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November 20, 2013
E-cigarettes spark claims debate

Question:  When is a smoker not a smoker?

Answer:  When he/she smokes an electronic cigarette.

The growing popularity of electronic cigarettes (also known as e-cigarettes) is creating debates among insurance underwriters and consumers alike.

Are they a smoking device, like a pipe, or the latest smoking cessation product?  The answer is unclear.

E-cigarettes are electronic inhalers designed as a substitute for tobacco smoking.  The mechanical devices use heating elements to vaporize a liquid solution, usually composed of propylene glycol, liquid nicotine and flavouring.   Powered by small batteries, the liquid solution is heated, creating a steam-like vapour, which is then inhaled, like a cigarette.

In United States, some large employers, including Wal-Mart and UPS, consider e-cigarettes to be just another smoking device and charge their group plan members higher premiums for their group health and life insurance, arguing that the dangers and addictive qualities of nicotine are well documented.

However, advocates of e-cigarettes counter that the devices can be used to gradually wean nicotine addicts from smoking.  Users can gradually reduce the nicotine content at each fill-up, opening the potential for them to kick the nicotine habit altogether.  As well, e-cigarettes do not contain harmful tar and chemicals associated with the consumption of tobacco products.

The devices have received a mixed reaction worldwide.  In Austria and Denmark, they are considered safe medical products to help curtail smoking.  Most European countries allow them to be sold in the same manner as cigarettes, with strict limitations on public usage and sales to minors.  Other countries, including Brazil, Estonia, Australia, Egypt and others have either banned them or restricted their sale, maintaining that, with the exception of proven replacement therapies, any form of nicotine is potentially poisonous.

Canada’s position to date is similar to Europe’s.  While not endorsed by Health Canada, the products may be sold and used without penalty.

For plan sponsors, electronic cigarettes will likely prove to be a claims challenge, at least in the short term.  Until their status is clarified by Health Canada or similar agency, claims for reimbursement of the costs of e-cigarettes or their components are likely to be declined.

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