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After a year of growing vaping concerns, critics urge the federal government to take control – Ottawa Citizen

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In recent years, vaping has gone from a phenomenon to a crisis among Canadian teens and young adults, say researchers.


Vaping may be helping some adults quit smoking, but use of vaping products among young people is growing alarmingly.


Adnan Abidi / REUTERS

Fifteen years after they were introduced in Canada, e-cigarettes made headlines in 2019 with a spike in vaping-related illnesses and soaring rates of youth vaping.

If 2019 was the year of the vaping scare, observers and critics are hoping that 2020 will be the year in which Canada gains some control over the issue.

Before the year was over the federal government began taking steps in that direction by announcing a ban on promotion of vaping products in spaces where young people could see them, including on social media. It also announced that e-cigarettes must carry mandatory health warnings and must be child resistant.

Critics want to see the government go much further when it comes to reducing teen vaping.

The mandate letter to newly appointed federal Health Minister Patty Hajdu suggests the government could go further. The letter, released in mid-December, tells the health minister to “tackle the rapid increase in vaping among young people,” in collaboration with other levels of government by taking regulatory action to “reduce the promotion and appeal of vaping products to young people and by educating the public to raise awareness of health risks.”

The federal government and others have their work cut out.

In recent years, vaping has gone from a phenomenon to a crisis among Canadian teens and young adults, researchers say.

In groundbreaking research, Professor David Hammond of the University of Waterloo found that between 2017 and 2018 vaping increased by a stunning 74 per cent among Canadian teens between the ages of 16 and 19. His ongoing research suggests there has been a similar increase in youth vaping in 2019 and Hammond believes numbers of youth vaping could go higher yet.

The Canadian Student tobacco, Alcohol and Drugs survey for 2018-2019 found e-cigarette use by students doubled between 2016-17 and 2018-19. Twenty per cent of students surveyed (approximately 418,000) had used e-cigarettes in the past 30 days, an increase from 10 per cent the last time the survey was done in 2016-17.

The figures are shocking, but likely no surprising to those who have been seeing the first-hand evidence in schools and other places teenagers frequent.

In Ottawa and elsewhere, schools have taken the doors off bathrooms to try to control vaping, without much luck. Teachers report students vaping in class — exhaling into the sleeves to try to hide it and vaping wherever they can.

The huge spike in teen vaping is likely related to high rates of nicotine in Juul e-cigarettes and other popular products.

Before Juul came along, there were almost no e-cigarette brands with more than 20 mg of nicotine for each millilitre of e-liquid. That is the limit in Europe. But in North America, Juul contains 57 mg of nicotine. The federal government only limits nicotine to 66 mg or below.

The biggest change in the market, said Hammond, is that Juul designed a product that could deliver higher amounts of nicotine while remaining smooth tasting. The result has been high rates of nicotine addiction, mainly among youth.

Along with spiking teen vaping rates, dramatic and deadly cases of vaping-related illnesses have been in the news, especially in the U.S. where 52 people have died and more than 2,400 have been hospitalized. In Canada, 14 cases of vaping related illness have been reported.

The acute illnesses and deaths in the U.S. have been linked to the additive Vitamin E acetate in THC in most cases.

A study published in December, found e-cigarette users were significantly more likely to develop long-term chronic lung disease than non-smokers.

The issues have occurred against a backdrop of weak or non-existent federal regulations in Canada, which has been consulting on tougher regulations. Some provinces have toughened their laws, including a ban on the sale of flavoured vaping liquid in New Brunswick and a reduction in nicotine levels in British Columbia.

Hammond said Health Canada has failed to properly regulate the product and as a result has failed both the adult smokers who could use them to quit cigarettes and the teenagers who have become addicted to nicotine.

E-cigarettes, he noted, are less harmful than cigarettes, but they are also highly addictive: “It might not make sense to sell them beside the chips and chocolate bars.”

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Meanwhile, many of the adult smokers who could reduce their harm by switching to e-cigarettes are no longer interested. “Adults don’t want to go near them. Everyone sees this as something 15-year-olds grab on the way to a party.”

Ottawa’s Dr. Andrew Pipe said the federal government needs to step up with tougher regulations. The existing regulations are tepid, he said, and have left a regulatory vacuum. Even the changes announced at the end of the year do not come close to what he and others want to see — notably banning flavoured e-cigarettes.

Pipe, who is considered the country’s foremost expert on smoking cessation, was instrumental in developing the Ottawa Model for Smoking Cessation at the University of Ottawa Heart Institute. He wants to see flavoured e-cigarettes banned and limits on nicotine, in addition to the restrictions on where they can be sold and mandatory health warnings, which have been announced.

One of the sad ironies of the lack of regulation, Pipe said, is that the potential of e-cigarettes to be used as harm reduction “has now essentially been squandered. No responsible clinician is now going to entertain the use of e-cigarettes as a harm reduction aid. Their potential for harm reduction has gone out the window.”

Pipe urged the new federal minister of health to act strongly to turn around soaring youth vaping rates buy using emergency powers to expedite changes while longer-term regulations are being developed.

“We are dealing with an urgent, emergent public health issue which many have labelled a crisis.”

epayne@postmedia.com

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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