Holding an e-cigarette, Rachel Steen asked Toronto’s Board of Health to reject "fear-mongering" about a product she said keeps her from smoking.

"Don’t take my life away. I need access," Steen said at city hall Monday afternoon, Aug. 18, before the board decided to call on the province to add electronic cigarettes to its public smoking bans across Ontario.

"If I don’t have this, I will smoke."

Later, Steen said the quit-or-die message doesn’t work for many smokers, and e-cigarettes let people keep their nicotine habit without killing them.

Toronto’s medical officer of health, however, said the full health effects of e-cigarettes – a battery-operated and still-evolving "nicotine-delivery system" – are unknown.

"This is a remarkably unregulated product that can be bought by children," Dr. David McKeown told the board.

Vaping, as the vapour-producing use of e-cigarettes is called, doesn’t come under provincial laws on smoking, and "could run the risk of re-normalizing smoking behaviour, particularly with youth," he said.

McKeown said fruit and candy flavours sold for e-cigarettes appeal to youth, adding though the device is praised as an anti-smoking aid, it’s not approved as one by Health Canada.

Monday’s unanimous endorsement of having the province prohibit e-cigarette use wherever smoking is prohibited, ban sales to minors and remove e-cigarette displays in stores will lead to a follow-up report in February.

If the province doesn’t act by then, the city should, McKeown said.

Steven Moreau, CEO and co-founder of e-cigarette maker e-Stream Canada, said treating his product the same as cigarettes is like comparing Pepsi to Labatt Blue.

Founded in 2011, the Ontario-based company has dozens of locations and more than 100 employees in two provinces, said Moreau, who wouldn’t tell the board what e-Stream’s annual sales or revenues are.

He did say e-Stream had "witnessed" thousands of smokers switching to e-cigarettes, and others quitting the use of both.

"I can’t legally say this is a smoking cessation device, but people are using it for that," said Moreau, who, like other e-cigarette company representatives who appeared, said his firm tries to sell only to smokers and never to minors.

Boris Giller, representing 180 Smoke, said it’s "ageist to assume adults don’t enjoy fruity flavours," and argued there’s zero evidence to support the "fallacy" e-cigarettes are a gateway to smoking.

Steen, who was vaping an apple pie flavour briefly in the committee room and then outside, said if such flavouring was banned, she’d go back to smoking, "because what’s the point?"

Lilian Riad-Allen of the Centre for Addiction and Mental Health told the board vaping can be a trigger to resume smoking, and since about half its patients are smokers, CAMH included e-cigarette use in its smoking ban.

McKeown said none of the measures the board supported – including having the federal government regulate maximum nicotine dosages in e-cigarettes and have them sold in child-proof bottles – will stop their use by people who want to stop smoking.

Parkdale-High Park Councillor Gord Perks said he believes in the principle of harm reduction when it comes to addictive substances, but the e-cigarette industry "doesn’t want to play by the rules."

E-cigarettes are either a consumer product, like coffee, or they’re a drug, and the industry wants them classified as neither, said Perks, arguing the restrictions backed by the board are reasonable but don’t go far enough.

Scarborough-Rouge River Councillor Raymond Cho’s suggestion the province be asked to allow e-cigarettes sales only in licensed drug stores was left out of the boards’ position, at least for now.