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Meeting Summary - May 8, 2023: Scientific Advisory Board on Vaping Products

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Organization: Health Canada or Public Health Agency of Canada

Date published: February 2024

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Meeting summary

  1. On May 8, 2023, members of the Scientific Advisory Board (SAB) on Vaping Products met virtually. The agenda is attached in Appendix I.
  2. The meeting opened with remarks from the interim chair, Dr. Carolyn Baglole, Associate Professor in the Departments of Pathology, Pharmacology & Therapeutics and Experimental Medicine at McGill University. Dr. Baglole welcomed participants and acknowledged the board's gathering took place virtually across many Indigenous lands, including the land of the traditional unceded territory of the Anishinaabeg People. A short round table followed.

  3. Dr. Sonia Johnson, Director General, Tobacco Control Directorate, Health Canada, provided updates from Health Canada. She discussed updates to Health Canada website, advances in Health Canada's smoking cessation campaign since the November, and the launch of the Consider the Consequences of Vaping self-led module for educators. Dr. Johnson also shared upcoming events, regulations, and data releases. Finally, Dr. Johnson provided some background statistics for the SAB with a focus on the groups left behind despite recent declines in cigarette sales and smoking prevalence.

    Following Dr. Johnson's presentation, the board initiated discussion on topics including: investigating initiation of smoking among different equity groups to target prevention efforts, additional data on contraband tobacco, and potential additions to the Vaping Product Reporting Regulations.

  4. Next, Dr. Peter Selby presented on the CAMH Vector project. The project is a mixed methods project that aims to weigh existing evidence of the health impacts of vaping for populations who use and do not use combustible tobacco and share results widely to help inform decision makers in the field of tobacco control. The project will include a literature review to summarize and measure the strength of the evidence on the health outcomes of vaping products and convene an international subject matter expert panel to evaluate. Evidence-based recommendations and knowledge products to illustrate the findings will be developed. A discussion followed Dr. Selby's presentation and included the following topics:
    • Anticipated gaps in the literature including vaping among equity deserving groups and the prevalence of access to contraband cigarettes.
    • The planned methodology for the expert panel review.
    • How to prioritize the outcomes examined in the review.
    • Some potential challenges identified by the group included coming to different conclusions that other reviews and keeping the review up to date given the rapidly evolving evidence.
    • The importance of not taking a pan-aboriginal approach was as for some tobacco is a sacred plant, but for others it is not and allowing Indigenous partners to dictate the next steps through a slow and deliberate process.
    • Finally, there was much discussion on the project's Knowledge Translation (KT) strategy. Strategies for engagement included engaging existing networks, tailoring products to the anticipated target audience, and providing context to recommendations to help individuals make informed decisions. Potential challenges identified included communicating the nuance of uncertainty, communicating the differences between lab and human studies, communicating the lack of evidence in some areas, and the lack of an approved therapeutic product. Key stakeholders for disseminating the findings were identified including health care providers and schools (for youth).
  5. The afternoon session began with a brief welcome from the chair and an introduction for presentations from SAB members on the topic of access to smoking cessation and who is being reached with an equity lens.
  6. Dr. Judith Bartlett presented on smoking among the Metis population. She highlighted that despite similar rates of working for income among Metis and other Winnipeggers, there is a significant discrepancy in income and high school graduation among Metis people. Smoking is higher among Manitoba Metis and vaping is higher among some BS Metis youth. Moving forward, Dr. Bartlett recommended a distinction-based approach and preventions efforts including early education, youth messaging, and extra curriculars.
  7. Dr. Nicholas Chadi presented on smoking cessation for children and youth. He highlighted the importance of reaching young people where they are at in the online space. He provided an overview of prevention strategies that show promise for youth and highlighted the need for cessation strategies to be relevant and accessible to youth.
  8. Dr. Réka Gustafson presented on the local public health perspective in British Columbia. She started by acknowledging that smoking continues to decline in BC but that there are still many challenges to smoking cessation in the province including cost and navigating the system. She recommended that the systematic implementation of programs, sustained targeted funding for said programs, and focusing on institution-level changes could help improve smoking cessation.
  9. Dr. Milan Khara presented on his experiences at the Vancouver General Hospital Smoking Cessation Clinic. He emphasized the primary struggle of the clinic is to sustain funding. Having a systemized evidence-based treatment for patients is needed to push the needle on harder to treat populations.
  10. Dr. Nancy Rigotti recommended embedding tobacco treatment services into places where high prevalence groups get their healthcare and receive other services. She highlighted that hospitalization is a key teachable moment where tobacco treatment services could be embedded. Evidence shows that while there is a strong effect of continued counselling after discharge, there may still be positive effects with no post-discharge care.
  11. Following the presentations, there was a discussion period focusing on opportunities for Health Canada to accelerate smoking cessation in Canada including among higher prevalence populations. Board members stressed that there is a need for anything that is implemented to be systematic. Some barriers identified by board members include the divided nature of the Canadian health care system and the current high need to prioritize mental health and other substance use challenges among Canadians. Many other suggestions were discussion including:
    • The creation of an accreditation standard with smoking cessation training being systematised within the healthcare system.
    • Starting patients on smoking cessation treatment regardless of whether they have a quit date set and allowing them to reduce their use over time.
    • Creating sustained targeting funding for smoking cessation programming and structured treatment infrastructure across Canada.
    • Some board members expressed that a Health Canada authorized vaping product would help accelerate cessation. However, they also identified the challenges of incentivising a company to go through the process to do so and navigating the potential conflict of interest if a tobacco company were to obtain authorization for a vaping product.
    • Retail restrictions for e-cigarettes were mentioned as an option that would also open the door for retail restrictions for cigarettes.
    • Some suggestions were for equity deserving groups specifically such as working to get smoking cessation services where lower socioeconomic status individuals are already accessing services and overreaching equity deserving groups in any programs implemented.
    • The strong evidence for financial incentives to help people quit smoking was also mentioned however it was acknowledged that this is not necessarily a politically acceptable option.
  12. In closing, Dr. Baglole and Dr. Johnson thanked all members for their participation. The next meeting of the Scientific Advisory Board on Vaping Products will be held in November 2023.

Appendix I – Meeting Agenda

Scientific Advisory Board (SAB) on Vaping Products

May 8, 2023

10:00am – 10:10am: Welcome (Dr. Carolyn Baglole)

10:10am – 10:45am: Health Canada updates, Q & A period (Dr. Sonia Johnson / All)

10:45am – 12:15pm: Health effects of vaping products

12:15pm – 12:45pm: Break

12:45pm – 3:00pm: Strategies for smoking cessation with an equity lens

3:00pm – 3:15pm: Closing remarks and thank-you (Dr. Sonia Johnson & Dr. Carolyn Baglole)

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