U.S. must do something about vaping, Trump says

The United States has a problem with vaping and must do something about it, U.S. President Donald Trump told reporters Wednesday as he met with government officials at the White House about the emerging health concerns around electronic cigarettes.

U.S. public health officials are investigating 450 cases of vaping-related lung illness across 33 states and one U.S. territory, including six suspected deaths.

"We have a problem in our country. It's a new problem … and it's called vaping," Trump said. "Especially vaping as it pertains to innocent children."

The nationwide investigation led by the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration has not linked the illnesses to any specific e-cigarette device, ingredient or additive. 

U.S. Health and Human Services Secretary Alex Azar said the FDA is looking at whether to require all e-cigarette flavours, aside from tobacco flavours, to be removed from the market. 

Azar said they've seen a huge spike in youth use of minted menthol-flavoured e-cigarettes. 

Details on the U.S. plans to combat youth e-cigarette use are sparse.

In Canada, Parliament passed the new Tobacco and Vaping Products Act (TVPA) in May. Restrictions now in place include: 

• Prohibiting the sale of vaping products to persons under 18.
• Restricting the promotion of vaping products across all media channels, including social media.

"The act specifically restricts the promotion of vaping products with candy and dessert flavours, such as crème brûlée and blueberry cake. The United States does not currently have a similar regulatory framework in place," Health Canada spokesperson Tammy Jarbeau said in an email.

Canadian Medical Association president Dr. Sandy Buchman said physicians are concerned about the rising number of Canadian youths who are vaping.

"We believe the federal government needs to move more urgently to address this emerging public health issue," Buchman said in a statement to CBC News on Wednesday.

"As news emerges from the U.S. and more research is conducted, we believe it is time to be extremely vigilant in Canada and not repeat past mistakes. Health Canada must therefore play a leadership role to reduce the potential risks."

The CMA said:

• Vaping products should be treated the same as tobacco.
• Marketing and promotion of vaping products should not be permitted in public places, broadcast or print media, with no exceptions.
• Like tobacco, health warning labels should be prominent to ensure that consumers understand the risks.

No cases of the acute lung illness associated with e-cigarette use have been reported in Canada.

'Not fully appreciating how dangerous it is'

Dr. Richard Stanwick, chief medical health officer for Island Health in Victoria, said Canada needs a surveillance system to see if the illness is emerging in this country. 

"It's one of these situations where it's an unknown," Stanwick told CBC News.

He advised people to stop vaping.

For adults over the legal age (18 or 19 depending on the province), the advice for tobacco consumption is to switch to pharmaceutical-grade products for nicotine replacement, Stanwick said. For adults using tetrahydrocannabinol (THC), which gives users a high, find a different way to consume it than inhaling, he said.  

"We have to say that this is not a harmless activity and as a means of delivering nicotine and THC, it's associated with significant risk," Stanwick said, who wrote the Canadian Paediatric Society's position statement on e-cigarettes.

"I think part of it is that the public is really not fully appreciating how dangerous it is, and probably most importantly amongst our teens and youth, that it's seen as cool way of consuming the product, and they are not fully appreciating the risks."

There's a lot of interest among scientists to find out the exact cause or causes of the severe, life-threatening lung illness associated with e-cigarette use in the U.S. that's landed some previously healthy people in intensive care. Some needed to be put on breathing machines before they recovered. 

"Clearly, if there's one agent or one pathway, or one flavouring or a group of flavourings that are causing this, we really do need to let people know because, quite candidly, I suspect in spite of the anxiety that's associated with this particular condition, the majority of people will continue to vape," Stanwick said. 

 The Washington-based Vapor Technology Association said in a statement that the U.S. flavour ban would force smokers "to choose between smoking again … or finding what they want and need on the black market."

The group represents vaping manufacturers, retailers and distributors.