HomeMy WebLinkAbout03/11/2014 11 Prohibition of Electronic Cigarettes in No Smoking Areas; YMC Amendment 6.80.010; YMC Addition 6.80.035BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No.
For Meeting of: 3/11/2014
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ITEM TITLE: Ordinance relating to Public Safety; amending section
6.80.010 to add the definition of Electronic Cigarette and
adding a new section 6.80.035 prohibiting the use of
electronic cigarettes in any place where smoking is prohibited
by law.
SUBMITTED BY: Cynthia I. Martinez, Senior Assistant City Attorney/575-6030
SUMMARY EXPLANATION:
The Public Safety Committee reviewed an MRSC publication describing the hazards associated
with the emissions from electronic cigarettes (E -cigarettes). Electronic cigarettes are a new
delivery device for both nicotine and marijuana. Unlike the traditional cigarettes, E -
cigarettes produce a vapor rather than smoke. See attached. The Public Safety Committee is
forwarding this ordinance regulating the use of E -cigarettes for consideration by the full
Council. The ordinance prohibits the use of E -cigarettes anywhere that smoking is prohibited.
The State Indoor Air Act prohibits smoking in any building open to the public or in a building
where an employee is/will be present. The State has adopted legislation that prohibits the sale
of E -cigarettes to minors. RCW 26.28.080.
Resolution:
Other (Specify):
Contract: Contract Term:
Start Date: End Date:
Amount:
Ordinance: X
Item Budgeted: NA
Funding Source/Fiscal
Impact:
Strategic Priority:
Insurance Required? No
Mail to:
Phone:
Public Safety
APPROVED FOR
SUBMITTAL:
RECOMMENDATION:
Adopt the Ordinance.
City Manager
ATTACHMENTS:
Description Upload Date
Ordinance -E -Cigarette 3-11-2014 3/3/2014
MRSC Publication re Hazards Associated with E -
Cigarettes
3/3/2014
Type
Ordinance
Backup IMaterliall
AN ORDINANCE
ORDINANCE NO. 2014 -
relating to Public Safety; amending section 6.80.010 to add the definition
of Electronic Cigarette and adding a new section 6.80.035 prohibiting the
use of electronic cigarettes in any place where smoking is prohibited by
law.
BE IT ORDAINED BY THE CITY OF YAKIMA:
Section 1. Section 6.80.010 of the City of Yakima Code is hereby amended to read as
follows:
6.80.010 Definitions.
As used in this chapter, the following terms have the meaning indicated unless the context
clearly indicates otherwise.
(1) "Electronic Cigarette (E -cigarettes)" means an electronic inhaler meant to
simulate and substitute for tobacco smoking.
(4) "Smoke" or "smoking" means the carrying or smoking of any kind of lighted
pipe, cigar, cigarette, or any other lighted smoking equipment.
(2) "Public place" means that portion of any building or vehicle used by and
open to the public, regardless of whether the building or vehicle is owned in whole
or in part by private persons or entities, the state of Washington, or other public
entity, and regardless of whether a fee is charged for admission, and includes a
presumptively reasonable minimum distance, as set forth in YMC 6.80.060, of
twenty-five feet from entrances, exits, windows that open, and ventilation intakes
that serve an enclosed area where smoking is prohibited. A public place does not
include a private residence unless the private residence is used to provide licensed
child care, foster care, adult care, or other similar social service care on the
premises.
Public places include, but are not limited to: schools, elevators, public conveyances or
transportation facilities, museums, concert halls, theaters, auditoriums, exhibition halls, indoor
sports arenas, hospitals, nursing homes, health care facilities or clinics, enclosed shopping
centers, retail stores, retail service establishments, financial institutions, education facilities,
ticket areas, public hearing facilities, state legislative chambers and immediately adjacent
hallways, public restrooms, libraries, restaurants, waiting areas, lobbies, bars, taverns, bowling
alleys, skating rinks, casinos, reception areas, and no less than seventy-five percent of the
sleeping quarters within a hotel or motel that are rented to guests. A public place does not
include a private residence. This chapter is not intended to restrict smoking in private facilities
which are occasionally open to the public except upon the occasions when the facility is open to
the public.
