Monday, July 13, 2009

Suffolk County is First Local Government to Consider a Ban On Electronic Cigarette Use in Public Places

Legislator Jon Cooper has introduced legislation in Suffolk County which, if passed, would make the county the first locality in the nation to outlaw the use of electronic cigarettes in public places. The proposed bill bans the use of electronic cigarettes in all places where cigarette smoking is prohibited. In addition, the bill bans the sale of electronic cigarettes to anyone below the age of 19.

The legislator's press release introduces the issue as follows: "Suffolk County has been at the vanguard of national efforts to break America’s addiction to smoking. But now a new, high-tech smoking threat has emerged in the form of 'electronic cigarettes.'"

Cooper goes on to assert that: "E-cigarettes closely resemble and purposefully mimic the art of smoking by having users inhale vaporized liquid nicotine (often through kid-friendly, flavored cartridges) created by heat through an electronic ignition system. ... After inhaling, the user then blows out the heated vapors producing a "cloud" of undetermined substances that is virtually indistinguishable from traditional smoke. ... Manufacturers of these devices still have not subjected them to independent, peer-reviewed, scientific examination. A known neurotoxin, nicotine is also one of the most highly addictive substances available for public consumption. More lethal than strychnine, just 60 milligrams of nicotine on the tongue "about three drops" is enough to kill a 160 pound person. In contrast: The lethal dose for strychnine is 75 mg. For diamondback rattlesnake venom it’s 100 mg.You’d need to ingest 200 mg of arsenic to do somebody in. Cyanide's lethal dose is 500 mg." ...

"So now, after nearly a decade of progress on public smoking bans nationwide, e-cigarettes are being used where traditional forms of smoking are outlawed. This is causing distress from non-smokers worried about the health effects of second-hand smoke. ... Non-smokers worried about the health effects of second-hand ingestion will no longer have to stress about being exposed to a cloud of vapor from an e-cigarette."

The proposal follows a petition put out by the anti-smoking group Action on Smoking and Health, which called for regulation of electronic cigarettes due to the potential for severe health effects of nicotine exposure among exposed nonsmokers.

The Rest of the Story

I have to first say that any astute reader should suspect something is up when a supposedly scientific treatment of this issue makes a comparison between the lethal dose of nicotine in an electronic cigarette and the lethal dose of strychnine, arsenic, or cyanide. And when that scientific treatment of the issue terms nicotine a "neurotoxin."

To be fair, if Assemblyman Cooper is concerned about the potential for nicotine poisoning of children in Suffolk County, he would surely want to start by removing nicotine patches, inhalers, and gums from the counters of pharmacies throughout the county, where they are easily available for purchase - without a prescription - by kids.

And if he is concerned about the potential for nicotine toxicity among customers in restaurants, I assume he would also want to ban the use of nicotine inhalers in these restaurants.

To be sure, nicotine inhalers and nicotine replacement products are far more prevalent in Suffolk County that electronic cigarettes.

I mention this only because it is important to recognize that what is going on here is not a scientific discussion, but an ideological and political one.

From a scientific perspective, there simply is no evidence at this time that electronic cigarette use poses any significant risk to nonsmokers. In my opinion, one of the necessary pre-requisites to enact government regulations that intrude into private business by regulating the conditions within those establishments is that scientific evidence must first be presented that documents a significant hazard.

This has simply not been done yet with respect to electronic cigarettes.

I find it disingenuous of Cooper to suggest that "the user then blows out the heated vapors producing a "cloud" of undetermined substances that is virtually indistinguishable from traditional smoke." The e-cigarette has been tested and the only two substances that are emitted and which might expose a bystander to any degree are nicotine and propylene glycol. It is unclear that electronic cigarette use causes significant exposure to either of these substances among nonusers.

But more importantly, it is disingenuous to suggest that the vapor is indistinguishable from traditional smoke and that it contains a cloud of "undetermined substances." It is quite clear that while cigarette smoke contains more than 10,000 chemicals plus nicotine, electronic cigarette emit just the nicotine without any of these other 10,000 chemicals.

Why leave out this important information and suggest to the reader that a nonsmoker is getting potentially the same hazardous exposure to secondhand smoke from e-cigarettes as she gets from conventional cigarettes? Why attempt to deceive people like this? Why not just be forthright and tell people the truth? Why not present the information in some semblance of an objective, scientific manner?

Finally, I must say that the entire premise of Cooper's concern is misguided. It isn't electronic cigarettes that are a threat to efforts to break America's addiction to tobacco. In fact, electronic cigarettes may just be an important innovation that helps Americans to break their addiction to tobacco cigarettes. This could well be a major contribution to efforts to break addiction to smoking.

Any concern about the hazardous effects of "electronic secondhand smoke" (which should really be called "secondhand vapor") is a hypothetical one at this point. In the absence of any evidence that there is significant exposure to nicotine among bystanders from electronic cigarettes, I think it is premature to ban electronic cigarette use in public places.

One thing to remember is that people using electronic cigarettes are those who are trying to quit smoking and to reduce their exposure to tobacco smoke. By banning e-cigarette use in public places, we are essentially forcing these individuals to use them in places where smoking is allowed - possibly designated smoking areas. This could expose them to secondhand smoke and to a powerful trigger to resume smoking. The proposed policy could actually have detrimental health effects.

Let me emphasize that my commentary relates to the banning of e-cigarette use in public places. I don't have a problem with restricting the sale of these products to adults only.

Of note, however, the very first article I am aware of which discussed this proposal seems to give the impression that Cooper's original proposal was to ban electronic cigarettes entirely. Is it possible that the initial proposal was for an all-out ban, but that it was revised to ban sales only to minors?

Finally, I believe (but am not certain) that the bill is still under consideration and that there will be another public hearing and vote later this month. Any readers from Suffolk County please feel free to fill us in if you have more information.

I think this will be a very interesting debate and it may well be an issue that is considered elsewhere very soon.

No comments: