An open letter to the Quebec Minister of Health (and to the EU, WHO and other groups considering a vape flavour ban)

To: Minister Christian DUBÉ

Minister of Health, The National Assembly of Quebec

ministre@msss.gouv.qc.ca,

May 1^st 2023

Dear Minister Dube

Alcohol is harmful to young people. Alcohol consumption may lead to aggressive behaviour, automobile accidents, alcohol overdose and sudden death. Chronic use may lead to addiction, liver failure and death. Consumption during pregnancy is harmful to the foetus. Alcohol is carcinogenic.

Alcohol comes in many flavours. In addition to the traditional beer and wine flavours, there are a wide variety of fruit-flavoured cocktails and fruit-based alcoholic sodas that are attractive to young people. Almost all young people who drink alcohol consume flavoured drinks.

However, we do not ban flavoured alcohol products to “protect our youth” from the dangers of alcohol. Instead, we set and enforce an age limit for alcohol sale and consumption. People who sell alcohol undergo rigorous training. If they sell to people who are under age they can be fined and lose their license to sell alcohol.

While alcohol consumption has almost no health benefits, for people who smoke, vaping is a very much safer alternative to smoking cigarettes. Vaping products contain the nicotine that they crave, but are tobacco-free and do not produce tar or carbon monoxide. As the Health Canada web site says, “switching completely to vaping nicotine is less harmful than continuing to smoke” (https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/quit-smoking.html). Flavours make vaping more attractive to adult smokers, helping them to switch and to greatly reducing their risks of cancer, heart disease and breathing problems.

Vaping is less harmful to youth than drinking alcohol, because vaping does not lead to aggressive behaviour or dangerous driving.  People who vape to excess feel sick and stop before they reach dangerous nicotine levels.

Health Canada considered imposing a federal ban on flavoured vape, but after a critical appraisal of the issue, after obtaining expert advice, and after studying the effects of such a ban on smoking rates in the Atlantic Provinces, they decided not to proceed. (https://smoke-free.ca/health-canadas-vaping-flavour-ban-is-still-missing-in-action/) Quebec should follow their example.

Adults should have the right to drink flavoured alcohol and to inhale flavoured vape. Youth should be protected by enforcing appropriate age limits on sale and access to both alcohol and vaping products.

Dr. John Oyston MB BS, BMedSci, FRCA, FRCP(C)

Appendix:

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UPDATE 3 May 2023

I received a response from the public relations department that stated, in part:

Vaping can create a “gateway effect” to traditional smoking, the harmful effects of which are known and documented. It is therefore necessary to act to prevent a new generation from being exposed to a product that is harmful to health.

L’équipe du Ministère
Ministère de la Santé et des Services sociaux, relations-citoyens@msss.gouv.qc.ca

This argument is NOT supported by real-world evidence.

I replied:

You support a vape flavour ban by saying: “Vaping can create a “gateway effect” to traditional smoking.”

If there were a gateway effect, then high rates of teen vaping would increase teen cigarette use, when in fact, teen smoking is at historically low levels.

Note Health Canada’s view:

“Most academics who participated in the consultations focussed some attention on the “gateway effect” associated with vaping products. Most do not agree that youth who use vaping products are more likely to transition to smoking cigarettes. By way of example, some point to the increase in vaping since 2017, which, if vaping were a gateway, should have produced an associated increase in the rate of smoking among youth and young adults at the population level. Instead, they note that youth smoking rates are at an all-time low in Canada and the US. Some have concluded that the “gateway effect” has not been validated by evidence and that vaping products are reducing smoking at accelerated rates beyond predicted trends.” 

Report of the First Legislative Review of the Tobacco and Vaping Products Act 
https://www.canada.ca/en/health-canada/programs/consultation-legislative-review-tobacco-vaping-products-act/final-report.html