Background:
In May 2018 the federal government in Canada legalized the sale of e-cigarettes, converting an illegal-but-tolerated marketplace for unregulated vaping products into one where cigarettes were sold as fast moving consumer goods (FMCG). The stated goals of the legalization were to provide smokers with ‘access to more choice’. This ‘harm reduction approach aims to reduce the negative consequences of cigarette smoking by recognizing the potential benefits of using less harmful alternatives’. Against the advice of public health charities, the government allowed many forms of advertising and promotion, including broadcast advertising, billboards, free sampling and instore displays. Several provinces implemented their restrictions on these practices, leaving a patchwork of different regulations across the country. In the same year, the federal government legalized the sale of cannabis, converting an illegal-but-tolerated marketplace into one where cannabis was sold as a highly restricted product. Following the advice of health charities, the government imposed relatively strict restrictions on cannabis promotions, comparable to those in place for tobacco products. Provincial governments adopted different approaches to retail distribution.

Objectives:
To compare the impact of a legalized e-cigarette market in Canada, taking into consideration regional regulatory differences.

Methods:
Analysis of marketing tactics by companies, the prevalence of use and attitudes and behaviours of Canadians.

Results:
Even where provincial promotional regulations were strict, youth uptake of e-cigarettes increased significantly. The legislation put in place did not prepare for the reality of industry marketing.

Conclusions:
The Canadian experience with these two drug categories and 10 subnational regulatory approaches demonstrates the vulnerabilities of public health to liberalized markets and the benefits of a regulatory restrictions. Lessons for other regions can be drawn.