Health Canada and their Quebec counterparts are investigating Imperial Tobacco for possibly violating tobacco advertising laws. The campaign in question is the Facts Not Fear website that Imperial launched to counter misinformation around vaping. Unless you’ve been living under a rock the last year, you have probably encountered some of this misinformation. Whether you recognize it as misinformation or not depends on which side of the fence you sit on.
So what kind of information has Imperial Tobacco potentially violated tobacco advertising rules with? Are they advertising to children? Trying to convince adults that they can safely smoke alongside vaping or that they should consider vaping to relieve stress and unwind at the end of a long day? No, they’re being investigated for daring to say that, “Health Canada’s website affirms that “Vaping is less harmful than smoking.” (It does, in case you’re wondering.) They also quote a report from Public Health England and a review by the National Academies of Sciences, Engineering and Medicine. That is one of the potential infractions: daring to repeat health claims made by our own government, among other public health and scientific bodies, to counter the lie that vaping may be as dangerous as smoking.
Mathieu Morissette of the Quebec Heart and Lung Institute also takes issue with the statement from Imperial Tobacco that, “A product that was introduced as a potentially reduced-harm alternative for adult smokers (with the support of Health Canada) is now on the verge of being regulated to the point where it is no longer viable, forcing people back to combustible cigarettes.” “That’s probably false,” Morissette told the CBC. “For it to no longer be viable, it would have to be not available at all. And to say people would be forced to return to ordinary cigarettes? Not at all. People could decide to stop smoking or to use other products that already exist to stop smoking.”
Sure. They could do that, technically that’s entirely possible, but the fact that there are an estimated five million people who smoke in Canada suggests that the choice isn’t so black and white for many smokers. The 16% of Canadians who currently smoke indicates a resistance to just deciding to stop smoking or using other approved products to quit. Today’s smokers have been targeted with anti-smoking campaigns, have been forced out of buildings and public spaces, have faced both public and private disparagement, have been pleaded with by loved ones and medical professionals, have been marked as villainous by Hollywood, have had all advertising removed and their cigarette packages plastered with scary and revolting pictures, have been called dirty and smelly and disgusting and stupid… It would be fair to say that the smokers who have stuck with the habit are committed. But on the one hand Morissette would like Imperial Tobacco to account for a statement that he feels is “probably false” (in other words, may be, in his opinion) while asserting that people could do something they have thus far shown no inclination to do.
Morissette further takes a very limited view of “viable.” Viable in his estimation means strictly to exist. But the dictionary definition of viable more closely aligns with how Imperial Tobacco is using it. Viable in the Cambridge dictionary is defined as “able to exist, perform as intended, or succeed.” In Merriam-Webster, “a) capable of working, functioning, or developing adequately as in viable alternatives, b) capable of existence and development as an independent unit, The colony is now a viable state, c) (1) having a reasonable chance of succeeding, a viable candidate, (2) financially sustainable, a viable enterprise.” These aren’t outlier definitions, this is what “viable” is understood to mean.
If it seems I am belabouring the point it is because this is the sort of thing that the industry, and people who have quit smoking through vaping, face all the time. Everything that they say or do is subject to the most intense scrutiny while the “other side” is let off with no critical examination at all. The statements at issue on the Facts not Fear website can be easily fact checked. There’s no deep dive required here. Does Health Canada say on their website that “Vaping is less harmful than smoking”? Yes, they do. Should anyone be able to repeat what Health Canada has stated, if the quote is properly attributed? It would seem that they should. Except that we’ve descended down some Orwellian rabbit hole where there is not only question as to what people or companies can say of their own accord but who they can repeat, extending to the declarations of our great masters. It would be farcical if there wasn’t so much at stake.
A conservative estimate puts vaping at twice as effective as traditional nicotine replacement therapies and yet industry is prevented from telling you that, prevented even from saying that vaping is less harmful than smoking cigarettes. Consumers are shouted down by public health officials and legislators with no real understanding of the technology as having “no proof” even when they offer up medical studies and research. Respected doctors and specialists with decades of experience, including in tobacco control and research, are dismissed as no more credible than a man off the street. In the meantime, these same public health officials and legislators can offer up whatever crazy thing pops into their heads without the need to qualify it at all and the mainstream media chooses to amplify these messages without question. It is gaslighting on a massive scale.
The flavours issue is a prime example. Legislators, public health officials, and media personalities have all decried the flavours available in nicotine e-liquids. Flavours must be meant to appeal to children. Adults don’t need flavours (an actual statement made by too many people to attribute a single source). Have you ever heard anything crazier? But it’s been repeated enough times that the public is starting to pick it up. “Hey, what is up with the flavours?” People are having these discussions over lattes and macchiatos at cafés and lunches at restaurants without any tinge of self-awareness. “Excuse me, waiter? Can we get two more raspberry Moscato milkshakes, please? Hold the whip on mine.”
