Meeting November 12-13, 2020: Scientific Advisory Board on Vaping Products
- Dr. Carolyn Baglole
- Dr. Marisa Creatore (Interim Chair)
- Dr. Geoffrey Fong
- Dr. Maciej Goniewicz
- Dr. Lorraine Greaves
- Dr. David Hammond
- Dr. Sonia Johnson (Executive Secretary)
- Dr. Andrew Pipe
- Dr. Rachel Tyndale
- Dr. Kenneth Warner
- Dr. Linda Bauld
- Dr. Steven Hoffman (Chair)
- Dr. David Mills
- Dr. Trevor Mischki
- Dr. Christine Czoli
- Ms. Fatima Mussa
- Ms. Venika Christophe
- Ms. Dana Beaton
- Mr. Denis Choiniere
- Mr. Mathew Cook
- Ms. Sunita Gingras
- Ms. Femina Kanji
- Ms. Ivana Kosarac
- Mr. Rafael Sordili
- Ms. Sheila Molnar
- Ms. Kelly Thickett
- Dr. Hanan Abramovici
- On November 12th and 13th, 2020, members of the Scientific Advisory Board (SAB) on Vaping Products met virtually for the Board's sixth meeting. The agenda is attached in Appendix I.
- On the first day, Dr. Marisa Creatore welcomed attendees and presented the theme and objectives of the meeting, which were to be the role of flavours in vaping and approaches to flavour regulation in vaping products. This welcome was followed by a round of brief introductions by SAB members.
- Health Canada provided an update to the SAB on the federal response to vaping which Health Canada and its Health Portfolio partners have been undertaking since the last SAB meeting in November 2019. Dr. Sonia Johnson presented the most recent statistics on vaping prevalence rates from the 2019 Canadian Tobacco and Nicotine Survey. She noted that current Health Canada tobacco prevention measures appeared to be effective given the decline of youth smoking rates. She also highlighted some of the key activities Health Canada has undertaken in the federal response to youth vaping, including implementing new labelling and packaging requirements for vaping products, adopting new Vaping Product Promotion Regulations, investing $12M in the national public education campaign to inform youth and families of the risks of vaping, and relaunching the Quit4Life program to include vaping cessation, among others. Dr. Johnson outlined Health Canada's next steps in its regulatory response to youth vaping, which involves proposing restrictions on nicotine concentrations and flavours in vaping products. After Dr. Johnson's presentation, the SAB members followed up with questions in regards to the availability of 2020 data, public opinion research, nicotine concentration restrictions and vaping product cessation claims. The SAB expressed interest in discussing how Health Canada can best address flavour restrictions.
- Dr. David Hammond began the morning session with a presentation on the most recent findings of the ITC Youth Tobacco and Vaping Survey, including trends in youth vaping among 16-19 year olds in Canada, the United States (US) and England, and their associated policy implications. Dr. Hammond presented data regarding youth perceptions of vaping products, reasons for use of vaping products, and use of particular vaping product flavours. In addition, he discussed impacts of the flavour restrictions implemented in the US, noting that these had very limited impact on the use of flavoured e-cigarettes among youth, given that they only applied to a subset of products. Dr. Hammond also observed a broader market-wide shift to vaping products with higher nicotine concentrations. The SAB discussed the implications of these trends in Canada.
- Dr. Geoffrey Fong presented on the role of flavours in vaping among adults in Canada and the US, and shared results of the ITC Four Country Smoking and Vaping Survey, which included trends of vaping and flavours among adults from Canada, England, Australia and the US. Dr. Fong highlighted flavour preferences among adult vapers, including among exclusive vapers and dual users. Dr. Fong emphasized that assessing the population impact of current flavour restrictions in Canada and the US will require assessing the relationship between flavours and reasons for vaping; particularly for smoking cessation among current smokers, and for preventing relapse among former smokers. He noted that research studies show that non-tobacco flavours, especially fruit, are popular among adult vapers, including those who have quit smoking and are exclusively vaping. He also noted that ITC cross-sectional and longitudinal studies find that fruit and sweet flavours are associated with vaping to quit smoking and with a greater likelihood of quitting smoking. The SAB discussed the differential impacts of flavour restrictions on youth and adult vapers, as well as the impacts of flavour restrictions on smoking cessation.
