What’s Going On With Vaping-Related Illnesses In Canada?

A teenager in London, ON, is now off life support after being the first Canadian reported to have a vaping-related illness. (Over 500 people in the U.S. have been affected and nine have died.) But with nearly 300,000 Canadians using e-cigarettes daily and teens the fastest growing population of vapers, it’s likely inevitable there will be more. So, what’s going on? We went to the experts to find out.

E-cigarettes or vapes, are battery-powered devices that contain a liquid, which is often flavoured and usually contains nicotine. "The device heats the liquid up very quickly when you inhale on it and creates this vapour, which you then breathe in and breathe out,” says Dr. Matthew Stanbrook, staff respirologist at Toronto Western Hospital.

Nicotine is, as we know, addictive, not to mention damaging to the heart, lungs, and more. The liquid solution in e-cigarettes also typically contains propylene glycol, vegetable glycol and other chemicals, and there’s no regulation or safety precautions around their manufacturing.

Yup. The Canadian Government legalized vaping for anyone 18 and older in May 2018. This opened the doors for international brands like the “iPhone of e-cigarettes” Juul to begin selling its nicotine-containing products in Canada.

So far, doctors aren’t really sure. There isn’t any one product or ingredient that experts have been able to pinpoint as the cause. "We haven’t seen an outbreak of cases like this ever before," says Stanbrook. Most people will develop symptoms — shortness of breath, cough, chest pain, nausea, vomiting, abdominal pain and diarrhea — within a few days of using an e-cigarette, but in some cases these issues can come weeks or months into vaping.

Sure, there's no tobacco, and there are lower concentrations of carcinogenic toxins in e-cigarettes than cigarettes (which is why so many people used them to stop smoking; even though federal law prohibits them from being marketed that way), but the toxins are still there. In fact, there may be higher concentrations of nicotine in e-cigarettes than in cigarettes, according to Christina Sperling, senior director of programs and services with the Ontario Lung Association For example, one Juul pod delivers the same amount of nicotine as a pack of 20 cigarettes.

We also tend to vape more than we might smoke. "When you go out for a cigarette, you have your one cigarette, you go inside, but with vaping there’s no end to it, you can keep continuously doing it," adds Sperling. "Physiologically people just aren’t even thinking about how much they’re probably taking in."

Earlier this year, Health Canada announced proposed measures to restrict advertising and marketing of vaping products, but those have yet to be made law. Most recently, a group of Canadian health organizations, including the Canadian Medical Association, the Canadian Lung Association and Heart & Stroke Foundation of Canada, have appealed for immediate political action to stop the promotion of vaping products. As part of this, says Sperling, they’re advocating for warnings on e-cigarettes like we see on cigarette packaging, and bans on flavours. "They banned menthol cigarettes because they thought that was more attractive, so the same thing should be done in terms of the flavours for vaping."

Ontario's Deputy Premier and Minister of Health, Christine Elliott, has issued what's called a “Minister's Order” requiring hospitals to report vaping-related illnesses to public health. It’s similar to mandatory reporting we have with measles and tuberculosis. Creating this database is crucial for health officials to finally understand the scope of vaping-related illness and what's causing it, says Stanbrook. "We have to remember, we know from a century’s worth of research on tobacco that it takes many, many years before you start to see disease," he says. "We’ve only had vaping for about 10 years, so it’s not surprising that only now do we start to see concrete links with disease in people from vaping."