CanadaHealthIndustry

Health Canada speaks on the vaping-related illness crisis

Published on October 25, 2019 · Last updated July 28, 2020
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By now, many Canadians have heard about the slew of vaping-related illnesses and associated deaths that are seemingly sweeping the US. But what does this news mean for Canadians, with our recently legalized adult-use cannabis?

In the US, cannabis remains illegal at the federal level, but some individual states have legalized the substance for either medical or adult use. As a result, there remains a large legacy market for cannabis products. In particular, vape pens have become popular in many US states as a discreet way to consume THC.

Here in Canada, adult-use cannabis is legal, but vape pens and concentrates have yet to enter the scene. These products, among others, became legal in Canada on Oct. 17, 2019, but have not yet become available for sale. Despite this, some Canadians are using illicit market vape pen cartridges to consume cannabis.

The arrival of legal cannabis vape pens in Canada will bring with it many questions. How can Canadians vaporize cannabis safely? What should Canadians know about vaping-related illnesses? And what is Health Canada doing to ensure that the legal products it will offer are safe?

What are vaping-related illnesses?

Vaping-related illness is a catch-all term to describe a late 2019 outbreak of illnesses thought to result from the use of e-cigarettes and vaping.

The symptoms typically include shortness of breath, dizziness, nausea, weakness, and tiredness.

Scientists have coined the term EVALI, which stands for “e-cigarette, or vaping, product use associated lung injury,” to refer to the syndrome. Leafly and others refer to “vaping-associated pulmonary illness” as VAPI.

Vaping-related illnesses are not associated with vaporizing dry cannabis flowers.

Scientists are not yet sure of the causes of the illness. Most sufferers report using vape products containing THC, but some report using nicotine-containing products only.

Importantly, vaping-related illnesses are not associated with vaporizing dry cannabis flowers. The illness is linked to vape pens and e-cigarettes which use e-liquid, rather than cannabis flowers.

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Early research indicated that a single ingredient may be the cause of the problems. This ingredient is called vitamin E acetate, and it is typically used as a thickener in cannabis-containing vape cartridges.

However, in an Oct. 18, 2019 release, the CDC insisted that the cause of VAPI has not yet been determined.

“No single compound or ingredient has emerged as the cause of these injuries to date, and there might be more than one cause. Available data suggest THC-containing products play a role in this outbreak, but the specific chemical or chemicals responsible for [VAPI] have not yet been identified, and nicotine-containing products have not been excluded as a possible cause.”

For now, the CDC recommends that persons “should not use e-cigarette, or vaping, products that contain THC. Persons should not buy any type of e-cigarette, or vaping, products, particularly those containing THC, off the street.”

What should Canadians know?

Although the first cases appeared in the US, Canada has not been spared in the vaping illness crisis. As of Oct. 17, 2019, there are five confirmed or probable cases of VAPI in Canada.

In an Oct. 11 statement, Health Canada urged Canadians to “consider refraining from using e-cigarettes or vaping products, particularly any products that have been purchased illegally, including any products that contain THC.”

As of Oct. 2019, all vape pen products containing THC are unregulated, as legal products have not yet hit the markets. Despite this, Canadians do use cannabis-containing vape products. An Aug. 2019 report from Statistics Canada indicates that 19% of Canadians who used cannabis in the first half of 2019 used vape pens.

Purchasing from a legal source assures the consumer that the product they are getting has been tested by a laboratory.

“Canadian consumers have been using illicit cannabinoid-infused vape products for many years. To date, all of these products have been unregulated. The good news is that with Legalization 2.0, Canadian consumers won’t have to rely on the legacy market for cannabinoid-infused vape products,” said cannabis professional Paul Pedersen, CEO of Vancouver-based Nextleaf Solutions.

“The recent issues related to vaping, primarily associated with cannabinoid-based vapes in the US, underscore the importance of a properly regulated marketplace where players must abide by strict quality assurance and control standards,” Pedersen continued.

“In the Canadian legal cannabis framework, purchasing from a legal source assures the consumer that the product they are getting has been tested by a laboratory, typically one that is independent and third-party, which meets the quality standards set by Health Canada.”

Health Canada and regulated cannabis vape products

Health Canada has been somewhat inconsistent with their position on the vaping illness crisis. With legal cannabis vape products on the horizon, Canadians will no doubt have questions about their safety.

In the Oct. 11 statement, Health Canada advised Canadians to use regulated, approved legal cannabis products, when they become available:

“If you use vaping products, do not buy them from illegal or unregulated sources, including products containing THC. Products obtained from the illegal market are not subject to any controls or oversight and may pose additional risks to your health and safety.”

Yet in the same breath, the statement urges Canadians to “consider refraining from vaping” altogether. So are government-regulated cannabis vape products safe, or not?

When asked this question directly, Health Canada spokeswoman Maryse Durette responded on Oct. 23:

“All federally licensed producers of all legal cannabis products must comply with good production practices, product formulation restrictions, quality standards for ingredients, limits on microbial and chemical contaminants, and mandatory testing requirements, among other strict requirements,” said the spokeswoman.

Durette emphasized the stringent regulations on vaping products in particular.

“… In developing the regulations governing the production and sale of new cannabis products, including vaping products, Health Canada took into consideration risks associated with various routes of exposure to cannabis … Some of the regulatory requirements pertaining to inhalable cannabis extracts, such as vaping products, are even more stringent than those for other non-inhaled cannabis products,” she continued.

Durette assured Canadians that the agency is aware of the vaping illness situation, and will not hesitate to act if it is warranted.

“Health Canada and the Public Health Agency of Canada are actively monitoring the vaping illness situation in the US and in Canada, and are in close contact with the US Food and Drug Administration and the US Centers for Disease Control and Prevention to better understand their investigation into the cause or causes of the vaping illnesses,” she explained.

“Health Canada will continue to monitor all available data sources and surveillance systems and will take additional action, if warranted and as appropriate, to protect the health and safety of Canadians.”

Echoing these sentiments, Pedersen was also confident that regulation will protect Canadians.

“In the event that a [legal] product … was found to be out of compliance with the regulations, a rapid recall system ensures that the public was informed of the potential issue, and an investigation could be completed in a timely manner, hopefully preventing similar issues in the future.”

When asked what Canadian cannabis consumers should do in light of the vaping health crisis, Pedersen had a simple message.

“With the recent issues related to vape products, I’d recommend consumers wait for legal cannabis vape options, and stick to vaporizing dried flower until those legal products are available,” he explained.

In summary: Safe vaping dos and don’ts

Do:

  • Buy only legal, Health Canada-approved cannabis vape pen products when they are available
  • Consider vaporizing dry herb instead of using a vape pen
  • If you choose to risk using illicit market products, look for ingredients lists and research the ingredients in your e-liquid

Don’t:

    • Purchase illicit market cannabis products, especially THC-infused e-liquids
    • Purchase vape cartridges from corner stores or online unregulated retailers, as these are illegal

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Laura Tennant
Laura Tennant
Laura Tennant is a Toronto freelance science writer. She has an Honours B.Sc. in Neuroscience from the University of Toronto. She hopes her writing will help others make better-informed choices about their health and lifestyle.
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