The Globe and Mail published an op-ed about vaping which was an unfortunate mix of truths, half-truths, and lies. ( When will Canada get on the same page about the risks of Vaping? Globe and Mail, Aug 1, 2020.) I wrote this letter in response, but it was not published.

Drs Lemons and Walker are right to be concerned about breathlessness, but their diagnosis and treatment are misguided.

It is not vaping which causes COPD and lung cancer, it is cigarette smoking. Despite 50 yrs of tobacco control, and decades of conventional anti-smoking treatment, 4.6 m Canadians still smoke. In the last 6 months Covid-19 killed 9,000 Canadians, but tobacco killed 22,500.

Research has shown that smokers with lung disease get better when they switch to vaping. If all American smokers switched, this would save about 6 million lives.

Research also shows that quitting by vaping is almost twice as likely to succeed as quitting with conventional nicotine replacement therapy.

Too many teens are vaping. We need to enforce existing bans on the sale of vaping equipment to people under 18 (or 19, or 21, depending on the province). We also need to enforce the ban on advertising to children, and a total ban on advertising vaping on social media would be reasonable.

Teens who experiment with vaping are likely to experiment with smoking, just as teens who try beer are likely to try wine and whisky. However, teen smoking rates are at historic low levels, probably because many teens have found vaping to be a safer and more convenient alternative. A new generation which uses clean nicotine by vaping could be an existential threat to the tobacco industry.

Vape juice with 60mg/ml nicotine is strong medicine. A person who smokes two or more packs of cigarettes a day needs that much nicotine, so it should be available in pharmacies and specialist adult-only vape shops. It should not be sold in supermarkets, gas stations and corner stores.

Nicotine is addictive, but it is the tar in combustible cigarettes which causes cancer, heart and lung disease, and death. The supposed effects of nicotine on the teenage brain are based on data from rodents.

Flavours make vaping more attractive both to teens and to adult smokers. Smokers are increasingly using vape juice with non-tobacco flavours to quit. This gets them away from the smell and taste of tobacco, and makes them less likely to relapse back to smoking.

The world’s 1.1 billion smokers desperately need vaping equipment and medications made to medical standards. This could be a huge business opportunity for Canadian researchers and industry.

Limiting or banning smokers’ access to vaping supplies supports the tobacco industry. It would be a fatal mistake.