(3) "Place of employment" means any area under the control of a public or
private employer which employees are required to pass through during the course
of employment, including, but not limited to: entrances and exits to the places of
employment, and including a presumptively reasonably minimum distance, as set
forth in YMC 6.80.060, of twenty-five feet from entrances, exits, windows that
open, and ventilation intakes that serve an enclosed area where smoking is
prohibited; work areas; restrooms; conference and classrooms; break rooms and
cafeterias; and other common areas. A private residence or home-based business,
unless used to provide licensed child care, foster care, adult care, or other similar
social service care on the premises, is not a place of employment. (Ord. 2005-83 §
1 (part), 2005).
Section 2. Section 6.80.035 of the City of Yakima Code is hereby added as a new section to
read as follows:
6.80.035 Use of Electronic Cigarettes Prohibited
The Use of Electronic Cigarettes is prohibited in any area where smoking is prohibited
by law. Anyone violating this section shall be subject to the fine amount enumerated in
section 6.08.050 of this Chapter.
PASSED BY THE CITY COUNCIL, signed and approved this 11th day of March, 2014.
ATTEST: Micah Cawley, Mayor
City Clerk
Publication Date:
Effective Date:
E -Cigarettes — Can They Be Used in Public Places or Places of Employment? I MRSC Ins... Page 1 of 2
E -Cigarettes — Can They Be Used in Public Places or Places of
Posted ori November 6, 2013 by Paul Siu5vaa7
Atomizer
C rtria9a
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toy
In 2005, the voters approved Initi901, prohibiting smoking in
public places and places of employment; that initiative is now codified
tFnlgrt in chapter.• 70.1.€ 0 RCW. Under RCW /o.16o,o2o(1), the terns
"smoke" and "smoking" are defined to mean "the carrying or smoking
of any kind of lighted pipe, cigar, cigarette, or any other lighted smoking equipment." Since the initiative's
adoption, electronic cigarettes — or e -cigarettes -- have become popular. Does the initiative apply to e -cigarettes?
What is an e -cigarette? According to Wi kpedia, an e -cigarette
is an electronic inhaler meant to simulate and substitute for tobacco smoking. It generally utilizes a heating
element that vaporizes a liquid solution. Some release nicotine, while some merely release flavored vapor,
They are often designed to mimic traditional smoking implements, such as cigarettes or cigars, in their use
and/or appearance.
If this description is accurate, would use of an e -cigarette be prohibited by the state .law prohibiting smoking in
public places or places of employment? In my opinion, probably not. The Initiative 901 definition of "smoke" or
smoking" makes reference to cigars, cigarette, pipes and other lighted smoking equipment. See RCW 70.160.020
(1). But e -cigarettes are not lighted; they create vapor (rather than smoke) through heating — not burning — a
liquid solution. The manner of their use does not appear to correspond with this statutory definition of "smoking."
Even though the use of an e -cigarette may not be smoking, there may be health hazards regarding their use. The
American Lung Association reports that, in lab tests conducted by the Food and Drug Administration (FDA) in
2009, detectable levels of toxic cancer-causing chemicals were found in some e -cigarettes. (E -cigarettes are not.
currently regulated by the FDA.) The Lung Association also warns that there may be risks from secondhand
emissions, as two studies found formaldehyde, benzene, and tobacco -specific nitrosamines corning from
secondhand emissions.
Given the health concerns, some local boards of health in the state and other jurisdictions have adopted or are
considering adopting regulations controlling the use and/or sale of e -cigarettes. King County, for example,
prohibits the sale of e -cigarettes to minors, the offer of free or discounted e -cigarettes, and the use of e -cigarettes
in any area where smoking is prohibited by law.. The Tacorua/Pierce County Board of Health has adopted similar
restrictions, including limitations on the use of e -cigarettes in certain public places. Clark County prohibits the
sale of e -cigarettes to minors and Places limits on samples and the use of coupons, as does the City of Spokane.
The Washington Attorney General, along with 41 other state attorneys general, rc cerwtly wrote the FDA urging that
agency to regulate e -cigarettes in the same manner as tobacco products are regulated. The desire to regulate e -
cigarettes, however, is certainly not universal, and attempts to regulate them have drawn some spirited objections.
In response to my initial question, I conclude that a person could use an e -cigarette in a public place or place of
employment without violating any current state law. If a local jurisdiction wishes to achieve a different result, as
some have, it will need to adopt its own regulations addressing e -cigarettes.
