CDA Essentials 2018 • Volume 5 • Issue 8

14 | 2018 | Issue 8 CDA at W ork Dr. Aaron Burry ❘� Why did CDA revise its position statement? The CDA Committee on Clinical and Scientific Affairs and the CDA Advocacy Committee started discussions about revising the position statement on tobacco because some of the recommendations in the old statement had already been implemented in Canada and weren’t relevant anymore, such as putting restrictions on where people could smoke. Since those committee discussions first began, two major legislative changes occurred. Cannabis and vaping products containing nicotine—which were both previously considered illegal in Canada—were legalized. Studies show that people who use tobacco, cannabis or vaping products don’t use just one product, they often use them in combination. And we don’t know how combined use of these products will impact oral health over the long term. This is new territory. ❘� When did vaping products that contain nicotine become legal in Canada? The Tobacco and Vaping Products Act was enacted in May this year although there was little public discourse about it in Canada. The legislation allows vaping products containing nicotine to be legally sold as consumer products. From a public health perspective, vaping sweet liquids that contain a highly addictive substance—sometimes in concentrations higher than a cigarette—introduces an increased risk of nicotine addiction. We can see this happening in the United States, where public backlash against rising nicotine addiction among nonsmoking teens prompted Juul Labs, the biggest e-cigarette company in the U.S., to stop selling most of its flavoured e-cigarette pods in stores. This only happened quite recently (November 2018), but the company continues to sell flavoured pods here in Canada. ❘� Vaping is perceived by some as being less harmful than smoking tobacco. What can dentists tell patients about the known and potential risks of vaping? I think the most important point to make is that nicotine is one of the most addictive substances out there. So if a patient is vaping with nicotine, have a conversation about addiction. I think there needs to be a message of caution because there’s so much we don’t know about the long-term health consequences of vaping. Whether vaping is an effective aid for smoking cessation is unclear at this point. An effective first-line smoking cessation medication is still the transdermal nicotine patch. ❘� Now that smoking cannabis is legal in Canada, patients are more likely to disclose that they’re using cannabis. Are there evidence-based guidelines on cannabis use for reducing health risks? An excellent resource is Canada’s Lower-Risk Cannabis Use Guidelines, which have been endorsed by a number of health organizations, including the Mental Health Commission of Canada, Canadian Public Health Association, Canadian Medical Association and Centre for Addiction and Mental Health. The guidelines present recommendations about a range of factors that affect health risks associated with non-medical cannabis use, including choice of products, consumption methods and frequency of use. It’s true that more patients started disclosing their cannabis use when there was talk about legalization. At one community health clinic, about 70% of the patients I see between age New CDA Position Statement Considers Tobacco, Cannabis and Vaping Products CDA recently revised its position statement on the use of tobacco products to also include smoking cannabis and vaping. Dr. Aaron Burry, CDA associate director of professional affairs, spoke with CDA Essentials about why it’s important for dentists to have a conversation with patients who may be looking for less harmful alternatives to cigarettes, and who now have legal access to cannabis and vaping products for the first time.