Can you even imagine someone suggesting that you don’t need flavour in your alcoholic or caffeinated beverage (both products presumably intended for adults)? As we roll out marijuana edibles in Canada, the argument has effectively been made that we (adults) need our recreational drugs to be flavoured. But not a nicotine product designed to displace combustible cigarettes? How are we having this conversation with any degree of seriousness? The (obnoxious) argument is sometimes made that if smokers could stand the taste of a cigarette, they should be able to tolerate an unflavoured or tobacco flavoured vape. That ignores what pharmaceutical companies have been aware of for years: that breaking the connection between the taste of tobacco and nicotine delivery is a useful mechanism if cessation is to be achieved, hence Cool Berry Nicorette Quickmist. Or it supposes that smokers should be penalized or subject to some amount of suffering for electing to quit smoking by a method that we don’t approve of, for our own personal reasons. Neither is a particularly good look on a group who wants to claim the moral high ground.
But returning to the issue of messaging in particular. The Canadian government has mandated that the industry cannot, “promote a vaping product, including by means of the packaging, by comparing the health effects arising from the use of the product or from its emissions with those arising from the use of a tobacco product or from its emissions.” So, they cannot say that vaping carries considerably less risk than smoking or that second hand vapour is any less dangerous than second hand smoke. Those are true statements, backed by extensive research, but they cannot be said. Not by the independent vaping industry and not by tobacco companies, who one might expect the government would like to promote less harmful alternatives.
This is important to be communicated to the public at large because the industry is often hit with the criticism that if vaping is indeed intended to displace smoking, to help smokers to quit, why is vaping not marketed that way? Fair question- reasonable question. Because they are not allowed to; it is illegal. The pharmaceutical companies have a lock on that: they’re the ones able to make claims about cessation, hence why their products can be marketed as a “nicotine replacement therapies (NRTs)” and vaping cannot. NRTs are medically approved, hence the differentiation. “Vaping” is classified separately with tobacco (though it contains no tobacco). But they also cannot, “promote a vaping product, including by means of the packaging, if there are reasonable grounds to believe that the promotion could discourage tobacco cessation or encourage the resumed use of tobacco products.” Still with me?
“You can’t say that vaping is harmless,” is another charge often levelled against the vaping industry (who aren’t saying that). Hardly anything is “harmless,” that’s true, but up to now no serious harm has been linked to nicotine vaping (not to be confused with vaping THC cut with vitamin E acetate which- okay- public health authorities and the media did confuse for a period of time and some still purposely do). In fact, Public Health England maintains that vaping nicotine is 95% less harmful than smoking. But varenicline, a medically approved oral NRT, is also not “harmless.” Potential side effects listed on the Champix product page include dizziness, blackouts, seizures, new or worse cardiovascular problems, heart attack, constipation, gas, vomiting, and allergic and skin reactions that can be “life threatening.” From their page: “There have been post marketing reports of serious neuropsychiatric symptoms… including anxiety, psychosis, mood swings, aggression, depressed mood, agitation, hallucinations, hostility, changes in behaviour or thinking, suicidal ideation, suicidal behaviour and suicide, as well as worsening of pre-existing psychiatric disorder.”
In 2015, the Vancouver Sun analyzed Health Canada’s own data on varenicline use in Canada (sold under the Champix brand) and found that in the first seven years of legal sales in Canada “…in addition to the 44 deaths, there were about 350 reports of Champix causing suicide attempts or suicidal ideation, 30 reports of homicidal ideation, and 64 of amnesia. There were also approximately 600 reports of Champix causing depression, 230 of aggression, 180 of anger, and 150 of mental side-effects, including hallucinations and psychotic disorders.” The governments of Alberta, British Columbia, Saskatchewan, Manitoba, Ontario, Quebec and the Northwest Territories all subsidize treatment with varenicline.
In defence of varenicline treatment, governments point to the serious effects of smoking up to and including death. They cite the estimated 45,000 Canadians who will die of a tobacco-related disease every year. And by their estimation the risk of varenicline is worth the potential it has (combined with support therapy) to prevent those deaths. Whether you agree with that or not, that is the government’s assertion. My point is not to bash varenicline (though I personally would not take the risk) or to question the government’s position. It is rather to point out the hypocrisy of demanding that vaping prove itself safer than smoking to a considerably greater extent than it requires of medically approved (and subsidized) NRTs. Even if vaping were 50% less harmful than smoking instead of the 95% claimed, by the same logic that varenicline is supported vaping should be as well.