FolVow
http://insight.'sc.org/2013/ 11 /06/e-cigarettes-can-they-lbe-used-in-public-places-or-place... 2/28/2014
i Distributed at the
Meeting .L411:
Back to CASAA.org Main
TUESDAY, MARCH 11, 2014
CASAA Testimony to Philadelphia City Council Regarding
Proposed Ordinance to Ban E -Cigarette Use Wherever
Smoking is Prohibited
- Recommend this on Google
Testimony of Carl V. Phillins, PhD, Consumer Advocates for Smoke-free Alternatives
Association (CASAA)
to the Philadelphia City Council
regarding e -cigarettes (in opposition to Bill No. 14009500 and in opposition unless untended
to Bill No. 14009600)
11 March 2014
My name is Carl V Phillips, PhD 1 currently live in xxx, New Hampshire, but have close ties to
Philadelphia and until a few months ago I was a resident of the Philadelphia suburbs and was
affiliated with Drexel University 1 am the Scientific Director of CASAA, The Consumer
Advocates rot Smoke-free Alternatives Association, and also work as a private consultant. I ant
testifying on behalf of CASAA, which is a public health non-govemmental organization (NGO)
and consumer representative, not an industry group. CASAA is the leading consumer
representative of users of e -cigarettes and other low-risk alternatives to smoking. CASAA is a
nonprofit volunteer organization and 1 am not being compensated for providing this testimony
1 am a public health scientist and award-winning epidemiologist. 1 spent most of my career as a
professor of public health, and most of that focusing on tobacco harm reduction. 1 have been
doing research on smoke-free alternatives to smoking, including e -cigarettes, for longer than
almost any other researcher in the world and have published numerous journal articles and other
writings on the topic.
CASAA supports prohibiting sales of e -cigarettes to minors at the city, state, and national levels.
There is really no honest opposition to such policies, with merchants and industry joining us, the
consumer advocates, in supporting them. Indeed, reputable merchants already enforce such
restrictions even when they are not mandated by law The only opposition to such restrictions
comes from so-called public health groups, who are apparently attempting to increase e-etgarelle
usage by children so they can use it as an excuse to restrict adult access.
ABOUT CASAA
Our mission is 10 ensure the
availability of effective, affordable
and reduced harm alternatives to
smoking by increasing public
awareness and education; to
encourage the testing and
development of products to achieve
acceptable safety standards and
reasonable regulation; and to
promote the benefits of reduced
harm alternatives.
FIND CALLS TO ACTION 8 LOCAL
ALERTS
• CTA
• LocalAlert
CONTENTS
2014 (36)
♦ March (3)
Call to Action! New Jersey's
Governor Christie is.
CASAA Testimony to
Philadelphia City Council
Regar
Local Alert! Newton,
Massachusetts Ordinance E -
Ci.
However, we cannot support Bill No 14009600 as currently written and ask that it be amended.
First, it defines e -cigarettes as "electronic smoking devices" which they are most certainly not.
There is no stroke produced, and referring to e -cigarette use as smoking is misleading,
inflammatory, and potential harmful since it might dissuade smokers from switching to this
healthier alternative The Bill further uses the phrase "unauthorized nicotine delivery products",
which is both inflammatory and rather cryptic (are cigarettes authorized?). Pennsylvania is
currently considering SB 1055, which would impose similar restrictions on sales to minors, and
uses the term "alternative nicotine product" We urge you to amend the language to match that of
the Commonwealth's bill or at least to choose some alterative phrase that, like theirs, is
appropriately non judgmental and technically accurate. Second, SB 1055 would require different
signage than you are currently considering. In order to avoid imposing contradictory
requirements on merchants, we ask that you change the wording of the required signage to match
that of the Commonwealth's bill.
There is little more to say about that, so the remainder of my testimony focuses on the proposed
ban of e -cigarette use where smoking is banned.
The key observation is that the environmental exposure from e -cigarettes is not at all similar to
stroking. A recent review of all the available science on the vapor from e -cigarettes by Prof Igor
Burstyn of Drexel University concluded that the exposure to chemicals to the user, both intended
ingredients and contaminants, was far below the level that would create any health concern. That
is to the user himself. The conclusion was that the exposure to any bystanders is 100 or 1000 or
10,000 times less than that quantity which was already shown to be inconsequential. Since Prof
Burstyn is expected to testify at the hearing on this Bill, 1 will defer to him on further details.
