Trouble and opportunity with e-cigarettes

Darlene LaRose had her first cigarette at age 10. By the time she hit her 30s, the Gibsons, B.C. resident was smoking a pack a day. She hated it.

So LaRose tried to quit, each time with the help of nicotine replacement therapy (NRT) products like the Nicorette patch, or with prescription drugs. But inevitably, three months later, the overpowering urge to light up would send her scrambling for a cigarette.

Then, in 2012, a friend introduced LaRose to electronic cigarettes. He told her the battery-powered device, which lets users inhale and exhale flavoured vapour that resembles smoke, helped him kick the bad habit. Intrigued, LaRose gave it shot, quitting cold turkey and using e-cigarettes as her only crutch.

A year later, she’s still smoke-free. How exactly did the e-cigarettes help? “It’s the fact that you can do that hand to mouth . It’s tricking your body into thinking you’re smoking, which makes that nicotine withdrawal subside.”

E-cigarette companies’ Facebook pages are filled with similar testimonials. And their products are catching on. According to Euromonitor estimates, the global e-cigarette market is worth over US$2 billion, having enjoyed stable growth since the product’s invention in 2003. But the impressive numbers belie the controversy surrounding e-cigarettes, and the dilemma they present for retailers.

Some experts argue that e-cigarettes hold promise as a smoking cessation tool. Others fear they are little more than starter drugs for teens, who’ll eventually graduate to tobacco products. “There’s no doubt that e-cigarettes have really divided the public health community,” says David Hammond, an associate professor at the School of Public Health at the University of Waterloo.

Hammond co-authored a study, conducted in 2010 and 2011, which revealed just four per cent of Canadian adult smokers have tried e-cigarettes. But awareness of the product is high – about 40 per cent among current and former smokers. In the report’s conclusion, the researchers wrote that “as the market evolves, awareness, trial and use of is likely to increase.”

In fact, e-cigarette companies like Calgary-based Dune are reporting steady growth. Brian Langois, the company’s VP of sales, says sales to grocers, pharmacies and convenience stores are doubling every month. “Major retailers across the country are stocking these products because they see the potential and the growth of this category,” he notes.

Rexall is one of those retailers. The pharmacy chain launched the category last April with Jasper and Jasper products, and has since expanded its offering to include Dune. Kevin Yakimishyn, Rexall’s category manager for over-the-counter products, says he has “seen excellent results in the first year, and have exceeded our expectations.”

But like all retailers, the drugstore chain has to be careful about what it puts on its shelves. It’s illegal to sell e-cigarettes containing nicotine in this country.

Manufacturers, meanwhile, aren’t allowed to sell e-cigs that make health claims – for example, suggesting their products can help users quit smoking. As of yet, there are no rules dictating where retailers can and cannot display the products. So many companies, including Rexall, Lawton Drug’s (owned by Sobeys) and Loblaws, often place them next to NRT products.

Fred Bristow, managing pharmacist at Loblaw’s Queen and Portland location in Toronto, says he prefers to keep e-cigarettes in the store’s smoking cessation section so they are within visual range of the pharmacy. That way, if he sees someone looking at the products, he can walk over and make recommendations.

Other grocers, like Safeway, display e-cigarettes at their customer service desks. Walmart says they do not carry the category. Nor does Metro, according to a spokesperson, “except if an independent store manager would decide to sell some on his counters.” A rep for Shoppers Drug Mart says they are currently testing e-cigarettes in a few markets, but did not provide details on where they are stocked.

John Shaske, an independent pharmacist in Gibsons, B.C., keeps his e-cigs behind the pharmacy counter. Though he says he’s not a “true fan” of the products, Shaske adds: “Do I really care what methods somebody uses, as long as it’s not illegal? Why not use any tool you can to get off smoking?”

That’s a common argument thrown around in the debate over e-cigarettes. They can’t be worse than the real thing, right?

“Tobacco cigarettes are known to contain 3,500 different chemicals, which are carcinogenic,” says Dune’s Langois. “Dune products contain glycerol, flavouring and water. It allows to feel like they are smoking… but they’re not taking in any of the harmful chemicals.” According to Hammond, some preliminary research has shown e-cigarettes with nicotine may help some smokers kick the habit.

Even Melodie Tilson, director of policy for the Non-Smokers’ Rights Association, acknowledges the products have shown “great potential” as smoking cessation aids. But she says right now, the category is under-researched.

“These products have not been adequately studied to know what the risks to health would be of long-term use.” Like the Canadian Lung Association, the NSRA worries that consumers will be misled into thinking e-cigarettes are scientifically proven cessation aids. And as far as Health Canada is concerned, they are not. In a release, the agency warns the products “have not been fully evaluated for safety, quality and efficacy.”

Tilson is also concerned that e-cigarettes will normalize smoking. Worse still, kid-friendly flavours like bubblegum, chocolate and pop could appeal to youth. And because the products aren’t age restricted, there’s nothing stopping teens from buying them.

According to Hammond, a yet-to-be-published study found the number of young Canadians who have used e-cigs (a practice known as “vaping”) may be significantly higher than the number of adults who’ve tried them. “It could be as high as anywhere from about one-third of current smokers that have tried these and about six per cent of non-smokers,” he says.

E-cigarettes can also be risky for retailers, especially now that the media has caught on to their controversy. London Drugs is certainly familiar with the effects of negative e-cigarette coverage. A recent radio segment on CBC’s The Current, which pitted Tilson against the medical director of Canadian e-cigarette brand Smoke NV, prompted the western drugstore chain to begin IDing customers who purchase the products.

Better, then, for grocers and pharmacies to get ahead of the controversy. Hammond recommends retailers “do their homework,” researching manufacturers, and ensuring their products don’t make unfounded health claims. It may also be time for retailers to reconsider where the products are displayed.

As Bristow says, e-cigarettes “shouldn’t be there for people to experiment with.”