Can Electronic Cigarettes Save All Canadians Money?

The debate over tobacco use, tobacco taxation, and the health care costs associated with tobacco use in Canada has always been heated.  Smokers generally take the position that it is a private activity and they should have the freedom to partake.  They also argue that the money they spend on cigarettes, which about 63% to 80% is taxes, pays to offset the costs of future health care for smokers.  Non-smokers are generally adamant that the revenue from tobacco sales is a far cry from covering all the associated health costs.

So lets look at the numbers.  This is from a CBC article last updated in 2007 using statistics from 1993.  Although these numbers have changed over time, this will give us a relative comparison between tobacco tax revenue and associated health care cost:

They estimate that, in Canada, the societal costs attributable to smoking for 1993 were approximately $11 billion, of which $3 billion was spent on direct health care costs such as hospitalization and physician time. The remaining $8 billion was due to lost productivity. In comparison, it is estimated that in 1993/94, revenue from taxes on cigarettes totalled $2.6 billion. – from The Cost of Smoking on CBC.

As you can see, it is fairly straight forward.  The tobacco tax revenue generated was approximately $400,000,000 less than the money spent directly on health care costs.  This doesn’t include the additional $8 billion estimated on lost productivity due to smoking.  So how can electronic cigarettes help?

Let’s just say that every smoker switches to e-cigarettes.  Let’s say, hypothetically that e-cigarettes, like other smokeless tobacco, carry a harm rate of 5% of tobacco smoking, as estimated by the International Agency for Research on Cancer. That equates to a cost of %5 of $3 billion or $150 million.  There is no lost productivity for smoke breaks with e-cigarettes (provided Canada doesn’t get pseudo-scientific and ban indoor use) and only 5% of the lost productivity due to hospital stays.  So on the high end it would be 5% of the lost productivity associated with smoking, or $400 million.

With no extra taxation on electronic cigarettes, the total monetary loss is at $550 million.

The net monetary cost of tobacco cigarettes is around $8.4 billion.  This does not take into consideration the cost of human suffering and death associated with smoking cigarettes.

Based on these rough numbers, electronic cigarette use has the potential to save the Canadian government $7.85 BILLION.  No matter how you do the numbers, e-cigarettes will cost the Canadian government, and hense the people, less money than smoking.

If you just argued that all smokers should just quit altogether, that has been tried and has failed.  Replacing tobacco smoking with vaping is a reasonable and achievable goal with the help of regulatory agencies and public health advocates.


Are Canadian Pharmaceutical Companies Involved?

In the United States the pharmaceutical companies are closely tied to public health organizations.  In fact a lot of the funding for many public health organizations comes from big pharma.  Not to mention that the FDA gets a lot of it’s funding from licensing, fees, and fines from the major players in the legal drug trade.  In the US these public health groups have been strictly against the electronic cigarette.  Consider this: in the last year and a half Pfizer alone gave groups such as the American Lung Association, Campaign for Tobacco-Free Kids, American Legacy Foundation, and the Action on Smoking and Health (among others) a collective 2.8 million dollars. So it is not hard to see why these groups would be against the e-cigarette, which is in direct competition with many of the nicotine based products pharmaceutical companies such as Pfizer sell.  But that doesn’t mean it is in the best interest of public health.

The question is, do pharmaceutical companies in Canada have this same amount of pull over public health organizations in Canada?  To try and answer this question, we did a search on google for health organizations in Canada.  We immediately came across the Canadian Public Health Association or CPHA.  We first looked into their policy regarding electronic cigarettes and reduced harm tobacco products.  Here is what we found:

Although the evidence suggests that the overall health risk of smokeless tobacco is roughly 5% of that of cigarettes, the International Agency for Research on Cancer continues to classify smokeless tobacco products as Group 1 carcinogens; these products cause cancers of the oral cavity and pancreas in humans. Moreover, they deliver nicotine in quantities and at rates that cause psychoactive effects, which eventually lead to tolerance and addiction. Several new products and delivery agents are being produced and marketed as smoking substitutes. These include the electronic cigarette, which is promoted as a non-tobacco alternative nicotinedelivery device. – CPHA Source

We couldn’t find exactly how much money they received from the private sector, but we did come across this statement from the CPHA’s annual report:

In September 2006, CPHA’s Board of Directors approved a “Corporate Relations / Corporate Sponsorship Policy” to guide CPHA’s collaboration with the private sector.