In short, the premise that vaping (e -cigarette use) should be restricted because of clean air
concerns is misguided. There is simply no appreciable risk to bystanders from vaping. Standing
next to someone who is eating, sipping coffee, or just breathing, exposes bystanders to
measurable levels of chemicals that are toxic or carcinogenic in high quantities. But the
quantities are so low that they are not considered a risk. The same is true for e -cigarette use.
Please do not be tricked by claims that there are a few molecules of scary -sounding chemicals in
the air, and therefore restrictions are needed; pretty much everything puts out a few molecules of
many chemicals into the air, and 1 assume you do not plan to ban steaming cups of coffee.
Moreover, as you have probably heard, vaping is about 99% less risky than smoking, and
hundreds of thousands of American smokers who would not have otherwise quit have switched to
e -cigarettes, thus reducing their health risks almost as much as if they had quit cold turkey
Anything that discourages such switching is thus bad for public health. You might be inclined to
say "better safe than sorry" about the environmental exposure issue, but sometimes "safe" is very
costly In this case, it is very costly to public health. Being able to use an e -cigarette in a bar or
one's office, rather than having to trudge outside to smoke, is a big draw Come for the
convenience, stay for the 99% reduction in health risk. Take away that convenience and you are
going to be responsible for causing many people who would have quit to just keep smoking
because they feel like they might as well. This will kill people. This is hardly "erring on the side
of caution"
Another argument that is sometimes made in favor of bans is to prevent children from seeing
people using e -cigarettes. The goal is dubious.in itself. Kids see adults doing a lot of things that
they are not allowed to do — that is just part of life. Moreover, seeing people ostentatiously nut
smoking, and seeing them seeking a substitute because they Lind that quitting cold turkey is not
an option, seems like a good message to send to the kids. But even if we assume that this is a
legitimate goal, how does making smokers step out of bars and private offices onto the street
further this goal? This seems like it would stake e -cigarettes more visible, not less. Yes, there
are stories — probably mostly apocryphal — about teachers vaping in front of their pupils. But if
that is the concern, it is easy enough to prevent that and similar specific concerns without
imposing an unjustified, burdensome, and anti -public-health blanket restriction.
You have no doubt heard so-called public health organizations urging you to enact these
restrictions, and wonder why they would be staking such claims given that there is no scientific
or public health justification for them. The reason is, quite supply, that they are not motivated by
genuine health concerns. They will claim that there is a risk to bystanders or That we just don't
know enough, both of which are false. if someone you hear from does not know that. it is only
because he has avoided reading the scientific literature on the topic before presuming to opine to
► February (20)
► January (13)
I. 2013 (125)
► 2012 (95)
►
2011 (80)
The Rest of the Story•
Tobacco News Analysis and
Commentary
E -Cigarettes are a Gateway to
Cigarette Use and Inhibit
Quitting? Then Why is the
Decline in Cigarette
Consumption Accelerating? -
According to Stan Glantz and a
number of anti-smoking groups
and agencies, including the
CDC, electronic cigarettes have
been shown to be a gateway to
yout.
11 hours ago
Stop the ANTZ
It's not "just an addiction" -
Although my 21 year old son has
a mother who advocates
smokeless altematives for
smokers, he and his older
brother (who was quite anti-
smoking when he was.
3 days ago
Anti-THR Lie of the Day
Stanton Glantz is such a liar that
even the ACS balks: his latest
ecig gateway "study - by Carl V
Philips Stanton Glantz recently
published a paper, Electronic
Cigarettes and Conventional
Cigarette Use Among US
Adolescents; A Cross-
sectional
3 days ago
Tobacco Truth
UCSF Study Falsely Links E -
Cigarettes to Sinoking -
Academics at the University of
California San Francisco have
used the 2011 and 2012
National Youth Tobacco Survey
to fabricate a claim that "e -
cigarette.
4 days ago
Tobacco Harm Reduction:
News & Opinions
Onto new pastures - Given that
this venue originated when the
authors were all working
together at the University of
Alberta but now have diverged
(while still sharing the com.