- Dr. Ken Warner wrapped up the afternoon with a presentation on how simulation models can inform our understanding of the public health impacts of vaping. Dr. Warner presented a model to estimate the population health impacts of vaping products. Under various scenarios it indicated an overall net gain towards public health. Dr. Warner emphasized that these models highlight that vaping is not likely to be the sole magic bullet that completely eliminates smoking; rather it is one tool in the collection of tobacco control measures and policies. The SAB discussed the relationship between smoking, vaping, overall cessation outcomes and public health impacts, and remaining research gaps in this field.
- The second day of the meeting opened with a brief welcome by the Chair and review of agenda for the day, and an overview of guiding questions for SAB members to consider for the day's discussion.
- Representatives of Health Canada's Tobacco Control Directorate (TCD) presented an overview of data and methodologies for defining vaping product flavours. The presentation began with an overview of surveillance and market data regarding vaping product flavours. Health Canada then described potential approaches to restrict flavours federally, including through the promotion of flavours in product branding, the characterization of flavours (affecting sensory experience) and flavouring ingredients (focusing on chemistry of vaping products). Specifically, Health Canada outlined the methodology approaches it has developed to allow regulators - using tobacco flavour as a case study - to define the compounds that best mimic tobacco flavour. While no consensus was reached by the SAB regarding recommendations, the SAB raised the following considerations for Health Canada:
- Relationships between the presence and concentration of flavouring chemicals and their impact on the sensory experience among consumers, including interactions of chemicals in the aerosol;
- Drawing from regulatory work in other jurisdictions and adapting approaches to the Canadian context;
- The potential impacts of restrictions on consumer safety and the industry;
- The importance of clarifying objectives of the regulatory response, and of balancing the needs of and impacts on non-smoking youth as well as adult smokers;
- Opportunities for applied research to examine impacts of flavour restrictions implemented by several provinces in Canada; and
- Considering additional regulatory measures on vaping product device characteristics and technologies.
- The SAB reflected on the evolution of its work in this first term over the last three years, and discussed future opportunities. Members shared feedback regarding the structure of SAB meetings and processes for sharing research and formulating recommendations. The members expressed appreciation for the inclusion of a broad array of perspectives and expertise on the Board, given its mandate.
- In closing, Dr. Creatore reflected on the sixth SAB meeting and thanked the presenters and members for sharing their expertise in discussions on vaping. Dr. Sonia Johnson thanked the Board for its contributions over the past 3 years, and confirmed that the SAB will be renewed for another term. Dr. Creatore adjourned the meeting and thanked the board and departmental officials for their participation.
APPENDIX I – MEETING AGENDA
Scientific Advisory Board (SAB) on Vaping Products
Meeting #6 – November 12 & 13, 2020
11:00am – 12:00pm: Introduction
- Welcome from the Chair (Dr. Marisa Creatore)
- Brief introductions (All)
- Health Canada updates (Dr. Sonia Johnson)
12:00pm – 1:00pm: The role of flavours in vaping and impacts of flavour restrictions
- Youth vaping and flavours: 2017-2020 data from the ITC Youth Surveys (Dr. David Hammond)
- The role of flavours in vaping among adults in Canada and the United States and possible implications for flavour restrictions (Dr. Geoffrey Fong)
- Discussion on the role of flavours in vaping and opportunities for regulation
1:00pm – 1:30pm: Break
1:30pm – 3:00pm:
- How simulation models can inform understanding of the effects of vaping (Dr. Kenneth Warner)
- Discussion on the impacts of vaping and research gaps
11:20am – 1:00pm: Approaches to vaping product flavour regulation
- Overview of surveillance & market data on flavours and approaches to flavour regulation (Health Canada)
- Discussion on approaches to flavour regulation
1:00pm – 1:30pm: Break
1:30pm – 1:45pm: Discussion on approaches to flavour regulation (cont'd)
1:45pm – 2:15pm: Discussion on the evolution of SAB work & future opportunities
2:15pm – 2:30pm: Conclusion
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