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There are still many unknowns about vaping

vapour on black background

Vaping has been in the news a lot lately. Still relatively new in Canada (only in May 2018 did it became legal to get vaping products that contain nicotine), there’s a lot to learn about these products, which are gaining popularity, particularly among youth.

As a gynecologist, Dr. Nancy Durand says she’s started to ask her patients their vaping status, like she’s done for a long time about smoking cigarettes.

“It’s an important risk factor. Research suggests that vaping may increase your risk of high blood pressure and cardiovascular disease and stroke,” she said. “Vaping while on the birth control pill may be like smoking on the pill – it may increase the risk of blood clots in the legs and lungs that can cause stroke and death.”

Dr. Durand says there are still a lot of unknowns about vaping, even for health professionals like herself who stay up-to-date with research.

“For the first time in 30 years, nicotine use has dramatically increased through the use of vaping products. Many physicians are unaware of this,” Dr. Durand says. “The frequency has exponentially increased in young people, and I think few are really aware of the amount of nicotine they are ingesting and how addictive it is.”

Below, Sunnybrook Smoking Cessation leads Lisa Di Prospero and Karelin Martina, along with help from Health Canada, answer some common questions about vaping. 

What’s a vape?

Vaping is the act of inhaling or exhaling an aerosol produced by a vaping product, such as an e-cigarette, according to Health Canada.

Vaping products (including e-cigarettes or vapes) come in many shapes and sizes — from long cigarette-like units, to ones shaped like USB sticks to small boxes with a mouthpiece.

How do these products work?

The device heats the liquid into a vapour, which then turns into an aerosol.

Vaporizers run on rechargeable batteries and have refillable tanks for e-juice made up of nicotine, flavouring and other chemicals. Some models allow you to fill your own tank and others use pre-filled pods. The pods can be filled with e-juice, dry flowers or leaves or other drugs. Many contain nicotine.

Vaping doesn’t require burning like cigarette smoking.

Is it true vaping might be worse than smoking in terms of how much nicotine you take in?

Some models of vape reportedly use pods where one pod has the equivalent in nicotine to a pack of cigarettes, so it would really depend on what vape product you use and how often you go through a pod. Using a vape with nicotine can lead to nicotine dependence.

The long-term effects of vaping are still being studied.

What other harms might vaping be linked to?

While nicotine is not known to cause cancer, there are health risks associated with it. Nicotine is highly addictive.

According to Health Canada, vaping liquid containing nicotine is poisonous, particularly to young children. Even in small amounts, vaping liquid containing nicotine can be very harmful if swallowed or absorbed through the skin.

“Vegetable glycerine and propylene glycol are the main liquids in vaping products. These are considered safe for use in many consumer products such as cosmetics and sweeteners,” according to Health Canada. “However, the long-term safety of inhaling the substances in vaping products is unknown and continues to be assessed.

Chemicals used for flavour in vaping products are used by food manufacturers to add flavour to their products. While safe to eat, these ingredients have not been tested to see if they are safe to breathe in.”

Nicotine has particular affects for pregnant women: nicotine use of any kind may increase the risk of miscarriage and it may increase the risk of growth restriction of the baby in pregnancy by affecting placental blood supply. Substances in vaping liquid may affect fetal brain and lung development.

Other long-term effects of vaping are still being studied and more research is needed.

What is the respiratory illness that is being linked to them?

There have been reports in the US and now in Canada of severe lung disease in people requiring ICU admissions and even death.

The Centre for Disease Control says, based on reports from several states, patients have had respiratory symptoms (cough, shortness of breath, chest pain) and some have had gastrointestinal upset (nausea, diarrhea, vomiting) or other symptoms (fatigue, fever, weight loss). All sought medical health and all reported using vape products within a few days to a few weeks. Read more here.

Health Canada is advising people who use vape products to carefully monitor their health for symptoms of respiratory illness (cough, shortness of breath, chest pain). Seek medical help quickly if you have concerns about your health.

These started as a smoking cessation tool – what do I do if I’m using a vape in order to cut down on smoking? Should I stop?

Nicotine is approved for use in smoking cessation products like the patch or nicotine gums. Vaping has been recommended as a product to support smoking quit attempts. If you are currently using vaping as a smoking cessation product, it is best to talk to your family doctor, pharmacist, call Telehealth and/or call the Nicotine Dependence Clinic at CAMH to get the most up to date recommendations.

Do all vape pods contain nicotine?

Pods may have varying degrees of nicotine or they might contain cannabinoid products (chemicals that interact with the endocannabinoid system in our body and alter the way that system communicates with our body and brain). Be sure to read the label carefully and be aware of how much nicotine you are consuming.

Does it matter where you get the vape and pods? Are they regulated?

Vaping products are governed under the Canada Consumer Product Safety Act and are subject to the Consumer Chemicals and Container Regulations.

There have been reports of counterfeit pods of popular brands. If you choose to vape, purchase pods only from trusted vendors.

What should I tell my teenager about vaping? I had thought it was safe and ok. 

In Ontario, vapes are included under the Smoke-Free Ontario Act and therefore it’s illegal to sell or provide a vape to someone under age 19.

That said, the Ontario Student Drug Use and Health Survey 2017 showed that nearly 20 per cent of Grade 12 students vape along with 16 per cent of Grade 11s.

Nicotine can alter brain development, and teen brains are still works in progress. Many e-substances may affect memory and concentration too.

So, all evidence we have right now points to talking to your teen about vaping like you would about smoking: vaping is not harmless. It can harm your brain and other aspects of your health and it’s best to avoid it. If your teen already vapes, talk to them about the facts. Yes, e-cigarettes or vapes might be less harmful than regular cigarettes but they aren’t without risk. For help quitting, speak to your healthcare provider. Or check out Teens.SmokeFree.gov for lots of resources and information.



Toronto Public Health

Health Canada

Centre for Disease Control

About the author


Alexis Dobranowski

Alexis Dobranowski is a Communications Advisor at Sunnybrook.