1 year ago
The Truth About Nicotine
Chronic Conditions Require
Ongoing Treatment - Some
people have suggested that the
way to help more smokers quit is
to offer treatment for a longer
period --say from 6 to 8 months,
as opposed to 6 to 8.
you about it. They will claim that there are unknown risks to the user herself, but that is not
relevant. If there really were great risks to the user — and there is overwhelming evidence that
there are not — we would be talking about a ban, not an environmental restriction.
The reality is that these organizations are not wonied about protecting bystanders or even product
users themselves. They are not really concerned about children, as evidenced by their opposition
to minor sales bans (perhaps 1101 the one you are considering, but many others in other
jurisdictions). They are frustrated that this solution to the public health scourge of smoking is
happening in spite of their dismally ineffective efforts to eradicate all tobacco use, rather that
because of them These organizations have lost touch with their original goal of eliminating the
health impacts from smoking — something that e -cigarettes do almost as well as quitting cold
turkey — and have become an industry in themselves that is devoted to the hopeless dream of
eliminating all tobacco product use. They are hostile toward e -cigarettes not because they are a
threat to public health, but because they will achieve the public health goal in a way that they
simply find morally objectionable.
They will argue that restricting the use of e -cigarettes is an easy extension of restricting
smoking, and therefore we should just do it. But please pause and think about that. Bans like
this get called "public place" bans, but most of the places they affect are private. It is an
enormous imposition on people's freedom to deny an employer, restaurateur, or bar owner the
right to decide whether a legal activity that causes no measurable harm will be allowed on her
private property Our society rely re/uclan!/y came to the agreement that smoking was uniquely
harmful enough that such a huge restriction on private free choice was warranted. Now you are
being asked — based on hand -waving speculation — to impose such enormous restrictions on
private behavior You are being asked to forbid people from engaging in a low-risk activity that
reduces smoking in thousands of private venues — even though vaping does not appear to pose
any threat to bystanders. Not only will this hurl, rather than benefit, public health, but it will
also casually take away personal freedom in a way That is not befitting the cradle of American
libery
Posted by Julie Woessner at 2:05 PM
Labels: Carl Phillips, Dr Carl Phillips, Drexel study, e -cigarette ban, e -cigarette bans, Pennsylvania,
Philadelphia
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1 year ago
I Distributed at th
• I Meeting '3-U-14 i(
Research on the Safety of Electronic Cigarettes
The huffingtonpost.com reports that former U.S. Surgeon General Dr. Richard Carmona, who highlighted the dangers of
secondhand smoke and supported a ban on all tobacco products, is joining the board of directors for NJOY Inc., the
nation's leading electronic cigarette company. They quote Carmona as saying:
"We still have one out of five people in America smoking ... there's a lot more work to do. To dismiss (e -cigarettes) and not
even consider it ... would be a disservice to the public who are looking for alternatives."
http://www. huffingtonpost.com/2013/03/25/ex-su rgeon-general-electronic-ciga rettes_n_2948715.htm I
The follow is regarding the safety of exhaled vapor. The following is from the CASSA website. CASSA is the Consumer
Advocates for Smoke-free Alternatives Association. The site summarizes the study published by Dr. Igor Berstyn in
January 2014 called "Peering through the mist: systematic review of what the chemistry of contaminants in electronic
cigarettes tells us about health risks."
By reviewing over 9,000 observations about the chemistry of the vapor and the liquid in e -cigarettes, Dr. Burstyn was able
to determine that the levels of contaminants e -cigarette users are exposed to are insignificant, far below levels that would
pose any health risk.
Additionally, there is no health risk to bystanders. Proposals to ban e -cigarettes in places where smoking is banned have
been based on concern there is a potential risk to bystanders, but the study shows there is no concern.
/-)The study did caution that e -cigarette users are inhaling substantial quantities of the main chemicals in e -cigarette liquid
(propylene glycol and glycerin). While these chemicals are not considered dangerous and the levels are far below
occupational exposure limits, Dr. Burstyn did suggest ongoing monitoring to confirm that there is no risk. The chemical
contaminants are of even Tess concern. While there have been many claims that formaldehyde, acrolein, nitrosamines,
metals, and ethylene glycol found in e -cigarette vapor poses a health hazard, the study concluded that all of these have
been found only at trivial levels that pose no health concern.
