Evidence of meeting #89 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cigarettes.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Neil Collishaw  Research Director, Physicians for a Smoke-Free Canada
Rob Cunningham  Senior Policy Analyst, Canadian Cancer Society
Lesley James  Senior Manager, Health Policy, Heart and Stroke Foundation of Canada
Gaston Ostiguy  Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

I think you have to look at the way the questions were asked. “Have you ever tried electronic cigarettes in the last week?”; “Have you ever tried electronic cigarettes over the last month?”

February 12th, 2018 / 1:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

Well, it asked whether they have “ever”.... I'll finish that, but that was the question, “Have you ever tried...?”, and they were twice as likely. That was the finding.

Another question has to do with whether there's relative harm, and as you said, Ms. James, qualitative as opposed to quantitative relative harm. I have another Canadian Medical Association Journal article, and this is from October 2017. It talks about electronic cigarette use and smoking initiation among youth.

Now, I'll be the first to say, it's correlation—we have not proven cause and effect—but this says very clearly, on a very large longitudinal study, that young people who start vaping are significantly more likely to take up the smoking of cigarettes.

Is this not in itself a potentially harmful and dangerous product?

I'd just like a yes or no from the panel.

1:40 p.m.

Research Director, Physicians for a Smoke-Free Canada

Neil Collishaw

Yes, it is.

1:40 p.m.

Senior Policy Analyst, Canadian Cancer Society

1:40 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

Yes, but with some limitations.

1:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

Okay, what are the limitations, very quickly, sir?

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

It has to be a long-term study—

1:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

But we do know that when a person starts as a young person, they are very likely to be addicted. We know that; it has been known for decades. Would you not agree?

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

Well, you don't become addicted after 10 or 15 cigarettes—

1:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

No, but the more likely you are to smoke, the more likely you are to be addicted. I think that would be clear and has been clear for decades.

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

I think, again, it has to be.... I wish you would go to the last report of Public Health England, issued last week. They review all the studies: the American studies that you're talking about, the Canadian studies—

1:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

These are Canadian studies, fairly recent large Canadian studies.

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

Yes. They discuss all this, and it's very difficult to analyze this data because of the way the questions were asked. You have to be very careful about saying that it's—

1:40 p.m.

Liberal

Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB

We can only use the data we have.

1:40 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

Yes, but all the data all over the world.

1:45 p.m.

Liberal

The Chair Liberal Bill Casey

Thank you very much.

Ms. Gladu.

1:45 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Thank you, Chair.

We all know that smoking is not good for you, so it's sad and troubling that the government is legalizing the smoking form of marijuana. I know there are some people who vape cannabis. I don't really see that this is covered, either in the cannabis legislation or in the vaping legislation specifically. Would you recommend that we include it, and if so, where?

1:45 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

Through a combination of Bill C-45 and this bill, it will not be possible to consume cannabis wherever smoking is banned in federal workplaces—banks, broadcasting, the RCMP, or the federal government.

Vaping devices can be used to consume cannabis and other substances, so that's a question if widespread advertising of these devices is to be allowed. It's much more open than in the cannabis act. The government should not intend to undermine the restrictions it has in the cannabis act.

1:45 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

Lesley James

I would agree, and with the legalization of marijuana, the Heart and Stroke supports the low-risk user guidelines. They are detailed in that they are developed by the Canadian Medical Association and the Centre for Addiction and Mental Health around how Canadians can reduce the risk if they choose to use cannabis. Within that, there are details about vaping marijuana.

1:45 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Very good.

I have another myth-busting item. I hear quite often that folks who are either diabetic or in some cases obese and trying to get away from that are starting to vape using the cherry-flavoured kind of thing we're talking about.

Have you heard about this at all? Is it a myth? Is it real?

1:45 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

I would expect it's anecdotal. I've seen no indication that this is widespread, or any level of volume of activity apart from anecdotal.

1:45 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

Polosa in Italy has published a paper about this, and up to now vaping doesn't seem to help people lose weight. This is about the only study I'm aware of.

1:45 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

One of the questions I have has to do with the nicotine concentration that we're going to allow. Do you think that we should be taking our signal from...? The U.S. is trying to reduce the amount of nicotine they're going to allow in products. Should we start with a reduced concentration of nicotine allowed for vaping products?

1:45 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

With respect to vaping products, the government has a consultation paper. They have regulatory authority. There should be some upper limit in nicotine products as to how much nicotine would be allowed. There's a different issue with respect to cigarettes. A proposal to take nicotine out of cigarettes is simply not viable in Canada. People smoke for the nicotine. It would functionally be the same as banning cigarettes, and in Canada we can't ban cigarettes.