And their list of those companies the collaborated with:

Presenting Partners
* AstraZeneca Canada Inc. ****
* Parmalat
* Maple Leaf Foods

Public Health Champions
* Pfizer Canada Inc. ****
* Amgen Canada Inc. ****

Legacy Benefactor
* Lysol (Reckitt Benckiser (Canada) Inc.)

Public Health Pathfinder
* University of Waterloo

Public Health Supporters
* Dalla Lana School of Public Health,
University of Toronto
* Merck Frosst Canada ****

The companies with **** are pharmaceuticals.

So smokeless tobacco is 5% as dangerous as tobacco cigarettes, but they are still against them.  And what CPHA doesn’t tell you is that there are risks with using pharmaceutical nicotine products.  Drilling down to the heart of this: Is it bias to recommend one group of products (nicotine gum, patches, sprays, and whatever else big pharma brings out) and not another such e-cigarettes?  Wouldn’t it be in the best interest of health to recommend a product that is 95% more healthy than tobacco cigarettes?  Nothing is 100% safe so why is the CPHA against reduced harm tobacco products?  And if your argument is that they still cause cancer (albeit at a rate 95% lower than cigarettes) then why are they against e-cigarettes which have never been shown to cause cancer?  I’ll let you be the judge.

Agree, End The Ban On Nicotine E-Cigarettes In Canada

In a comment article printed in the National Post at the end of last year, Jesse Kline makes the argument for ending the ban in Canada on electronic cigarettes that contain nicotine.  While I fully agree the ban is not in the best interest of the health of Canadians, there are a few issues with some of the facts and speculation made in the article.  I thought it important to set the record straight.

First, some praise.  It was good to see that people are realizing the ban on e-cigarettes in Canada is only for those products that contain nicotine.  For some time many thought it was a general ban, but without nicotine or health claims Health Canada has little say over a product made up of electronics and containing no drugs.  Jesse did fail to mention that health claims such as “quit smoking” or “healthy alternative” do bring Health Canada into the picture, but all-in-all he had it right.

Where he failed to do some research was the sentence: “The devices contain a heating element that turns a liquid made of propylene glycol, vegetable glycerine (two common food additives) and nicotine into a water vapour,”  In truth, the liquid or e-liquid as it is often called, is made up of propylene glycol, glycerin, water, flavorings, and potentially nicotine.  But the big issue I have is “water vapour”.  This is a common misconception.  The vapour from an e-cigarette has been shown to contain the same ingredients as the liquid, although not in the exact same percentages, since the vaporization process does not effect each substance in the same way.  This can be shown with some testing of e-liquid.

Jesse also claims there are no carcinogens in e-cigarette vapor.  This is only partially true.  Without nicotine, yes, there are no carcinogens.  However with nicotine there are trace amounts.  This is not a big deal when you consider BBQ’d meat has trace amounts of carcinogens, but none-the-less it was not completely accurate.

The last and most serious falsity with the article is from this quote:

A number of studies have shown that the illusion of smoking created by the device helps to satisfy cravings, but without nicotine, it cannot help smokers get over the physiological dependence that is created by the drug.

True, studies have shown e-cigarettes help smokers, but I have always found it curious that experts and users alike believe that it is important to keep using nicotine to get over the addiction to nicotine.  Although in rare cases such as heroin addiction, other drugs are used to ween the addicted off the drug, it seems counter intuitive to keep using nicotine to get over an addiction to nicotine. What I would recommend to people is to quit smoking cold turkey and if they like, use and e-cigarette with no nicotine to get the action of smoking, if they still want it.

Overall we applaud Jesse Kline for speaking his mind and bringing more light to the issue of electronic cigarettes in Canada.