The study did not address the effects of nicotine because e -cigarette users are consuming it intentionally. Nicotine, when it
does not involve smoking, is very low risk and has not been clearly shown to cause any disease. However, like caffeine and
other common indulgences, it may cause some tiny risk of heart attack and stroke, and so e -cigarettes, along with other
tobacco and nicotine products, are probably not risk-free. If there is any risk from nicotine, however, it is so low that it is
similar to everyday hazards like drinking coffee or eating dessert, and is far less than the risk from smoking.
http://blog.casaa.org/2013/08/new-study-confirms-that-chemicals-in.html
You can read the full study by Dr Berstyn here: http://www.biomedcentral.com/1471-2458/14/18/
The following excepts are from Dr. Berstyn's paper:
There was no evidence of potential for exposures of e -cigarette users to contaminants that are associated with risk to
health at a level that would warrant attention if it were an involuntary workplace exposures.
By the standards of occupational hygiene, current data do not indicate that exposures to vapers from contaminants in
electronic cigarettes warrant a concern. There are no known toxicological synergies among compounds in the aerosol, and
mixture of the contaminants does not pose a risk to health.
In this next section he refers to TSNA which stands for tobacco -specific nitrosamines. He also mentions Nicotine
Replacement Therapy NRT which includes gum, inhalers, lozenges, nasal spray, and patches.
A better understanding about the sources of TSNA in the aerosol may be of some interest as well, but all results to date
consistently indicate quantities that are of no more concern than TSNA in smokeless tobacco or nicotine replacement
therapy (NRT) products.
Page 1 of 3
P. Foland: 509-307-5868
The cautions about propylene glycol and glycerin apply only to the exposure experienced by the vapers themselves.
Exposure of bystanders to the listed ingredients, let alone the contaminants, does not warrant a concern as the exposure is
likely to be orders of magnitude lower than exposure experienced by vapers.
Dr Berstyn also goes on to report about his concerns with the validity of previous reports of high levels of acrolein and
formaldehyde. He said in one study they admitted the "atomizer, generating high concentration carbonyls, had been
burned black". He also stated that "In unpublished work, there are individual values of formaldehyde, acro -Zein and
gly-ox-al that approach TLV [Threshold Limit Values], but it is uncertain how typical these are because there is reason to
believe the liquid was overheated..." These are just some of the examples of observations in his study that
demonstrates the inaccuracy of information that has been circulated to the public since product inception.
In reference to the claim by the American Lung Association that toxic cancer-causing chemicals were found:
The frequently stated concern about contamination of the liquid by a nontrivial quantity of ethylene glycol or diethylene
glycol remains based on a single sample of an early -technology product (and even this did not rise to the level of health
concern) and has not been replicated.
The following is from the CASSA website:
Quote Independent Tabs extensively tested other electronic cigarettes and found no evidence of diethylene glycol, the toxic
component of anti -freeze claimed to have been found in the brands the FDA tested. To further the confusion, electronic
cigarette liquid is made of propylene glycol, an ingredient recognized as safe for human consumption by the FDA. While
propylene glycol is sometimes used in anti -freeze, it is an additive intended to make it LESS harmful if accidentally
swallowed. The FDA tested just 18 cartridges, from only two companies. Out of those 18, just one tested positive for "about
1% diethylene glycol." Because so many other tests failed to find diethylene glycol, many experts conclude that the single
sample may have been contaminated in some other way. By no means is it considered a standard ingredient in electronic
cigarettes.
http://casaa.org/uploads/8 Biggest Electronic Cigarette_Myths.pdf
The following information is on the vape-ranks.com website regarding the main ingredient Propylene glycol:
... PG is recognized as safe for human consumption by the FDA, and can be found in a variety of food additives and
colorants, pharmaceutical inhalers or toothpaste. Propylene glycol is safe, non-toxic and environmentally friendly.
http://vaperanks.com/do-e-cigarettes-really-contain-antifreeze/
The second main ingredient is called Vegetable Glycerin and it is used in food applications and is USP grade.
The following is from the website for the American Council on Science and Health (ACSH).
Anti-cancer groups like the American Cancer Society and the American Heart Society have blasted the devices, but Dr.
