Do We Regulate E-Cigs, Ban Them, or What?


The Oxford English Dictionary crowned "vape" its Word of the Year in mid-November.  In doing so, "vape" beat out such words as "bae," "slacktivism," and "budtender," for the championship belt.

"Vape" is an abbreviation for the vapor or vaporization that occurs with smoking an e-cigarette. It is time to cut through the haze, however, because the regulation and use of e-cigarettes in the United States and Canada has raised serious challenges for consumers, politicians, and health officials.  

According to the Drug Policy Alliance's Tony Newman, the recent bylaws in city after city, which have banned e-cigarettes, are an example of how vaping is being demonized. In his view, "E-cig users should be worried and they should be pissed."  

Supporters of the new rules in cities have often noted that these safeguards are aimed at children. Yet critics have suggested that they were not consulted and nicotine is not even a necessary part of the e-cigarette experience. For many, marijuana is the vital ingredient.

The problem is this: policymakers are playing catch-up. In short, the science is lagging behind the expanding "vape" industry, which means that any regulation or ban at this stage will not be evidence-based. Well-intentioned, yes. Based on research, no.

On the one hand, e-cigarettes have not been proven as a legitimate and definitive aid in quitting smoking. Local and state governments as well as single-interest health organizations have tried to make this point repeatedly. (In Canada, provincial Lung Associations have demonstrated influence.) Still, this has not been disproven either. The jury is out.

On the other hand, the flavored liquid that substitutes for nicotine lacks proper regulatory standards and so the safety is problematic. Business owners can either craft the liquid themselves or purchase it from anywhere they wish. This raises some questions of security. It’s something of a "Wild West" market.

Does that mean we ought to regulate this market out of existence? Certainly not. Does this mean we should think critically? Absolutely.

Without appropriate controls over the liquid mixing process or the supply and distribution chain, though, consumer protection is undermined.  Really, it is unimaginable that a local pharmacy down the block could, for example, operate in an unregulated environment.

In a broader sense, the history of drugs is replete with examples of sought-after products that fit the e-cigarette mold.

Heroin was widely available over the counter and through the mail until the turn of the 20th century. Just order from Sears and Roebuck and you would shortly have a fresh supply in your cabinet. Actual cigarettes proliferated until the mid-1950s, when the first basic science began to demonstrate a link between cancer and smoking. And the thalidomide tragedy caused untold suffering because of a lack of safety standards with respect to pharmaceutical regulation.

In other words, addiction and safety studies have often lagged behind developments in the marketplace.  This is not a new phenomenon. Neither is it new that business owners would get in a back-and-forth, push-and-pull struggle with government and the health profession.

As Melinda Misuraca and Michael Hayes write in Alternet, "Vaporizer pens are all the rage these days." No surprise there’s a debate then, especially since high-profile celebrities like Sarah Silverman flash them in the public eye and advertisements can be found in Vogue and Vanity Fair.

As we begin a new year, the struggle in Canada, like the United States, has just started. In September 2014, the federal health minister, Rona Ambrose, called for more research from the government’s standing committee on health. And the investigations are ongoing, with no set timeline for conclusion. 

But the absence of scientific data and concrete findings has not stopped the province of Ontario. It recently introduced restrictive new rules on e-cigarettes and thereby sent a strong message to the rest of the country that the freedom to choose in the marketplace did not trump the government’s obligation to protect its citizens. No matter what the popularity of the vaporizer pen.

Other more conservative governments, as in Alberta and Saskatchewan, have decided to stand pat until the federal government assesses the positive and negative health impacts. Meanwhile, provincial Lung Associations have advocated for a system similar to Ontario’s tough regime as well as ramping up the research activity in-province.

Looking ahead, as various writers have already suggested, we should steer clear of prohibitionist impulses. At the same time, though, it may be prudent to avoid an all-out effort to normalize the e-pen, too.

While 2015 may well be the year when harm reduction reaches a long-awaited tipping point, "vaping" demonstrates the complicated nature of this core part of the drug reform movement. 

Policymakers and politicians at all levels of government have a tricky task ahead of them. In a period when not much is known about the health risks or benefits involved with "vape" culture, they will have to develop strategies that take into account the smoke and mirrors in front of them. 

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