Leaked: European Union May Be Planning To Ban E-Cigarettes

According to Michael Siegel from “The Rest of the Story: Tobacco News Analysis and Commentary” blog, the Tobacco Journal International received information indicating that the European Union may have plans to ban the electronic cigarette unless it is marketed by a pharmaceutical company as a nicotine replacement therapy product.  This was the same position that the FDA in the United States took until is was challenged in court.  The US court determined that absent any health claims, the electronic cigarette with nicotine is a tobacco product.  So what is the difference?

Well, as a tobacco product, the e-cigarette can be sold wherever cigarettes are sold.  This makes the most sense to have an impact on current smokers since getting e-cigarettes in front of smokers is key.  Also as a tobacco product, there are less stringent rules and regulations to enter the market.  This is beneficial to everyone because it means increased competition and product innovations.

Now as an NRT (nicotine replacement therapy) the e-cigarette would be treated as nicotine gum or the patch.  This means they would only be allowed to be sold in pharmacies as a quit smoking product.  This limits their market exposure and gives smokers the impression that e-cigarettes are solely meant to help them quit smoking.  But what about those smokers who like smoking, but want to simply “try something else”?  This is the same case when a smoker walks into a gas station to buy cigarettes and sees the smokeless tobacco product Snus.  They may not be thinking about quitting smoking, but rather just trying some other form of tobacco.  This may lead to reduced consumption of tobacco cigarettes; and isn’t that the point?

I hope the European Union bases their decision on facts and science rather than which existing industry has the most pull.  Keep choice alive, especially when that choice is an alternative to a known killer.

Canadians Are Concerned Over Vaping?

In a recent article by CBC, they claim parents are concerned over vaping i.e. the usage of electronic cigarettes by children.  The full article can be found here:

The article doesn’t cite any evidence that children are using electronic cigarettes.  It doesn’t discuss if children who already smoke where potentially the ones using them.  It doesn’t have any credible facts at all.  This type of “journalism” simply spreads fear about a product that is marketed directly to of age smokers across the world.    And in Canada, users can’t even get an e-cigarette with nicotine, which eliminates the danger of a child actually drinking the e-liquid, since without the nicotine there are no poisons in e-liquid which is made up of propylene glycol, glycerin, water, and food flavorings all of which are approved for use in food.

So to dismiss one product, with no known serious health effects (although the product is too young to comment on long term exposure) and yet not mention that the product is designed to replace a product (tobacco cigarettes) that kills about 50% of the users, is irresponsible at best.  Come on CBC, do some digging before you try to scare the Canadian public.

More E-Cigarette Studies and Articles

Study finds e-cigarette vapor contains exponentially less particulate matter (PM) than secondhand cigarette smoke


VPLive Vape Team replays Dr. Konstantinos Farsalinos’ e-cigarette heart study presentation at European Society of Cardiology, and interviews him. (begins at 24 minutes)


Dr. Melissa Walton Shirley – The e-cigarette: should cardiologists add this to our bag of tricks?


Dr. Seth Bilazarian – Smoking electronic cigarettes: A reasonable harm-reduction and smoking-cessation strategy?


PMI series- Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 1: Non-clinical and clinical insights


PMI series – Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 2: Smoke chemistry and in vitro toxicological evaluation using smoking regimens reflecting human puffing behavior


PMI series – Reduced exposure evaluation of an electrically heated cigarette smoking system. Part 3: Eight-day randomized clinical trial in the UK


PMI series – Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 4: Eight-day randomized clinical trial in Korea


PMI Series – Reduced exposure evaluation of an electrically heated cigarette smoking system. Part 5: 8-Day randomized clinical trial in Japan


PMI series – Reduced exposure evaluation of an electrically heated cigarette smoking system. Part 6: 6-day randomized clinical trial of a menthol cigarette in Japan


PMI Series – Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 7: A one-month, randomized, ambulatory, controlled clinical study in Poland


PMI Series – Reduced exposure evaluation of an Electrically Heated Cigarette Smoking System. Part 8: Nicotine Bridging – estimating smoke constituent exposure by their relationships to both nicotine levels in mainstream cigarette smoke and in smokers


Abstract presented at European Respiratory Society (ERS) confirms previous study finding that e-cigarettes modestly reduce airway resistance for ten minutes.