Elizabeth Whelan President of the American Council on Science and Health asks, "why are they against it? Because it looks
like a cigarette? Because smokers get a nicotine high? ... My message to anyone who knows a cigarette smoker is to
introduce him or her to e -cigarettes immediately." "They're a clean nicotine delivery device," she says. "You're not going
to be hurt by the nicotine."
http://acsh.org/2013/03/e-cig-support-from-new-sources/
I could also provide countless studies that show nicotine is not harmful but I will just quote one from
tobaccoharmreduction.com
Keep in mind the saying from toxicology: "The dose makes the poison." Enough of anything, delivered fast enough, is deadly
(including food or water). For many medicines you have on your shelf, ingesting the entire bottle at once would be deadly.
In any case, it is best to go back to the scientific evidence. Long term users of nicotine who do not smoke (ST users) suffer
few ill effects from their habits, as we describe above. If nicotine were deadly, we would expect to see a lot of these people
die prematurely. We do not see that.
http://www.tobaccoharmreduction.org/faq/nicotine.htm
Page 2 of 3
P. Foland: 509-307-5868
I invite you to go online and watch a video linked on the handout of the demonstration from last Saturday in Olympia
where members of the House of Representatives stood on the steps of the Capitol and commended the efforts of all
ecigarette users and businesses. This included House Representative J.T. Wilcox from Yelm WA, Graham Hunt from
Orting, Chris Reykdal from Olympia, and Dick Muri from Steilacoom.
https://www.youtube.com/watch?v=zBbythUV1zE
If fact Representative Muri said we are "doing God's work". He went on to say the government has spent millions of
dollars over the years trying to get people to quit smoking and we are doing it for free. What he means is that this
industry has flourished by word of mouth and people helping each other to quit smoking. He also said that the savings
in healthcare from smoking related illnesses will save the state millions.
Another report from the American Association of Public Health Physicians speaks of Harm Reduction:
Smokers who have tried, but failed to quit using medical guidance and pharmaceutical products, and smokers unable or
uninterested in quitting should consider switching to a less hazardous smoke-free tobacco/nicotine product for as long as
they feel the need for such a product. Such products include pharmaceutical Nicotine Replacement Therapy (NRT) products
used, off -Zabel, on a long term basis;, electronic "e" cigarettes, dissolvables (sticks, strips and orbs), snus, other forms of
moist snuff, and chewing tobacco.
http://www.aaphp.org/Tobacco
An article on the economist.com website reads:
E -cigarettes do not just save the lives of smokers: they bring other benefits too. Unlike cigarettes, they do not damage the
health of bystanders. They do not even smell that bad, so there is no public nuisance, let alone hazard, and thus no reason
to ban their use in public places. Pubs and restaurants should welcome them with open arms. The right approach is not to
denormalise smoking, but to normalise e -smoking. Those who enjoy nicotine will be able to continue to use it, while
everyone else will be spared both the public-health consequences of smoking and the nuisance of other people's smoke.
What's not to like?
http://www.economist.com/news/leaders/21573986-world-should-welcome-electronic-cigarette-no-smoke-why-fire
Lastly, the following statement is by Dr. Gilbert Ross also with the American Council on Science and Health. He is
speaking about the recent European Union regulatory program for ecigarettes.
E -cigarettes have absolutely nothing in them that may harm anyone, so restrictions make absolutely no sense and will serve
only to scare those 44 million addicted smokers from turning to a device that can save their lives. Furthermore, the level of
nicotine now allowed in e -cigarettes in Europe will make these devices completely inadequate for medium and heavy
smokers, thereby defeating the purpose of e -cigarettes as a method of tobacco harm reduction. The EU might as well be
telling those addicted smokers to keep on smoking. So no, the FDA should not use the EU as an example when deciding on
e -cigarette regulation. Instead, they should use sound science to promote public health.
http://acsh.org/2014/03/ny-times-editorial-board-gets-wrong-eu-e-cigarette-regulations/
Page 3 of 3
P. Foland: 509-307-5868
aa f
Distributed at thei
Meeting 3-I (-14 (f
posted on February 23, 2014 by Joel Nitzkin
Response to ANR Fact Sheet: Electronic
Cigarettes and Secondary Aerosol
This note is in response to the so-called "fact sheet" entitled "Electronic Cigarettes and
Secondhand Aerosol" produced by Americans for Nonsmokers Rights (ANR) February 20, 2014
[1] in anticipation of a legislative hearing in the City of Los Angeles scheduled for February 24,
2014.
