I spent 40 years working as an anesthesiologist. Too much of that time was spent caring for smokers while they underwent horrible, disfiguring and disabling operations, such as removing part of a lung or an amputation. These operations were only necessary because my patients began to smoke as teenagers, and were unable to quit in middle age when tobacco smoking started to cause irreversible damage to their bodies. In a compassionate society, we should not allow people to suffer so much for mistakes they made in their youth. We know that if we can get people to stop smoking in their 40s, they have a very good chance of avoiding disease, disability and death from tobacco smoking.

15% of Canadians still smoke, and 48,000 of them die every year as a result. January 16^th is the start of Canada’s National No-Smoking week, but this is not listed on Health Canada’s website. It seems as if Health Canada has given up on trying to help people to quit smoking. They committed to a goal of reducing the prevalence of smoking to 5% by 2035 but they have no plan to meet that target. Even if they fully implement all their current policies, they will fall a long way short of that goal.

Surely everyone can agree that the status quo is totally unacceptable? Current tobacco control and smoking cessation programs chip away at the edges of the problem, slowly decreasing smoking rates in rich countries but globally the total number of smokers still increases. When people in developing countries start to earn more money than they need for food and shelter, they start to spend the extra money on “luxuries” such as cigarettes.

What should we do? More of the same seems an unsatisfactory answer. It is time for a new approach, based on science.

Since the 1970’s scientists have known that nicotine gives smokers a buzz and often makes them dependent on smoking, but it is the carbon monoxide and thousands of other chemicals produced by burning tobacco leaves that cause cancer, lung disease, heart attacks and strokes.

What if we could find a way to give smokers the nicotine they crave without the poisons present in tobacco smoke? This is exactly what vaping does. E-cigarettes are tobacco-free electronic devices that give the users exactly as much nicotine as they need, mixed with vapour and optional flavours. They were invented by Hon Lik, a Chinese chemist who needed to quit smoking. They are a disruptive technology that could wipe out smoking the way that Netflix wiped out Blockbuster.

They are not harmless, but Public Health England estimates that they are unlikely to cause more than 5% of the harm of tobacco smoking. Vaping helps more people to quit than traditional treatments with nicotine replacement patches and gum. Vaping helps 50,000 British smokers to quit every year. Scientists have calculated that if all American smokers switched to vaping, this could save 6.6 million lives.

Smokers need accurate information about the risks and benefits of vaping. For example, the highly-publicized outbreak of a severe lung injury in the USA in 2019 was caused by contaminated, illegal, backstreet THC products and had nothing to do with legal nicotine vaping, even though the CDC erroneously labelled it “E-cigarette and vaping associated lung injury”.

Parents should not be worried that teenage vaping will lead to more teenage smoking. Teen smoking rates have declined even more rapidly as some teens have switched to vaping as a safer alternative.

We know more about the long-term safety of vaping than we do about the long-term safety of Covid vaccines. In each case, we know what is in the product and we can accurately predict how the body will respond. Both vaping and vaccines can help us avoid millions of unnecessary deaths.

Hidden in a remote corner of its website, Health Canada states: “Vaping is less harmful than smoking “, “Switching from tobacco cigarettes to vaping will reduce your exposure to many toxic and cancer-causing chemicals” and “Vaping products and e-cigarettes deliver nicotine in a less harmful way than smoking cigarettes. These products may reduce health risks for smokers who can’t or don’t want to quit using nicotine”. However, it does very little to educate smokers about vaping, and it forbids the vaping industry from using these statements in advertisements.

Instead of supporting vaping as a safer choice for adult smokers, governments are making it more expensive (with taxes), less effective (with low nicotine limits) and less enjoyable (with flavour bans).

I am haunted by the story of a couple who had a baby that got sick and died a few days after birth. That death could have been avoided by a test and a simple course of antibiotic tablets before the baby was born. At the time of the pregnancy, this treatment option had already been proven to be safe and effective, but physicians were slow to adopt the protocol. It was not being promoted by medical organizations and pregnant women were unaware that it was an option they should ask about.

This is exactly where we are now with vaping: the science proves that it is a safe and effective alternative to tobacco use, but physicians are not using it as a method to help people quit smoking, health organizations are not recommending it, and many smokers are not aware that vaping is a safer option for them.