But abstract author Christina Gratziou, Chair of the ERS Tobacco Control Committee, issues press release misrepresenting her own abstract’s findings by claiming: “Experts warn that e-cigarettes can damage the lungs”

February 2012 ERS policy opposes “the use of all tobacco and unapproved nicotine delivery products such as cigarettes, chewable tobacco, and emerging products that include electronic cigarettes (e-cigs), snus, dissolvable tobacco and waterpipes.”

News media repeats and further embellishes unsubstantiated claims in Gratziou’s press release


Mike Siegel: “Experts” from University of Athens Tell the Public They Are Not Sure if Smoking is Any More Hazardous than Vaping, Despite Lack of Demonstration of Clinically Significant Effects on Airways and Improvement in Respiratory Symptoms in Many Vapers


Mike Siegel: Commentary and Responses in Addiction Consider the Potential Role of Electronic Cigarettes in Smoking Cessation and Harm Reduction


Mike Siegel: Electronic Cigarette Opponents Fail to Disclose Relevant Conflicts of Interest to the Public


Mike Siegel: More Conflicts of Interest Being Hid by Electronic Cigarette Opponents: Funding of their Organization by Big Pharma Not Disclosed


CASAA sends letter to Univ. of Kentucky President and KY AG urging investigation of Ellen Hahn


NY legislature sends bill to Cuomo that would ban e-cigarette sales to minors


Riverside County (CA) Supervisors ignore facts and reality, ban e-cigarette use in county owned buildings due to false fear mongering allegations.


Naples (FL) gets vapor lounge for patrons to share electronic cigarette comaraderie


Links courtesy of:

Bill Godshall

Executive Director

Smokefree Pennsylvania

Reasons to Vape

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The actual 510 Cartomizer E cigarette
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E-Cigarette Controversy

European Society of Cardiology: Electronic cigarettes do not damage the heart (5/17/12 interview/presentation by Dr. Konstantinos Farsalinos)
Hayden McRobbie presents on e-cigarettes at the 2012 UK National Smoking Cessation Conference
Gizmodo: The Best E-Cigarette
Brad Rodu: E-Cigarettes Awareness and Use
Mike Siegel: Electronic Cigarette Opponents Now Making Up, Not Just Lying About Evidence
University of Kentucky College of Nursing lies about e-cigarettes on website and signs posted at campus
Mike Siegel: Tobacco Free UK declares that electronic cigarettes cause cancer
Mike Siegel: Author of article attacking e-cigarettes appears to have failed to disclose significant financial conflict of interest
Health Canada’s actions against one E-Cigarette company.

USA Today Article on E-Cigarettes and More

In USA Today article, e-cigarette prohibitionists continue to misrepresent evidence about e-cigarettes, TVECA estimates 5 million e-cigarettes will be sold in the US in 2012.
Promote harm reduction for smokers and let’s prevent 100,000 dead bodies!
Barbados Ministry of Health protects cigarette markets by taxing e-cigarettes same as cigarettes and by banning e-cigarette use in public places, repeats false and misleading claims by Obama appointees at FDA when they tried to ban e-cigarettes.
Government funded activist in NY falsely claims Lorillard sent more than 5 million e-cigarettes to London Olympics

The Latest E-Cigarette News

E-Cigarettes a Wake-Up Call for Big Tobacco
Big Tobacco bets on e-cigarette future
On the E Train
Disposables or rechargables: Which e-cigarette should you stock?
Being Modern: E-cigarettes
Dr. Michael Gough at Kenmore Mercy Hospital (NY) claims “using an e-cigarette is very similar to using a regular cigarette”
E-cigaretttes – ‘My addiction has practically gone’; Malta’s Health Ministry protects cigarette markets by falsely claiming “there is no scientific evidence to substantiate their use as an alternative to conventional tobacco.”