Pubdate: Sat, 14 Nov 2015
Source: Vancouver Sun (CN BC)
Copyright: 2015 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Authors: Richard Stanwick & Patricia Daly
Note: Richard Stanwick is Chief Medical Health Officer at Island 
Health in Victoria and Primary Author of Canadian Paediatric 
Society's Statement on E-cigarettes. Patricia Daly is Chief Medical 
Health Officer Vancouver Coastal Health and Primary Public Health 
Consultant on Regulation of Medical Marijuana Retail Outlets for the 
City of Vancouver
Page: F4

IS IT 'TIME FOR REAL CHANGE'?

Health Stakes High: Liberals Must Be Cautious in Legalizing Marijuana 
or Nicotine-Laced E-Cigarettes

Two drug-containing products of increasing public acceptance remain 
illegal - but perhaps not for long. The first is marijuana - a 
flashpoint in the recent national election and a source of the 
psychoactive drug tetrahydrocannabinol (THC). Presently, legal access 
is only through Health Canada's highly controlled medicalmarijuana 
program. Changes by the previous Conservative government also 
disallowed new program participants from ' growing their own.' This 
seemingly coincided with a national increase in non-sanctioned 
storefront marijuana retailers, some promoting marijuana for "health 
indications" far beyond evidence indicating a medical benefit. 
Enforcement issues fall to policing agencies. However, faced with 
more than 100marijuana retailers, the City of Vancouver is attempting 
control through comprehensive business licences. The requirements 
focus on the firms' operations and the character of the operators - 
all that's legally allowed. Regulation of the actual product re! 
mains a federal responsibility.

A second currently illegal drug-containing product has garnered much 
less attention - electronic cigarettes containing nicotine, the 
primary psychoactive ingredient in tobacco. Health Canada does not 
authorize the importation or sale of e-cigarettes containing 
nicotine, as their safety, quality, and efficacy remain unknown. 
Health Canada has also not approved any e-cigarette manufacturer's 
marketing using health claims such as being a smoking cessation aid. 
Despite this, nicotine e-cigarettes are readily available. The 
numbers of Canadian purveyors of such e-cigarettes easily exceed the 
number of marijuana retailers. (A leading U.S. financial analyst 
predicts sales of nicotine-containing e-cigarettes will surpass 
conventional cigarette purchases within a decade.) Enforcement falls 
only to a small number of Health Canada inspectors whose availability 
is limited.

The Conservative government's investment in achieving compliance with 
nicotine-containing e-cigarettes and marijuana regulations was at 
best uneven. A 2002 Canadian Senate Report estimates that between 
$200 million to $ 500 million is expended annually to administer 
Canadian marijuana laws.

Enforcement efforts aside, purveyors of both products are growing 
exponentially in economic clout and influence.

Currently, retail sales of these products are not subject to a 'sin 
tax' as levied on conventional cigarettes. Consequently, their future 
tax generation potential also may serve as a motivation for 
legalization. There could also be considerable savings in curtailing 
current expenditures on policing and prosecutions.

We recommend future policies be forged only after considering the 
far-reaching impact of these drug-containing products on human 
health. Neither nicotine nor marijuana should be used by pregnant 
women as their use could harm an unborn child's brain development.

The area of the brain controlling judgment and decisionmaking is not 
fully developed until the mid-20s. The younger an adolescent begins 
using nicotine or marijuana, the more likely it is that drug 
dependence or addiction will develop in adulthood.

Both using e-cigarettes and smoking marijuana generate large amounts 
of fine particles causing potential breathing problems in users and 
bystanders. Also, cancer-causing compounds have been found in the smoke/vapour.

As a smoking cessation aid and harm-reduction tool for current adult 
smokers, e-cigarettes are unproven. Concerns about the uses of 
marijuana have been raised within mainstream medicine. For both 
products, there is a need for more research and medical education.

The enticingly flavoured e-liquid used in e-cigarettes and edible 
marijuana baked products and candies are particularly attractive to 
children and youth. Serious childhood nicotine poisonings from 
e-liquids and discarded cartridges are increasing. Edible marijuana 
product poisonings are up in American states that have legalized marijuana.

Neither e-liquids nor marijuana products are meeting Canadian 
standards for production or labelling. Manufacturers are not 
routinely documenting the widely varying concentrations of nicotine and THC.

If one or both products are made legal, we advocate for the early 
application of a public health approach to policies and regulations, 
based on minimizing harm and promoting health.

If legalized, Ontario's Centre for Addiction and Mental Health 
provides a blueprint for legislation that should result in a net 
benefit to public health and safety while protecting those who are 
most vulnerable to harms from drug-containing products. (www.camh.ca)

Regardless of regulatory outcome, evidence-based public education is 
a priority, especially for children and youth who are most 
susceptible to the harms from these products. If informed adults 
choose to use drug-containing products, risks may be reduced by 
delaying use until early adulthood, avoiding daily or near-daily use, 
and using less potent products.
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MAP posted-by: Jay Bergstrom