From: Ian Irvine
To: Health Minister Patty Hajdu
Date: March 30, 2021
Re: Smart Youth Drive Enormous Smoking Declines
Last week, Statistics Canada reported that Canadians in their twenties are butting out at an unprecedented rate. Smoking among them fell from 13.3 percent to a mere 8 percent – a 40-percent drop – between 2019 and 2020 according to the Canadian Tobacco and Nicotine Survey.
This is a historic achievement and augurs well for Health Canada’s smoking prevalence target of 5 percent for 2035. Since smoking among those aged 15-19 is currently no more than 5 percent, that cohort has already reached the 2035 target – 14 years before the due date, and the 20-24 group is not far away.
It is unfortunate that these achievements have been largely ignored by a media that has been, for the most part, fixated on the concept of a vaping epidemic among these age groups.
Government policy towards tobacco has served the population well in the past 50 years. Governments were slow to act in the sixties and seventies but eventually enacted tax measures and restrictive policies – no-smoking rules, bans on advertising and sponsorships, age limits and so forth. By 2013 smoking had declined to 11 percent for those aged 15-19, 18 percent for 20-24 year olds, and about 16 percent for those aged 25 and above. These rates declined slightly in the following couple of years. Then a disruptive technology intruded on the scene –vaping.
Young people recognized early on that vaping was much less dangerous than smoking and they reorganized their sin portfolio accordingly. Public Health England had reported that the toxins in e-cigarettes were one twentieth of the toxins in regular cigarettes. By 2015, 6 percent of each of the young cohorts (15-19 and 20-24) were current vapers. Those aged 25 and above were slow to act and today they account for the lion’s share of smoking in the 20s.
Youth have made a wholesale switch from combustion-based nicotine products to smokeless nicotine, primarily vaping. Vaping is not risk free; the aerosol contains toxins and anyone is better off not using it. And even though we know vaping is hugely less toxic, we do not know its long-term health impacts. A lifetime of vaping cannot be good for the cardiovascular system. At the same time, the monumental declines in youth smoking, are linked to this increased use of liquid nicotine.
The challenge for policymaking today is to avoid making the pursuit of perfection the enemy of the good.
In the 90s, the late-teen parents of today’s youth had a daily smoking rate of about 25 percent. Today, daily vaping stands at about one third of that prevalence rate. And since e-cigs are just 5-percent as toxic, this means that the daily-smoking parents of today’s daily-vaping youth were consuming about 60 times the level of toxins.
This does not mean we should be unconcerned about vaping, but it at least suggests that we should not term current youth practices an epidemic.
In addition to monitoring youth access to all nicotine-based products, the next phase of smoking policy should be to target those aged 25 and above. Smokers in this age bracket are largely ignorant of the relative dangers of e-cigarettes and combustible cigarettes. The 2019 Canadian Tabaco and Nicotine Survey indicated that about two thirds of vapers were aware of relative risks, but that among non-vapers only about one person in seven had an accurate picture of relative risks.
Superior public health outcomes will come from transferring strongly habituated smokers to vaping than having them try quitting cold turkey and fail repeatedly. Independent research shows that, while successful quit rates are low no matter what cessation technique a smoker chooses, vaping has a high relative success rate.
The valid concerns about too many young people experimenting with e-cigarettes must not cloud our recognition of the trade-offs in public policy. Those who smoke a pack per day all of their lives die, on average, 10 years earlier than non-smokers. Getting habituated smokers to switch to vapes would add several years to lifespans.
If vaping were really a gateway to tobacco use, as argued by some health officials, smoking rates should increase among 20-year-olds as vapers move from their teens. But the data show exactly the opposite; vaping is a reverse gateway.
The federal government is currently proposing to place very severe restrictions on the vaping market in the form of nicotine content limits and flavour bans. It should be wary of killing the cigarette-extinguishing golden goose.
Ian Irvine is a professor of Economics at Concordia University, and a research fellow at the C.D. Howe Institute.
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The views expressed here are those of the author. The C.D. Howe Institute does not take corporate positions on policy matters.
