Challenges and priorities for E-cigarette regulation at the local level - Insights from an Ontario tobacco control community-of-practice

Background: There has been minimal policy development in Canada to regulate when and where e-cigarettes can be used, and no policies to-date to set a minimum legal sale age to purchase e-cigarettes. Public Health professionals that are members of an Ontario-wide Community-of-Practice (CoP) working on tobacco control issues were surveyed about e-cigarette activity at their health units. Findings: The survey was completed by 19 respondents from 17 different health units (response rate of 63%; representing 47% of the province's health units). When respondents were asked to describe how 'high a priority' the issue of e-cigarettes was within their health unit, 88% (n = 15) reported it was a 'medium' or 'high'. The vast majority of members of the CoP (90%, n = 17) reported that their health unit is experiencing questions from the public about the safety or health risks of e-cigarettes (e.g. e-juice, nicotine cartridges, poisoning, second-hand vapour), as well as questions about the efficacy of e-cigarettes to support cessation (90%, n = 17). Almost three quarters of respondents (74%, n = 14) reported that their health unit has received complaints about people using e-cigarettes in enclosed workplaces, and roughly one quarter (26%, n = 5) reported their health unit has received complaints about outdoor e-cigarette use. Conclusions: Most members of the CoP report that their local health unit is engaged in the issue of electronic cigarettes. Local authorities including cities and regions have the jurisdictional authority to regulate many dimensions of electronic smoking products including the creation of e-cigarette 'vapour-free' environments, and regulating sales to youth.