CAMH is a highly respected mental health institution in Toronto. It runs a smoking cessation program at its Nicotine Dependence Clinic. Health Canada’s Substance Use and Addictions Program funded CAMH to develop resources to help guide people who use nicotine, on how to lower their risk:

CAMH published a set of “Lower-Risk Nicotine Use Guidelines” which are available online at https://www.nicotinedependenceclinic.com/en/Pages/Lower-Risk-Nicotine-Use-Guidelin%E2%80%8Bes.aspx

These guidelines are important because they recognize that some people will use nicotine. Rather than condemn them for their use or addiction, these guidelines accept them and provide practical, actionable guidelines on how to use nicotine (including e-cigarettes or vapes) as safely as possible. The guidelines encourage smokers to switch to e-cigarettes:

“Make the switch to nicotine products that do not burn.
Further reduce your risk by switching to products that don’t have tobacco like NRT or e-cigarettes.“

“Switching completely to e-cigarettes will significantly reduce the harms associated with combusted tobacco.“

The guidelines include sensible advice on vaping such as:

“E-cigarettes are less harmful than combustible tobacco but are not completely harmless.
In addition to nicotine, most e-cigarette products contain and emit substances with unknown harms when inhaled.
If you use these products, you should consider the following :
Do not purchase unsafe illicit/black market e-liquids, pods or devices.
Don’t adulterate your products (THC, vitamin E, other oils, etc.) or modify the device.
Keep the products away from children.
It is unclear what risks are associated with using e-cigarettes and combustible tobacco concurrently.
Receive instruction on the use of the device given the variability in device types, etc“

… and they recognize the role of e-cigs in smoking cessation:

“People should try and quit using approved smoking cessation treatments first, but if they are unable or
unwilling to quit, e-cigarettes with nicotine may be an effective cessation aid for people who use combustible tobacco.

E-cigarettes as a cessation aid may be most effective when combined with behavioural counselling.
Smokers should be advised to switch completely from combustible tobacco to e-cigarettes and to use e-cigarettes when they would normally have smoked.

Continued use of e-cigarettes may reduce risk of relapse to combustible tobacco. “

None of these simple statements of fact will come as a surprise to anyone who has been following the science on nicotine and vaping, but I am so happy to hear them voiced by CAMH, an organization at the heart of the official tobacco control establishment in Canada, in a study funded by Health Canada.

Even the simple statement that e-cigs do not have tobacco in them is such a welcome relief when the USA deems vape to be a “tobacco product”.

Giving vapers simple, practical, actionable advice on how to vape as safely as possible is such a welcome contrast to the absolute prohibitionist stance of organizations like the CDC and WHO.

The guidelines give considerable medicolegal and political cover to healthcare workers contemplating recommending vaping to a smoker. “I acted within the CAMH guidelines on nicotine use” would be a very strong defence for anyone who was criticized or sued for recommending vaping.

I am hopeful that these guidelines will lead to a shift in the attitude of Canadian physicians and health care workers to vaping. They should help legitimize vaping as both a method of quitting tobacco and a safer source of nicotine for smokers who want to quit smoking but still need nicotine in their lives.