, and how can we reduce the harm to them, their families, and the communities in which they live? When we look at the regulation, I agree with you that we need to figure out how to regulate that product so that people are not choosing to buy things on the Internet that could blow up or expose them to chemicals and toxins.

Health committee  Yes, we're aware of those. Actually, the one in The Lancet was done in New Zealand by someone who is a close colleague of mine. Here's the issue: they can't get the same e-cigarette back because they can't tell, even if it's the same name brand, whether they're getting back the same product.

Health committee  Well, I think because of the way the studies are being done right now, most of them are done on recalcitrant smokers or peak smokers who are having difficulty stopping. What is being shown in the naturalistic studies is that in the current framework people are becoming dual users, which means when they can, they smoke cigarettes and when they can't smoke cigarettes they'll use their vapour device.

Health committee  I think you're absolutely right that to quit addictions people often need more than one attempt or they may need continuous support to stay off something. Certainly, we've seen that with, for example, prescription opioid users, heroin users. At least 25% of them, if not more, need long-term treatment rather than the short-term treatment we offer them.

Health committee  In the studies that have been done to date, depending on the generation of the device, you'll see early e-cigarettes did not generate as much because they didn't reach the temperature. The newer ones, the second generation, tend to generate a lot more of the vape and the aerosolizing of compounds.

Health committee  Well, I think you're seeing some variations around whether nicotine content in cigarettes is being regulated. What most people are doing is regulating flavourings or these other things that make cigarettes attractive. So most tobacco-controlled things.... Health Canada, for example, has the manufacturer submit the contents of their product to Health Canada, which cannot share that with anyone because of trademark or privacy rules.

Health committee  That's exactly right. We need to study it from that perspective. I'm sorry, your third question was...? You had a third question as well.

Health committee  Oh, yes. How feasible would it be to replace combustible cigarettes. I think that's an aspirational one. Of course, whenever we talk about changing something...society has been rife with these things. When you want to make a big, bold idea most people want to have the status quo.

Health committee  To do research in Canada is hard. To do experimental research with the actual product is hard. We can do population trends. We can look at people doing that, absolutely. But trying to do the study where we give one group e-cigarettes with nicotine and one group without nicotine is proving to be very difficult.

Health committee  Yes, thank you so much for your questions. They are important ones. We at CAMH really try to be the honest brokers around bringing the science to bear to what our recommendations are and point out where there are gaps. So I want to make sure that we are clear about that as well.