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Vaping: Towards a Regulatory Framework for E-Cigarettes VAPING: TOWARDS A REGULATORY FRAMEWORK FOR E-CIGARETTES Report of the Standing Committee on Health Ben Lobb Chair MARCH 2015 41st PARLIAMENT, SECOND SESSION Published under the authority of the Speaker of the House of Commons SPEAKER’S PERMISSION Reproduction of the proceedings of the House of Commons and its Committees, in whole or in part and in any medium, is hereby permitted provided that the reproduction is accurate and is not presented as official. This permission does not extend to reproduction, distribution or use for commercial purpose of financial gain. Reproduction or use outside this permission or without authorization may be treated as copyright infringement in accordance with the Copyright Act. Authorization may be obtained on written application to the Office of the Speaker of the House of Commons. Reproduction in accordance with this permission does not constitute publication under the authority of the House of Commons. The absolute privilege that applies to the proceedings of the House of Commons does not extend to these permitted reproductions. Where a reproduction includes briefs to a Standing Committee of the House of Commons, authorization for reproduction may be required from the authors in accordance with the Copyright Act. Nothing in this permission abrogates or derogates from the privileges, powers, immunities and rights of the House of Commons and its Committees. For greater certainty, this permission does not affect the prohibition against impeaching or questioning the proceedings of the House of Commons in courts or otherwise. The House of Commons retains the right and privilege to find users in contempt of Parliament if a reproduction or use is not in accordance with this permission. Also available on the Parliament of Canada Web Site at the following address: http://www.parl.gc.ca VAPING: TOWARDS A REGULATORY FRAMEWORK FOR E-CIGARETTES Report of the Standing Committee on Health Ben Lobb Chair MARCH 2015 41st PARLIAMENT, SECOND SESSION STANDING COMMITTEE ON HEALTH CHAIR Ben Lobb VICE-CHAIRS Murray Rankin Hon. Hedy Fry MEMBERS Matthew Kellway Christine Moore Wladyslaw Lizon David Wilks James Lunney Terence Young Cathy McLeod OTHER MEMBERS OF PARLIAMENT WHO PARTICIPATED Eve Adams Claude Gravelle Libby Davies Dany Morin CLERK OF THE COMMITTEE Andrew Bartholomew Chaplin LIBRARY OF PARLIAMENT Parliamentary Information and Research Service Havi Echenberg Marlisa Tiedemann iii THE STANDING COMMITTEE ON HEALTH has the honour to present its NINTH REPORT Pursuant to its mandate under Standing Order 108(2), the Committee has studied E-cigarettes and has agreed to report the following: v TABLE OF CONTENTS VAPING: TOWARD A REGULATORY FRAMEWORK FOR E-CIGARETTES ............... 1 INTRODUCTION ....................................................................................................... 1 BACKGROUND ......................................................................................................... 2 THE STATUS QUO ................................................................................................... 3 A. The status quo in Canada ................................................................................ 3 B. The status quo in other countries ..................................................................... 4 HEALTH RISKS AND POSSIBLE BENEFITS ASSOCIATED WITH ELECTRONIC CIGARETTES .................................................................................... 5 A. Health risks ...................................................................................................... 5 1. Health risks to users of electronic cigarettes ............................................... 5 2. Health risks to bystanders in proximity to individuals using electronic cigarettes .................................................................................................... 6 B. Potential health benefits ................................................................................... 6 1. Harm reduction ............................................................................................ 7 2. Smoking cessation ...................................................................................... 7 GATEWAY EFFECT .................................................................................................. 8 RENORMALIZATION ................................................................................................ 9 THE ROLE OF THE TOBACCO INDUSTRY ........................................................... 10 ACCESS TO ELECTRONIC CIGARETTES ............................................................ 11 RESEARCH ............................................................................................................. 12 REGULATING ELECTRONIC CIGARETTES .......................................................... 13 A. Possible frameworks for regulating electronic cigarettes ............................... 14 1. Regulate as tobacco products ................................................................... 14 2. Regulate as therapeutic products .............................................................. 14 3. Regulate as consumer products ................................................................ 15 4. Regulate within a new legislative framework ............................................. 15 B. Additional factors recommended for regulation .............................................. 17 1. Regulating devices .................................................................................... 17 a. Electronic cigarettes that do not contain nicotine ................................. 17 b. Restricting what electronic cigarettes can look like .............................. 18 c. Level of nicotine ................................................................................... 18 vii d. Information, reporting, disclosure and safety standards ....................... 19 e. Packaging and labelling of electronic cigarettes and their components ......................................................................................... 20 f. Health claims ........................................................................................ 21 2. Regulating how and where devices are promoted and used ..................... 21 a. Sale to minors ...................................................................................... 21 b. Use in public spaces ............................................................................ 22 c. Advertising ........................................................................................... 23 d. Cross-branding .................................................................................... 24 e. Flavours ............................................................................................... 25 LIST OF RECOMMENDATIONS .................................................................................. 27 APPENDIX A: RESEARCH IDENTIFIED IN TESTIMONY AND BRIEFS ..................... 31 APPENDIX B: LIST OF WITNESSES ........................................................................... 41 APPENDIX C: LIST OF BRIEFS ................................................................................... 45 REQUEST FOR GOVERNMENT RESPONSE ............................................................. 47 viii VAPING: TOWARD A REGULATORY FRAMEWORK FOR E-CIGARETTES INTRODUCTION On 29 September 2014, a letter from the Minister of Health to the Chair of the House of Commons Standing Committee on Health (the Committee) stated: “Due to a lack of evidence on the benefits or harms of e-cigarettes, it would be helpful for the Standing Committee on Health to study their potential risks and benefits, seek advice from a variety of health stakeholders, and provide a report.”1 On 7 October 2014, the Committee adopted the following motion: That, immediately following the Committee’s consideration of the draft report on marijuana’s health risk and harms, the Committee undertake a study of no fewer than five (5) meetings on e-cigarettes beginning with a briefing from government officials and that this study focus on the following areas: a) The potential risk, benefits and challenges associated with these products domestically, including the renormalization of smoking, and use as smoking cessation aids; b) The pros and cons of ways in which different jurisdictions both domestically and internationally have chosen to regulate these products; and c) Options for realizing any benefits and addressing any significant health and safety risks. While recognizing that business referred to the Committee by the House such as Government legislation or Estimates will take precedence in scheduling over this study. And that the Committee report its findings to the House. The Committee held eight meetings with 33 witnesses, including federal government officials, health officials from other levels of government, manufacturers of electronic cigarettes and related devices, users of the devices, stakeholder organizations, and medical experts. This report serves as a summary of evidence received from these witnesses and other interested stakeholders and the Committee’s recommendations based on that evidence. 1 Letter from the Minister of Health to the Chair of the Standing Committee on Health, 29 September 2014. 1 BACKGROUND The Committee heard from several witnesses that electronic devices intended to replace combustible cigarettes are not new, having first been introduced in 2007. However, as also described by witnesses, the technology surrounding
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