The Council of Chief Medical Officers of Health (CCMOH) recommended that federal, provincial and territorial governments enforce a wide prohibition, but allow exemptions for “a minimum set of flavours” for smokers trying to quit. It also suggested a minimum age of 21, and called for Ottawa to require vaping products to be sold in plain packaging marked with health warnings. (The Logic)

Talking point: The CCMOH said it is “significantly concerned” about youth vaping in Canada; the measures are designed to address that problem. The group’s statement also notes that federal regulation on many of its recommendations “would be preferred to create national consistency.” But some provinces have already enacted their own measures—Nova Scotia and B.C. will shortly enact a flavour ban and plain-packaging rules, respectively. Health Canada consulted on both flavours and packaging last year, and is considering the results. As The Logic reported earlier this month, market leader Juul Canada pre-empted any changes by halting production on four flavoured pods pending Ottawa’s decision. The company has previously backed increasing the legal age for vaping purchases to 21 in Quebec.

An otherwise healthy 17-year-old from London, Ont. nearly died after using flavoured e-cigarettes, often adding THC, daily for five months, according to a report published in the Canadian Medical Association Journal. He originally went to the hospital with a severe cough and was sent home with a prescription to treat pneumonia. His symptoms worsened and he was put on a ventilator five days later. Doctors were considering a lung transplant before he started responding to a high-dose treatment of corticosteroids. The illness is considered chronic, whereas most vapers who have gotten sick in the U.S. show acute symptoms of inflammatory pneumonia. (The Logic)

Talking point: The patient’s illness, called bronchiolitis obliterans, is similar to a chronic lung disease seen in factory workers exposed to diacetyl, a chemical used in microwave popcorn. Doctors don’t know the exact cause of the teen’s illness, but they think it could be flavouring ingredients in e-cigarettes. The report follows the B.C. government’s proposal to limit nicotine content, ban flavours and levy a tax on e-cigarettes. The rules would be the strictest yet in Canada. While there have been a handful of vaping illnesses reported in Canada, the numbers aren’t nearly as high as in the U.S. Still, health officials have called for nationwide emergency regulations on e-cigarettes before more people to get sick.

The new rules would limit nicotine concentrations in e-cigarettes to 20 milligrams per millilitre, restrict flavoured vaping sales to adult-only stores and raise the sales tax on vaping products from seven per cent to 20 per cent. If the legislation passes, the new tax would become effective on Jan. 1, 2020, with other regulations coming that April. (Vancouver Sun)

Talking point: The regulations would make B.C. the first province or territory with a tax specifically on vape sales. The proposed changes echo a push in the U.S. for tougher regulations amid an uptick in youth vaping and growing number of vaping-related lung injuries—as of November 13, there had been a reported 2,172 cases in the country, including 42 deaths. While Canada has seen relatively few cases of the illness, health officials have called on emergency regulations to be placed on e-cigarettes rather than wait for clearer evidence of their safety, or for more people to get sick. Also on Friday, Apple said it would remove all 181 vaping-related apps from its App Store, citing warnings from health authorities.

The move is part of an action plan issued Thursday by eight government bodies to quell the “distinct increase” in e-cigarette use among teens. Last week, the country also banned all online sales of vaping products. (Bloomberg)

Talking point: China’s e-cigarette market grew from an estimated US$451 million in 2016 to US$718 million in 2018. Losing the country’s online market and limiting the convenience of vaping could stymie that growth. The announcement follows a ban on the production, import and sale of e-cigarettes in India, another significant growth market for the vaping industry. And on Wednesday, U.S. Rep. Mark DeSaulnier introduced a bill to ban e-cigarette sales nationwide until the Food and Drug Administration completes pre-market reviews of the products. The threat of sweeping new regulations has rocked industry leader Juul, which lost US$14 billion in value after tobacco giant Altria wrote down its US$12.8-billion investment in the company by US$4.5 billion. The regulatory crackdown comes amid rising youth vaping rates and more people falling sick from a mysterious lung injury linked to vaping—as of Tuesday, 2,051 cases were reported, including 39 deaths.

Surveys of nearly 100,000 Canadians ages 11 to 25 found an overall increase in youth vaping rates between 2014 and 2017—before federal laws were enacted banning sales to minors. Provinces that prohibited e-cigarette sales to minors during the test period saw a 4.4 per cent increase in youth vaping, compared to a 9.7 per cent increase in provinces without bans. (The Logic)

Talking point: Hai Nguyen, the study’s lead researcher, suggested that banning flavoured e-cigarette products, among other measures, would be a more effective way to reduce youth vaping than simply banning sales to minors, noting that kids find other means of accessing the products. Meanwhile, Reuters reported on Tuesday that industry leader Juul Labs—which claims its target market is adult smokers trying to quit—knew soon after launching products that kids were getting addicted to its products, but didn’t change course. The company is now facing intense pressure from regulators and investors—last week, tobacco heavyweight Altria wrote down its US$12.8-billion investment in Juul by US$4.5 billion.

