Hello. I appreciate being here, committee members.
Today, I have the pleasure of discussing the issue of electronic cigarettes in Canada.
I would note that committee members have received a copy of our statement on e-cigarettes.
First, here is some information about the Heart and Stroke Foundation. Our mission is to prevent disease, save lives, and promote recovery. We're a volunteer-based health charity with 140,000 volunteers across the country and almost two million donors. We work very hard to impact the health of every Canadian family every day in every community from coast to coast to coast. Tobacco use is a key risk factor for heart disease and stroke, increasing the incidence of all forms of heart disease and stroke as well as other chronic diseases.
While we have made great progress in tobacco control over the years, reducing the smoking rate from 50% to 16% today, there is still a lot of work left to be done. Over the years the foundation has worked closely with its partners, such as the Canadian Cancer Society, and governments of all levels across the country, and we don't want e-cigarettes to reverse the progress we have made together on tobacco control. That's a really big concern for us.
Obviously I'm here today to speak about electronic cigarettes. As indicated by my colleague, these are a relatively new product category, and sales of them have been growing significantly over the last few years. They're also top of mind in the media and in the public health community.
I'll speak very briefly to some of the implications from a health-risk point of view, and also on some potential benefits.
The issue with e-cigarettes is that in terms of safety, we don't know what the contents are for some of these products. They vary from brand to brand. This is a real problem, because we don't have any standardized means of ensuring quality control in these products. They're available with and without nicotine, and both are a concern, especially from a renormalization point of view. The e-cigarettes containing nicotine, of course, are illegal in Canada; however, they are still prevalent.
While early studies and some anecdotal reports do indicate that e-cigarettes with nicotine have some potential as a smoking cessation tool, there still isn't enough evidence today for us to conclusively indicate that in fact they are a viable and effective tool. However, it is pointing in the right direction, so there is some potential promise.
Safety concerns, of course, are an issue because these products are unregulated. As my colleague indicated, it's the long-term health impact that we're really not sure about when it comes to e-cigarettes. The World Health Organization recently indicated that these substances are not merely water vapour, but they contain a lot of different chemicals, some with toxic or poisonous properties.
That said, and as also indicated by my colleague, they are likely a much safer alternative to traditional tobacco cigarettes, because we do know that with traditional tobacco cigarettes, the harm is overwhelmingly dangerous. There's significant evidence to indicate that, as we know.
It's also critical to determine whether e-cigarettes end up acting only as an add-on to cigarette smoking, resulting in dual use instead of complete cigarette smoking cessation. Also, researchers and public health experts are quite concerned that e-cigarettes could be a gateway to new tobacco addiction among those who have never smoked cigarettes before.
In particular, e-cigarette use is particularly appealing to youth. A study undertaken by the Canadian Cancer Society found that 18% of high school students in one jurisdiction in Canada—these are students who had never smoked before—had tried e-cigarettes, and another 31% were interested in using them. So it's a real concern.
Another issue, of course, is the marketing and promotion of e-cigarettes. Youth are targeted with the addition of attractive candy or fruit flavours. There are over 8,000 flavours being used worldwide right now in over 400 brands—or almost 500 brands.
In Canada it's illegal to make a health claim regarding an e-cigarette product's ability to aid in smoking cessation or to suggest that it's a safer alternative to traditional tobacco cigarettes. However, lifestyle marketing is common—and you've seen that in the ads that Mr. Cunningham has circulated to you. Also, companies often use celebrities and product placement to attract users.
Public health experts are concerned that if e-cigarettes are permitted to be used in public places and freely marketed, they could renormalize cigarette smoking behaviour and undermine our tobacco control and smoking cessation efforts.
In light of the need to maintain tobacco control efforts, and given the many unknowns around e-cigarette use, there has been growing demand for regulation in Canada and internationally. At all levels of government across the world there has been implementation of policies and regulations to address this issue. These include amendments to smoking acts, and complete bans, as have taken place in Brazil, Panama, Australia, and Israel. In theory, this could provide significant protection, but it could hinder potential cessation efforts if, in fact, these products are shown to be effective. For that reason, we don't recommend a complete ban.
Public-space bans are also very common in many cities across Canada and North America. These are a really strong means of protecting the public from second-hand vapours, and for preventing renormalization of tobacco smoking. As well, there are purchasing-age restrictions in many jurisdictions. These can protect youth from nicotine addiction and help prevent smoking initiation, but as also indicated by my colleague, these alone will not be sufficient.
These are some of the examples of how e-cigarettes are being addressed throughout the world and in Canada. As a result of this, the Heart and Stroke Foundation recommends—and this is found in the document that we circulated to the members—that the following actions be undertaken by the federal government to address all e-cigarettes.
The use of e-cigarettes in public spaces should be prohibited in workplaces where smoking is banned by law. For example in federal buildings, as indicated through the federal Non-smokers' Health Act.
E-cigarette sales should be prohibited to minors.
The advertising and promotion of e-cigarettes should be be strictly regulated. In particular, one of the things that we're concerned about is the co-branding of e-cigarettes with tobacco industry logos or brands. We don't want e-cigarettes being labelled as Rothmans, du Maurier, or Export A. That would only help to renormalize tobacco smoking.
The product should also be regulated. For example, flavour should be restricted. This is really important to prevent renormalization. As well, they should be visually distinct from regular cigarettes. E-cigarettes shouldn't have a filter, a glowing tip, etc. Having such would only help renormalization.
As well it's critical that Health Canada actively enforce the ban on e-cigarettes with nicotine. We know that Health Canada has sent out letters to retailers across the country to cease and desist, but we think in addition to this after a second infraction penalties should be applied to retailers that do not comply.
Finally it's very important to dedicate research funding to investigate this issue further. We need to determine what specifically are the long-term health risks and are these products potentially useful as a good quit aid?
In summary, Mr. Chair, the Heart and Stroke Foundation supports action on e-cigarettes. Taking into account the threat of renormalization and the creation of a new gateway to addiction and health risks, as well as the need for more information regarding the potential smoking cessation benefits of e-cigarettes, it's critical that the federal government move quickly to regulate all e-cigarettes and to commission further research.
Thank you.