World Health Organization Urges Countries to Ban Electronic Cigarettes Because They Could Increase Secondhand Smoke Exposure

The World Health Organization is urging countries to ban electronic cigarettes because, it argues, their use could increase secondhand smoke exposure, as some might claim that these devices do not contain tobacco and do not produce smoke.

In a 2012 World Health Organization (WHO) report on electronic cigarettes from the Conference of Parties to the Framework Convention on Tobacco Control, WHO states:

"the use of ENDS could hamper the implementation of Article 8 (Protection from exposure to tobacco smoke) as ENDS users in public places may claim that their electronic cigarette does not contain tobacco and/or does not produce second-hand tobacco smoke."

The Rest of the Story

This would be a valid argument if electronic cigarettes produced tobacco smoke and users were lying in claiming that these products do not produce secondhand smoke.

But the truth is that electronic cigarettes do not contain tobacco and do not produce secondhand smoke! Thus, it is the World Health Organization - not electronic cigarette users - who are hampering the implementation of Article 8 of the Framework Convention on Tobacco Control.

Because they do not produce secondhand smoke and involve no combustion of tobacco, the use of electronic cigarettes actually greatly reduces, rather than increases public exposure to secondhand smoke. Every electronic cigarette used represents that much less secondhand smoke that is produced. In fact, one of the major advantages of electronic cigarettes is that they do not produce secondhand smoke, and thus they benefit not only the user, but also the people who might otherwise be exposed to that person's cigarette smoke.

As Drs. Ted Wagener and Belinda Borrelli and I argue in an article in the journal Addiction: "an often unconsidered advantage of e-cigarettes is that they do not require combustion and therefore produce no second-hand smoke exposure (SHSe) to the user or to individuals in the smoker's environment. Second-hand smoke, especially in homes with children, poses a serious public health risk increasing the incidence of sudden infant death syndrome, respiratory illness, middle-ear disease and asthma. Children aged between 3 and 11 years have the highest levels of SHSe, probably because they spend a majority of their time in close proximity to a caregiver who smokes. Despite the strong national effort of introducing smoking bans in public spaces, children living with smokers have not experienced any reduction in their SHSe, as evidenced by serum cotinine levels. Furthermore, clinical interventions aimed at reducing children's SHSe by targeting caregiver smoking behavior (i.e. cessation and/or smoking outside) often fail to produce long-term cessation and result in minimal to no reduction in SHSe for children, as measured by objective indicators such as urinary or serum cotinine or a child-worn passive smoke monitor. A significant majority of parents return to smoking or do not maintain consistently smoke-free homes. As such, the current methods of reducing caregiver smoking behavior cannot be relied upon as the sole means of reducing children's SHSe. The use of e-cigarettes by caregivers who smoke and who are unable or unwilling to quit smoking by more traditional means may be a viable alternative method to reduce children's SHSe."

Thus, far from increasing secondhand smoke exposure, the use of electronic cigarettes will greatly reduce such exposure, especially in settings such as the household where parents who switch to electronic cigarettes will be able to greatly reduce their children's exposure to secondhand smoke.

The rest of the story is that it is the World Health Organization, not electronic cigarette users, who are undermining and hampering the implementation of Article 8 of FCTC and thus contributing towards an increase in population exposure to secondhand smoke and its associated hazards.