New guidance in Canada is recommending that vaping be the last resort for Canadians trying to quit smoking.
The recommendations, published Monday in the Canadian Medical Association Journal by the Canadian Task Force on Preventive Health Care, lay out new methods to help people reduce and stop smoking altogether.
Doctors are advised to ask their patients if they smoke and then work with them to determine a plan to quit.
The suggested plans include primary care advice, individual or group counselling with a trained cessation counsellor, nicotine replacements like gum or patches, and prescription drugs.
“Smoking is probably the greatest preventable cause of death and illness in Canada,” said Dr. Eddy Lang, a professor in the University of Calgary’s department of emergency medicine and member of the task force. “So why not make it a target of one of our guidelines and to help people sort out all of the various options that are available to help you quit smoking?”
The task force also strongly recommended against the use of some tools due to “very uncertain” data or little to no effect on cessation, such as acupuncture, hypnotherapy and electrostimulation.
According to Statistics Canada, about 12 per cent of Canadians 25 and older say they currently smoke, compared with four per cent of those 15 to 19.
The most recent Canadian Tobacco and Nicotine Survey showed 31 per cent of smokers 15 years and older have made an attempt to quit within the past year, with about 62 per cent trying to do so without any type of assistance.
But others used various tools in an attempt to quit, including 39.5 per cent trying to smoke less and 28 per cent switching to e-cigarettes as a method to stop smoking.
It’s that use of e-cigarettes that has doctors concerned.
Health agencies like Johns Hopkins Medicine have previously said vaping is less harmful than smoking cigarettes, but it is still advised to avoid them as they’re “still not safe” and contain thousands of chemicals.
The products contain nicotine and heavy metals such as nickel and tin, and their vapour contains similar carcinogens to those in cigarettes.
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Lang told Global News the presence of those chemicals and the lack of long-term safety data is why the task force recommended e-cigarettes be used as a last resort for quitting.
“We don’t know exactly what is going to be the long-term consequences of using nicotine via e-cigarettes for a prolonged period of time,” Lang said. “We also didn’t want to normalize it. We know it’s quite prominent and we think there’s better things that you can try to quit smoking before having to rely on e-cigarettes.”
The task force recommends against e-cigarette use except for smokers who haven’t had success with other options or are not willing to try those options. A strong preference to use e-cigarettes should also be taken into account when recommending smoking cessation tools, the task force says.
Health-care organizations like the Alberta Lung Association say there’s also concern that e-cigarettes are no longer being seen as a cessation tool, pointing to the products being sold with flavours like bubble gum or different types of fruit, something that appeals to youth.
“There’s a reason why flavoured cigarettes are banned and it is the same reason as these flavoured e-cigarettes,” said Jamie Happy, health and motion co-ordinator at the association. “They tend to be very favoured by youth and then that creates an entire population that is now nicotine dependent.”
The Canadian Tobacco and Nicotine Survey, released most recently in 2023, showed that 47.5 per cent of young adults 20 to 24 and 30 per cent of those 15 to 19 say they’ve tried vaping at least once in their lives. The survey also showed that of those 15 and older who used a vape in the 30 days before being asked, 78 per cent reported using an e-liquid containing nicotine.
A recent analysis by the University of York, in partnership with the London School of Hygiene and Tropical Medicine, found there was “consistent evidence” that young people who vaped were three times more likely to become smokers, with added links to the use of other substances like marijuana and alcohol. The study also warned of an increased risk of respiratory health issues.
The researchers analyzed 56 reviews conducted between 2016 and 2024 on the impacts of vaping in teens and adults up to age 24, including reviews conducted in Canada, the U.S. and the U.K.
Happy said vaping is becoming a replacement habit.
“People are replacing one habit with another because it doesn’t address the main issue, which is dependence to nicotine,” she said.
Lang said the difficulty of quitting smoking is recognized, but the hope is the recommendations will give people a range of options to try to stop.
“We know it’s hard to quit, it probably takes more than two or three times, but the health benefits are extraordinary, so that’s worth pursuing,” Lang said.
—with files from Global News’ Skylar Peters
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