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Quebec misrepresents the lung illness outbreak EVALI to justify its harmful policy proposal


BEAMSVILLE, Ontario, Dec. 15, 2020 — On Wednesday, December 9th, Minister Christian Dubé announced his proposed policy to further regulate vaping. Minister Dubé cited increased youth vaping rates and the American lung illness outbreak EVALI as the rationale for the prohibitive restrictions. The Canadian Vaping Association (CVA) has repeatedly shared the science with the Government of Quebec and health authorities demonstrating the outbreak was not caused by nicotine vaping. The addition of EVALI in Minister Dubé’s announcement makes it apparent that these regulations are not rooted in fact or science and his proposed policy relies on the misinformation and ignorance surrounding vaping.

Vitamin E acetate was discovered to be the cause of EVALI and is a prohibited ingredient under CCCR 2001 in regulated Canadian e-liquid. Vitamin E acetate has never been used by reputable e-liquid manufacturers globally. It was concluded by the Centers for Disease Control and Prevention (CDC) that illicit black-market cannabis products were using vitamin E acetate as a thickening agent.

Dr. Michael Siegel, Professor of Community Health Sciences at Boston University’s School of Public Health was among the first to identify illicit cannabis products as the culprit. They tested lung tissue samples from 29 case patients and all 29 (100%) were found to contain vitamin E acetate oil.

Many researchers have stated that due to there being only a small percentage of patients who reported never having used cannabis products, it is likely that they were reluctant to report having used a substance that is illegal in much of the United States. The CDC has since confirmed that the outbreak was caused by vaping cannabis and not nicotine. Additionally, the CDC tested hundreds of commercially available e-liquids and no trace of vitamin E acetate was found.

“This is significant because although not all of the case patients admitted to using THC vapes, the finding of vitamin E acetate in their lungs essentially proves that they were indeed vaping THC oils,” said Siegel referring to his findings. “This does not mean that they were lying; they may simply not have known what was in the product they were vaping, especially since most of these products are purchased off the black market or obtained from friends or dealers,” he added.

The media was quick to point the finger at nicotine vaping products as the cause but failed to report the link to cannabis products as vigorously. Even after black market cannabis products were discovered to be the cause, the media continued to use the term vaping without clarification. This misinformation and public confusion caused a ripple effect around the world, with 50% of people now wrongfully believing vaping is at least as harmful as smoking.

While North America has been slow to embrace vaping as a harm reduction tool, the UK was progressive in its adoption. However, North American misinformation regarding EVALI forced Public Health England to make a series of statements reassuring the public. In one of these statements, Public Health England said, “The mistaken belief that e-cigarettes are more harmful than smoking increased rapidly among UK smokers following the US lung injury outbreak in autumn 2019. US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping products, was a primary cause of the US outbreak. This substance is banned from UK-regulated nicotine vaping products.”

Additionally, research from the Yale School of Public Health found in their study, “Association of Vaping‐related Lung Injuries with Rates of E‐cigarette and Cannabis Use across US States,” that the outbreak was not caused by regulated nicotine or regulated cannabis vapour products, but instead caused by illicit black-market cannabis products that flooded the market due to flavour bans. The study’s researchers stated that it was prohibition that created the environment for a thriving black-market.

“While nicotine vaping was not the cause of the EVALI outbreak, it should serve as a warning of the dangers of the black-market. Minister Dubé’s proposed policy will not only force thousands of Quebecois back to smoking but will expand the black-market. Illicit sellers are not subject to age verification law or manufacturing standards. Should this policy be implemented, Minister Dubé must acknowledge that he will be responsible for endangering public health,” said Darryl Tempest, Executive Director of the CVA.

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