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. - --- MAP posted-by: Jay Bergstrom