Siddharth Breja, who was vice-president of global finance at Juul from May 2018 to March 2019, claims the company shipped a batch of about one million contaminated e-cigarettes in 2019, which he said it never issued a recall for or told customers about. Breja’s suit—which claims he was fired for whistleblowing and objecting to the company’s conduct—also alleges Juul sold pods that were almost a year old. Breja claims that when he advised then-CEO Kevin Burns against selling the old products, Burns replied, “Half our customers are drunk and vaping like mo-fos, who the fuck is going to notice the quality of our pods.” (The Logic)

Talking point: This is another in a string of bad headlines for Juul. The company pulled much of its product in the U.S. earlier this month in anticipation of sweeping bans on flavoured vaping products. It also plans to lay off between 10 and 15 per cent of its workforce—about 500 people—to focus on regulatory compliance rather than marketing. Despite the popularity of Juul’s products—its products account for about 75 per cent of the U.S. e-cigarette market——it has largely avoided blame for the rise in vaping related illnesses in the U.S., with health officials pointing instead to THC-containing products and devices bought on the black market. But this suit calls into question the company’s quality control at a time when regulators are on high alert for what exactly is causing vapers to get sick.

The prohibition was removed from a planned 2015 rule that gave the Food and Drug Administration oversight of e-cigarettes after the Obama administration’s Office of Management and Budget (OMB)—which assesses the economic impact of new regulations—consulted with more than 100 people over 46 days. That included 44 meetings with tobacco company lobbyists. (Los Angeles Times)

Talking point: Cecilia Muñoz, a former White House official, said that at the time, the “science wasn’t clear” on the effects of flavours on youth vaping. Since flavours made up a significant portion of vaping sales it would be unfair to stop businesses from selling them, she said. But the final rule excluded 15 pages of supporting documentation on how flavors affected youth vaping rates. The FDA is once again planning a ban on flavoured vaping liquids, but this time President Donald Trump is backing the move. And while tobacco giant Altria opposed the rule in 2015, Juul, in which it made a major investment, has promised not to lobby the government this time.

The patient, in their 50s, became severely ill after a few months using legal nicotine vaping products as a way to quit smoking.(CBC)

Talking point: The unidentified patient isn’t the first in Canada to suffer health issues apparently related to vaping—last week, a London, Ont. teenager was put on life support after using a vaping device, and federal officials are investigating a handful of similar cases nationwide. However, the Quebec patient is the first to meet the official federal definition, which includes a list of symptoms combined with a history of vaping, a negative test on a lung infection and no plausible alternative diagnoses. The news comes amid a wave of regulatory panic over vaping devices in Canada and the U.S., where the official number of vaping-related illnesses has climbed to 805. A handful of U.S. legislators—including President Donald Trump—have called for sweeping bans; Massachusetts has issued a four-month ban on all vapes, and Rhode Island, Michigan and New York have banned most flavoured vaping products. In Canada, Nunavut is considering tightening its regulations. But anti-tobacco activists argue that imposing vaping bans while cigarettes remain legal could have a negative public health impact and bolster the underground vape market.

A high-school-aged youth has been diagnosed with “severe respiratory illness,” and was on life support, but is now recovering, said Dr. Christopher Mackie, CEO of the health unit, in a press conference Wednesday. Mackie declined to specify the brand of the vape used and whether it contained cannabis. Seven deaths have been reported in the U.S., in cases mainly involving black-market vapes that contained THC, the psychoactive ingredient in cannabis. (The Logic, Gizmodo)

Talking point: Health Canada issued a vaping warning two weeks ago amid reports of the U.S. cases, advising users to monitor themselves for symptoms of pulmonary illness, like coughing and shortness of breath. Canada legalized vaping in May 2018, and the usage of e-cigarettes among teens has risen by 74 per cent since then, according to a University of Waterloo study. Health Canada is currently considering new restrictions on advertising to curb youth vaping, including on social media and at checkout in stores. It’s also considering adding more flavours to its banned list, which currently includes confectionary, dessert, cannabis, soft drink and energy drink flavours. In the U.S., President Donald Trump has stepped into the regulatory process, ordering the Food and Drug Administration to ban all flavoured e-cigarettes.