By Dr. Dawn Bowdish, Director of the Firestone Institute for Respiratory Health and Jessica Buckley, President & CEO, Lung Health Foundation
Canada’s healthcare crisis is usually described in familiar terms: long wait times, overcrowded emergency rooms, and not enough doctors and nurses. Governments respond with equally familiar promises: more hospital beds, more staff, more funding.
Of course, these investments are necessary. But they are no longer sufficient.
A sustainable healthcare system must pair workforce reform with prevention. Otherwise, we will continue to pour resources into treating illnesses that could have been avoided in the first place. Nowhere is this tension clearer than in respiratory health, and nowhere is the prevention gap more obvious than with smoking and vaping.
Canada’s healthcare workforce is under intense strain – staffing shortages, burnout, and moral distress are now routine realities for clinicians. Respiratory illnesses already place significant pressure on primary care doctors, respiratory therapists, emergency departments, and long-term care facilities. For many clinicians, this has normalized a form of “hallway medicine”, with preventable COPD exacerbations managed in overcrowded settings and under constant timeline constraints.
Yet too little attention is paid to preventing people from needing healthcare services in the first place. Supporting healthcare workers means both staffing them properly and protecting them from an endless influx of preventable disease.
Vaping exposes this contradiction clearly.
Originally marketed as a harm-reduction tool for adult smokers, vaping has become a youth-driven public health challenge. In 2022, 14 per cent of Canadian youth aged 15 to 19 reported vaping in the past 30 days – more than double the rate just five years earlier. Many products are flavoured and high in nicotine, increasing their appeal and addiction risk for young people whose brains are still developing. Emerging evidence links vaping to respiratory and cardiovascular harm, nicotine dependence, and a higher likelihood of transitioning to cigarette smoking. Long-term impacts are still being studied, but Canada’s history with tobacco offers a stark warning.
Tobacco remains the leading cause of preventable death in Canada, responsible for more than 45,000 deaths and over $16 billion in economic costs each year. Allowing vaping to follow a similar trajectory would be a preventable public policy failure.
This where federal leadership becomes critical.
While healthcare delivery is largely provincial, prevention, surveillance, and regulation require national coordination. Today, provincial approaches to vaping vary widely, with inconsistent rules and uneven enforcement. Regulatory gaps are easily exploited by industry, leaving youth protections dependent on postal codes.
The National Lung Health Alliance (NLHA), Canada’s leading advocacy network for lung health recently urged the House of Commons Standing Committee on Health (HESA) to commission a comprehensive federal study on the health impacts of vaping. This study would strengthen national surveillance, assess health outcomes, evaluate existing regulations, and identify effective prevention strategies.
Most important, it would give policymakers and healthcare providers the evidence they need to act before today’s youth become tomorrow’s patients.
Prevention is not just public health policy. It is workforce policy. We cannot recruit our way out of a problem we continue to create.
Investing in prevention through research, regulation, and public education is one of the most cost-effective ways to sustain Canada’s healthcare system. It protects its workers from burnout, ensures that scarce resources are used where they are truly unavoidable, and improves quality of life for Canadians long before illness takes hold. Supporting the mental health of healthcare workers begins with supporting the care they provide. They need time and tools to talk with patients about preventing and cessation, but financial strain and packed schedules rarely allow for it.
Reforms in Canada’s respiratory health sector must therefore focus on two tracks at once: improving timely access to care and reducing the future burden of disease. This means supporting healthcare professionals with adequate staffing and mental health resources, while at the same time reinforcing national prevention strategies for emerging threats like vaping.
Strong federal action on vaping would signal a serious commitment to a healthier, more sustainable future. It would acknowledge that prevention is not optional. It is foundational.
The real reform is not choosing between people and policy. It is recognizing that the health of one depends on the strength of the other.
