Earlier this week, regulators in the United States ordered Juul to pull its vaping products from the market, dealing a major blow to one of the most powerful players in the industry.
The company is appealing the decision by the U.S. Food and Drug Administration (FDA), asking a federal court to block a government order to stop selling its electronic cigarettes.
While the attempted ban in the U.S. doesn't directly affect Canada, some health advocates say it raises questions about the slow pace of regulation in this country.
Here's a closer look at the FDA's decision and what's happening in Canada.
Why was Juul banned?
As part of the FDA's review process, companies had to demonstrate that their e-cigarettes benefit public health. In practice, that means proving that adult smokers who use them are likely to quit or reduce their smoking, while teens are unlikely to get hooked on them.
In its decision, the FDA said that some of the biggest e-cigarette sellers like Juul may have played a "disproportionate" role in the rise in teen vaping. The agency said that Juul's application didn't have enough evidence to show that marketing its products "would be appropriate for the protection of the public health."
On Friday, the e-cigarette maker asked the court to pause what it called an "extraordinary and unlawful action'' by the FDA that would require it to immediately halt its business. The company filed an emergency motion with the U.S. Court of Appeals in Washington as it prepares to appeal the FDA's decision.
That dispute is far from over.
What about in Canada?
Juul's vaping products, as well as those sold by other companies, remain available in Canada.
Health Canada proposed a ban on flavoured vaping products last June. At the time, it cited research indicating that flavoured vaping products are "highly appealing to youth, and that youth are especially susceptible to the negative effects of nicotine – including altered brain development, which can cause challenges with memory and concentration."
But after a round of consultations last year, that proposed ban still hasn't been put into effect.
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Several provinces and territories have put in place their own limits on flavoured vaping products, citing their appeal to teenagers.
(Juul voluntarily stopped selling many of its flavoured cartridges in 2020 following criticism they were designed to entice youth.)
David Hammond, a public health professor at the University of Waterloo who researches vaping in youth, said banning Juul products in the U.S. won't necessarily have a significant impact on the industry as a whole, given its declining market share and the variety of products available.
"You know, it's like a tube of toothpaste. If you press at one point, you just kind of squeeze it to a different spot," he said.
What does Health Canada say?
"Health Canada has no plans to remove any vaping products from the Canadian market that comply with the Tobacco and Vaping Products Act and the Canada Consumer Product Safety Act," the agency told CBC News in an email.
The government has recently put in place new restrictions on the sector, including limits on advertising for e-cigarettes and the amount of nicotine in the products. It's also undergoing a review of the legislation for vaping products that went into effect in 2018.
On its website, Health Canada warns of the risks of e-cigarettes, saying "the potential long-term health effects of vaping remain unknown" and the government continues to investigate "severe pulmonary illness associated with vaping."
Last week, Health Canada announced another set of proposed regulations that would require vaping companies to disclose information about "sales and ingredients used in vaping products," to help the government "keep pace with the rapidly evolving vaping market."
How popular is vaping?
Vaping is popular among young people, with 14 per cent of Canadians between the ages of 15 and 19 having vaped in the last month of 2020, up from six per cent from the same month in 2017, according to the results of the Canadian Tobacco and Nicotine Survey.
Vaping is less popular for adults over the age of 25, with just three per cent reporting that they vaped within the last month in 2020.
Robert Schwartz, a senior scientist at Toronto's Centre for Addiction and Mental Health, said the regulatory challenge is to strike a balance between making these products available to adults as an alternative to cigarettes, while at the same time limiting their appeal to younger non-smokers.
"We definitely are finding that young people who would not otherwise become cigarette smokers have started to use e-cigarettes and they fairly quickly develop a dependence on them," said Schwartz.
"Our research is also demonstrating that some adults are able to quit by ... using these cigarettes."
What's the holdup?
Like Schwartz, Hammond said vaping products could be a useful tool in helping wean smokers off cigarettes. He said it doesn't make sense to put strict limits on vaping products if cigarettes, which are thought to be more harmful, are still available in corner stores.
"I don't think the answer lies just with how they are regulated," he said. "I think it lies with the industry and reframing these products as something that a 50-year-old uses to quit smoking and not a 15-year-old grabs on the way to a party."
Hammond, who sits on Health Canada's advisory board for vaping products, said the agency could stand to move more quickly given the stakes.
"There's no doubt these are difficult questions and the market shifts rapidly. But it's not an area where slow, plodding regulation is a good fit," he said.
Cynthia Callard, executive director of the advocacy group Physicians for a Smoke-Free Canada, said that, while the context is different in Canada, the FDA decision "is a reminder that governments can and should bar market access to products which cannot be shown to benefit public health."