Wednesday, November 6, 2013

Common Sense Solution for Indoor Vaping

E-cigarettes are gaining traction as legitimate harm reduction alternatives for cigarette smokers, but one nagging question persists: Should vaping be permitted in interior public spaces?

With few exceptions, indoor smoking bans, which protect nonsmokers from exposure to thousands of airborne toxins, are now the standard.  Tobacco prohibitionists would extend these measures to cover e-cigarette vapor.  E-cigarette enthusiasts insist they should be able to vape wherever they like, since their products’ vapor is harmless.  I’ll suggest a compromise that will please no one in these polarized factions.

E-cig fans point to scientific evidence that suggests that e-cigarette vapor confers extremely low health risks.  The FDA reports that adverse events related to e-cigarettes are virtually nonexistent (here), and it is unlikely that inhaling a mist of water, propylene glycol or glycerin, nicotine and flavors – even for an extended period – will lead to any medical illness. 

Consumer Advocates for Smoke-Free Alternatives funded a study of e-cigarette aerosols by Igor Burstyn at Drexel University’s Department of Environmental and Occupational Health.  He concluded that “there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces…the aerosol generated during vaping as a whole (contaminants plus declared ingredients), if it were an emission from industrial process, creates personal exposures that would justify surveillance of health among exposed persons in conjunction with investigation of means to keep health effects as low as reasonably achievable.  Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.”  Professor Burstyn’s report on his thorough investigation has not yet been published in a peer-reviewed forum.

The problem is that, however innocuous e-cigarette aerosols are, a bystander exposure level that is “orders of magnitude” lower than for vapers is still not zero.  Modern indoor environments are remarkably free of obvious airborne contaminants, such as smoke or noxious odors.  As a society, we frown upon indoor emissions of all types.  Interestingly, unobserved e-cig use is effectively undetectable, as resulting vapors dissipate almost instantly.  Vapers often suggest that indoor e-cig bans will force them outside, where they may return to deadly cigarettes; the reality is they can stay indoors and continue vaping, so long as they are discreet – no one will know.

Still, it is unreasonable for vapers to expect that they will be given a free pass to use e-cigarettes in every interior public space.  The fact that e-cigarette aerosols are low-exposure and low-risk for bystanders does not make a compelling case to allow them.

Vapers should realize that the vast majority of Americans do not use any form of tobacco, are ill-informed at best about e-cigarettes, and are uncomfortable with others exhaling clouds of an unknown substance. 


rainie said...

Many Americans do drink coffee and steam comes from their coffee and I don't know that there have been any studies that definitively say what is in that steam or its effects on bystanders. Yet there are coffee pots in virtually every office in America, emitting steam. Just sayin'.

Jonathan Bagley said...

As you say, Brad,

"Interestingly, unobserved e-cig use is effectively undetectable, as resulting vapors dissipate almost instantly."

This appears to be behind the, what I consider a reasonable compromise, of Salford University in Manchester UK.

Salford University is acknowledging that ecigs pose no danger, and allows their use out of sight.

The University of Manchester, discussed whether to adopt Salford's policy, but instead decided on an total ecig ban, which includes student accommodation (Good luck with that!). Its justification was the advice of the BMA, the doctors' trade union and not a scientific organisation. Scroll to the bottom of this for the BMA pdf on ecigs in the workplace.

Unfortunately, more and more UK businesses and public sector organisations are assuming the BMA's advice has some scientific basis and installing bans on ecig use indoors.

Jonathan Bagley said...

"....effectively undetectable, as resulting vapors dissipate almost instantly."

I timed it. About 8 seconds. About the time it takes for someone with dodgy knees to get up from his chair, walk to his office door and open it.

Brad Rodu said...

Thank you very much for linking to the University of Salford's practical and sensible e-cigarette policy.

Mick said...

Okay you see the problem here is that most of the population are non-smokers and are also totally misinformed about e-cig vapor. However an uneducated public should have no say whatsoever in actions that affect others.

So they might fear harm from vapor...but that fear is based on the marketing and misinformation bandied about by vested interests in tobacco.

The solution there is not to ban vaping publicly its to inform non smokers and educate them.

Generally when I'm asked to stop vaping in a public building I tell the person requesting it to sling their hook and get out of my face. That might seem harsh but I do it deliberately and because it WILL annoy the person requesting I cease.

It works because they are so annoyed they go off to see what can be done about it and find out I have a right to be annoyed by their ignorance and butting into my life and personal space.

They might not like it, but they will also understand I am doing them no harm.

Vocal EK said...

So the solution is to protect non-vapers from a largely imaginary health risk by endangering the lives of smokers and former smokers. Former smokers are sent to the smoking area to use their device. Even if there are no health risks associated with breathing 2nd hand smoke, frequent exposure to the smell of smoke can trigger a temptation to relapse. If we hide all the vapers, smokers either won't know that a low-risk alternative exists, or they will figure "If I'm going to be punished regardless of what I do, it's just easier to keep smoking." Allowing indoor use removes a powerful incentive to switch--especially during period of nasty weather.