And this is part of the frustration for both the vaping industry and for end-users: that entirely different standards are applied depending on which cessation aid is being discussed. It is obvious that very generous allowances are being made for pharmaceutical options while at the same time denying the value of a significantly more effective non-pharmaceutical, consumer-supported option. It’s just one in a line of double standards. Take for example the recent Chief Medical Officers’ recommendation to, “Research the effectiveness of vaping products in supporting smokers to end or reduce their use of all nicotine-containing products.” See that small but significant shift? It does not say, “Research the effectiveness of vaping products in supporting smokers to end or reduce their use of combustible cigarettes.” The combustible cigarettes that we know are the cause of 45,000 deaths a year in Canada. The Chief Medical Officers would shift the focus to nicotine though nicotine in and of itself is not connected to those deaths: the delivery system and the byproducts of that delivery system are.
And you can’t tell me that the Chief Medical Officers aren’t aware of the difference any more than you can convince me that the officials at the World Health Organization who wrote, approved, and published the message that second hand vapour is dangerous because it can “contain toxic substances, including glycol which is used to make antifreeze” didn’t know exactly how they were misleading the public. (The WHO has since, quietly and without apology, removed that statement. They did not distribute the amended version to journalists as they did their original post.) These are experts in their fields, professionals. They are intentionally misleading the public and creating fear about a technology that threatens not only to displace smoking but displace highly profitable, if only somewhat effective, pharmaceutical options and the pharmaceutical industry’s hold on the market.
But no matter how far-fetched or outright outlandish the assertions made by authorities and groups against vaping, we’re to accept them at face value. When people stand up in front of congressional hearings or in meetings with high level officials up to and including the President of the United States and talk about how their teenager became unrecognizable to them, a completely different being because they tried a nicotine vape, how hard it was to connect with their own child and bring them back from the brink… When it is suggested that nicotine vaping can shave ten to fifteen points off a teenager’s IQ… When a person testifies to getting pneumonia from being in range of someone vaping… When a so-called expert suggests that “combustion is not as important as we thought”… When the Journal of the American Heart Association, no less, publishes a study that claims to provide “more evidence that e-cigs cause heart attacks” based on heart attacks that patients suffered before they initiated vaping… If one end-user dares to call out, “You’ve got to be shitting me,” it will be used as evidence of an out of control subset of society in need of paternalistic care. It’s classist, it’s manipulative, and it’s quite simply cruel.
And we see less glaring but still obvious examples of this all the time, in the mainstream. For example, the sudden inability of the regular person to distinguish between smoke and vapour. It is played off as innocent or unintentional but it’s simply not possible that we, en masse, have lost all memory of the connection between smoke and fire. Yet time and again, professionals in public health, in media, and just on your neighbourhood block can be heard to be talking about people “smoking” e-cigarettes or discussing the “smoke” from vaping. The person vaping is left to argue until they’re blue in the face that there is no combustion, no fire, so no smoke and no smoking but it’s a fool’s errand. The intentional misuse of language is designed to irritate and stigmatize. Once the irritation is sufficient to trigger a reaction, that person can be dismissed as emotional and irrational and all of their previous (fully rational) arguments sloughed off.
The class discrimination in this battle should be shameful but too few have been brought to heel for it. We know that people who smoke, the world over, tend to be from marginalized and disadvantaged communities. We also know based on extensive research and over a decade of end-user use, that vaping is considerably less harmful than smoking. We know that traditional NRTs are only moderately effective. And yet we would remove or severely limit an option that seems considerably more user-friendly and effective and force people to choose from a list of options that either haven’t worked for them or don’t appeal to them, or risk death from smoking. On the one hand we glibly repeat that “the definition of insanity is doing the same thing over and over again and expecting different results” and on the other we recommend that course of action to the more than one billion smokers worldwide whose lives are at risk from tobacco related illness and chastise them if those treatments fail to work for them.
Even more despicably, we counter research and studies with nonsensical but passionate arguments, promote debunked myths, disseminate demonstrably false information, stir up hysteria about imagined possible future harms- all the while people are dying. In the guise of “helping” of all things. And if this group of people (vapers) dares to get fired up and expresses themselves in the wrong way, in socially unacceptable ways, we point the finger at them and scream “abuse!” as if that isn’t what we’ve been subjecting them to all the while. It’s classic gaslighting. In this particular case, if the anti-vaping campaign is triumphant it will undoubtedly force people back to smoking and keep others from making the switch. It will cost lives. I hope that Imperial Tobacco wins this fight. The average vape shop owner or former smoker is not positioned to win this argument- they simply haven’t the means to outlast the elitist faction that presumes to know better and intends to wipe out vaping in its current form.