Good morning to the committee. Thank you for the opportunity to speak today on electronic nicotine delivery systems, ENDS. I'll explain that term in a second.
I'm speaking in my role as the chief public health officer and chief medical officer of health for the Nova Scotia Department of Health and Wellness, as well as the recent past chair of the Council of Chief Medical Officers of Health.
For the committee, CCMOH consists of all the chief MOHs from the 13 provinces and territories, the national chief public health officer, senior officials from Health Canada, the first nations and Inuit health branch, Correctional Services Canada, Customs and Immigration Canada, and the Department of National Defence. As such, it represents senior government public health officials in Canada.
In 2013 the FPT deputy ministers of health asked CCMOH to provide their advice regarding the regulations on e-cigarettes. Today I'm going to speak to the position statement, which I know has been circulated to committee, that was developed by the provincial and territorial chief MOHs in response to that request. That position statement does represent the current consensus of FPT chief MOHs on the issue of electronic nicotine delivery systems.
To give a bit of background, e-cigarettes were developed in their current form in the early 2000s and have gained substantial market penetration globally. They are rapidly evolving as a product line, and alternative nicotine delivery systems are now appearing. That's the reason the language I will use today in our position statement is on the larger construct of ENDS and does not just use the term e-cigarettes.
It's important to acknowledge that some ENDS can also be sold for use with non nicotine-containing e-juice. There is also growing evidence that ENDS are increasingly being used for other substances, often illegal drugs such as marijuana.
The current legal status of e-cigarettes in Canada is such that electronic cigarettes with nicotine or that make health claims are regulated by the federal Food and Drugs Act, which means that they have to be authorized by Health Canada to be imported, advertised, or sold in Canada. To date, Health Canada has not given market authorization to any such products. E-cigarettes that don't have nicotine and don't make any health claims are regulated by the federal Canada Consumer Product Safety Act, which requires companies to ensure that the products they manufacture are safe.
Some points to make are that any assessment of policy options on ENDS must account for the need to acknowledge that we've made great strides in tobacco control in Canada with the greatest success being in the significant reduction in smoking rates for youth aged 15 to 19 years. But as new products such as ENDS emerge, it's important that we don't lose ground, particularly with the huge smoking segment.
Despite the current federal regulations, ENDS and e-juice-containing nicotine containers are readily available for purchase in all provinces and territories, both in stores and on the Internet. We can't ignore that reality. The lack of any regulations regarding product testing and labelling makes it extremely difficult to differentiate between those that contain nicotine and those that do not. There are also significant concerns around quality control and product safety.
We do also have to acknowledge that there has been a significant increase in the use of e-cigarettes, including by youth, since 2010.
The next point is that ENDS do present both risks and benefits at both the individual level and the population level, but there is no definitive scientific evidence in any of these areas at this time. However, waiting for more definitive evidence before taking action runs the very real risk of increasing overall and youth smoking rates, so essentially we can't wait to take some form of action.
To inform the development of the position statement, CCMOH held a virtual symposium in June 2014 to which we also invited members of the FPT Pan-Canadian Public Health Network Council, and the FPT Tobacco Control Liaison Committee. A summary of that symposium is an appendix to the position statement that was distributed to the committee. I won't take time to walk through that today.
The PT chief MOHs, in the summer of 2014, held follow-up discussions to discuss the information we had heard at the virtual symposium and developed our common position statement. That position statement was received by both the FPT deputy ministers and the ministers of health in August and September respectively in 2014.
Just to go through our position statement, this position statement is based on our collective expertise and experience in public health. The information was provided to us by five experts during the virtual symposium, as well as informed by discussions that we had among ourselves and by other discussions on ENDS products that many of us have been involved in.
We feel that given the current state of knowledge on ENDS, this position is an appropriate balance of allowing accessibility to these products as potential aids for cessation or reduction of tobacco use for existing tobacco users, while minimizing their potential to develop nicotine dependence and new tobacco users, as well as decrease the motivation for quitting for existing tobacco users.
I do need to clarify that our definition of ENDS in our policy includes both the devices as well as any accompanying e-juice containers. Our recommendations apply to all ENDS whether they contain nicotine or not.
Our recommendations that we made to provincial and territorial governments were to amend or develop legislation or regulations to first, make it illegal to sell ENDS to minors; second, make the point of sale display, advertising and promotion of ENDS illegal; and third, make it illegal to use ENDS in locations where tobacco smoking is currently prohibited.
Since we developed this position statement, Nova Scotia has passed legislation which brings all three of those recommendations into force as of May 31, 2015. Ontario currently has similar legislation in the legislative process.
For the federal government, our recommendation is, for the longer term, to develop a provincial-territorial engagement strategy to work together along with tobacco control experts to develop a new regulatory framework for ENDS.
We acknowledge that these products don't fit neatly as either a pharmaceutical or as a cessation product and ultimately we need a whole new regulatory approach to these products. However, given the time this process would require and the need for urgent regulatory action, we recommend in the short-term that ENDS should be considered as equivalent to cigarettes and regulated as such under existing federal legislation and regulations. That would mean advertising restrictions that are currently in place for tobacco products would apply to ENDS, that the standard labelling requirements that are required for tobacco products would apply for ENDS, and that the smoke-free requirements for federal workplaces and other federally controlled environments such as airports and airplanes would also apply to ENDS. We're also recommending that youth-oriented e-juice flavours should be banned.
I want to thank you for the opportunity to present today. I welcome any questions.