Carl V Phillips said...

Brad, I agree with the general "somewhere in between" sentiment, though I think it requires more nuance. [Please note, I am speaking for myself in writing this and my views may not represent those of CASAA.] It it perfectly reasonable to restrict lots of behaviors that create minor negative externalities for others, and if cultural norms are not enough to make it happen (as they do not seem to be anymore except in a few bits of Old Europe) then laws about public spaces and private rules for private spaces are reasonable. (Note that this cannot justify laws that override private decisions about minor externalities in private spaces -- e.g., not allowing pubs to allow vaping.)

It is perfectly reasonable to have (carefully considered and openly discussed) laws about behavior in enclosed or close-quarters public space that forbid eating, making a lot of noise, taking off your shoes, vaping, etc. This might violate the facile notion of freedom that dominates a lot of current discussions -- which is a strange soup of anarchy and oligarchy -- and care should be taken, of course. But it is perfectly reasonable to not allow one person's want to have a large negative impact on many others. The question is one of where to draw the line.

Right now, among common consumer behaviors that are forbidden in public space, the line is basically between smoking and everything else. (Of course, other classes of behavior are not allowed in public, like firing guns or taking off your pants, but these fall into different categories in most people's thinking.) If banning of vaping in such spaces were done as an extension of banning eating (which clearly creates more of a health hazard and probably creates more aesthetic negatives for more people), it seems fairly easy to make the case. Of course, there would be room for debate about banning those behaviors in a particular space, but they are reasonably comparable, so it seems pretty clear they should travel together.

But contrast this with the rhetoric that surrounds efforts to ban vaping. It is all about false claims of serious health risk and a false equivalence with that one "exception", smoking. If that is the basis for the proposed regulations, they they are unethical (based on lies) and not supported (no legitimate justification is even proposed). So long as this is the justification -- so long as the externality from vaping is compared to that of smoking rather than that of eating -- it is not reasonable, and reasonably people should oppose it.

This, of course, is separate from the public health argument (not to be confused with the "public health" industry's view), which favors being very liberal with vaping to make it more attractive compared to smoking.

Julie Woessner said...

Personally, I think my problem with this discussion revolves around the definition of "public space" and our increasing willingness to see private spaces as "public."

It seems to me that private property owners should be the ones to say whether or not a specific behavior should be permitted in their establishments. There is a BIG difference in my mind between a property owner deciding that he doesn't wish to permit vaping in his restaurant versus the government deciding for all of us that vaping in restaurants will not be permitted.

I fully support the right of businesses to make the decision as to whether or not to allow vaping on their premises. I can see where a particular restaurateur might prefer not to permit vaping in a dining area because what they are selling is not only food, but a dining experience. Plumes of vapor--even if they dissipate quickly and aren't at all dangerous--may not be part of the owner's vision of a good dining experience for patrons. And just as the business owner has the right to decide what should and shouldn't be permitted on his property, I have the choice as to whether or not to patronize or work in that establishment.

But to the extent you are suggesting that the government would be acting appropriately and in the best interests of the public to ban vaping in "public" spaces (which, as we all know, includes most all privately owned commercial spaces), I would strongly disagree. In a situation where the harm is negligible or nonexistent, it doesn't seem to me that the government should be in the business of banning such behavior in privately owned premises. I agree that not everyone understands that the vapor poses no danger to them and that it is not the same as smoking, but it seems to me that the answer here is not to cater to ignorance, but, rather, to educate the public.

I reject the notion that e-cigarettes should be treated in exactly the same fashion as smoking. I don't think anyone who has any real knowledge about this subject believes that exposure to so-called second-hand vapor poses any serious health risk to anyone. Instead, there is a concern that allowing e-cigarette use where smoking is not permitted will somehow normalize smoking. Rather silly if you ask me . . . vaping only normalizes smoking to the extent that people are incorrectly led to believe that they are the same, which is exactly what we're doing when we ridiculously define "smoking" to include e-cigarettes. And, of course, since the zealots have started banning smoking just about everywhere, including outdoors, we now find e-cigarettes being banned in outdoor areas, on beaches, and in areas where no one can even make a straight-faced argument that smoking is dangerous to bystanders, let alone e-cigarette use.

Having said that, when I vape in an area that is traditionally nonsmoking, I am discreet. I do not hide what I do. My device is visible, and I don't hunch over or otherwise disguise the fact that I am vaping. However, I hold my breath for a few seconds after inhaling, and when I exhale, there is quite literally nothing to see. In the nearly 5 years that I've been vaping, I've never once had anyone ask me not to vape, and it's been rare for anyone to pay it any attention at all. (The few encounters I've had were more along the lines of curiosity about what I was doing--and a bit of surprise and support when they realized that, yes, I was actually using an e-cigarette.)

Esther Oakley said...

That makes sense that even though vapes can be low risk, to not allow them indoors. At least not provide an all out access to smoke indoors. Maybe a possible solution is to have certain areas indoors designated as vaping areas. Since this is such a new thing it will be interesting to see how it develops in the next few years.