This note urges state and local legislatures not to ban e -cigarette use in no -smoking areas. Such a
ban will do nothing to protect bystanders. It will do nothing to promote cessation of smoking. It
would, however, potentially damage the health of the public by conveying a false impression that
e -cigarettes are as hazardous as combustible cigarettes, and, by that means, prevent some
inveterate smokers from switching to these far -less -hazardous products.
As a public health physician and long-term supporter of ANR, I am appalled at the inaccurate
and distorted presentation of the hazards posed by e -cigarettes to bystanders in indoor.
environments in this diatribe against e -cigarettes. This paper, unworthy of support by any health
related organization, is based on unfounded speculation, laboratory studies bearing no
relationship to real-life exposure, and presentation of the vapor inhaled by e -cigarette users as if
it were the vapor in indoor air exhaled by e -cigarette users. This paper does not reference the
now -extensive literature documenting real-life exposure to e -cigarettes by both users and
bystanders. It does not reference the trace quantities of organic chemicals exhaled by persons
who are neither smoking nor vaping. It does not present a single review or case report alleging
illness in an_e-cigarette user or in a bystander due to use or exposure to exhaled e -cigarette vapor,
If ANR was truly concerned about exposure of bystanders to exhaled nicotine in any form, it
could have and should have recommended prohibition of pharmaceutical nicotine vaporizers in
no -smoking areas many years ago. The fact that it has not raises serious questions as to why
ANR is recommending that e -cigarette use be banned in non-smoking areas at this time.
E -Cigarettes — A Public Health Perspective
ANR , and other opponents of e -cigarettes like to frame the e -cigarette debate in terms of the
health of the public v. evil and greedy tobacco companies intent on addicting teens to their
deadly products. While socially and politically correct in some public health circles, there a very
different public health perspective that should be considered.
Despite decades of tobacco control programming, there are still about 46 million smokers and
cigarette smoking causes an estimated 480,000 deaths per year in the United States._[)
Furthermore, the numbers of smokers and smoking -attributable deaths in the United States has
been essentially stable since 2004.13],14]
Given the 15-20 year delay between initiation of smoking and onset of potentially fatal smoking -
attributable illness, the vast majority of the 9,600,000 Americans who will die of a smoking -
attributable illness in the next 20 years (480,000 deaths per year x 20 years) are currently adult
American Smokers currently over 35 years of age. Tobacco harm reduction, with e -cigarettes as
a harm reduction modality, currently appears to be the only feasible policy option likely to
substantially reduce tobacco related illness and and death over the next 20 years. A THR
initiative, as an addition to current tobacco control programming would consist of informing
current smokers who are unable or unwilling to quit that they could reduce their risk of tobacco -
attributable illness and death by 98% or better by switching to a smokeless tobacco option or e -
cigarettes. A more complete and well referenced discussion of this topic can be found on the R
Street web site. [51
If the goal of ANR is to reduce tobacco -attributable illness and death, it should carefully consider
the potential benefits of e -cigarettes and realistically appraise their potential harms, as compared
to the pharmaceutical nicotine inhalers that ANR apparently endorses.
Hazards Posed by Environmental Tobacco Smoke
I, and many other public health physicians, have long supported ANR because of the hazard to
bystanders presented by environmental tobacco smoke. Tobacco smoke is a witch's brew of
toxic chemical substances from the incomplete combustion of tobacco:
About 85% of environmental tobacco smoke is sidestream smoke that curls off the end ora
cigarette when no-one is puffing on it. E -cigarettes have no sidestream smoke.;
ETS increases the risk of lung cancer and other cancers; heart and lung disease; the risk of low
birth weight; and is suspected of increasing the risk of birth defects. CDC estimates that
approximately 49,000 non-smokers die in the United States from exposure. [41
Hazards (if any) Posed by E -cigarettes to Bystanders
[E -cigarettes have no products of combustion. Nothing curls off the end of an e -cigarette when
ino-one is puffing on it. The mainstream vapor exhaled by the user includes only the tiniest traces
of chemical contaminants.
A number of studies have been very recently published dealing with the concentration of organic
;chemicals in exhaled e -cigarette vapor. Basically, these studies show that when the e -cigarette
user exhales into a glass tube or similar container, trace quantities of a variety of organic;
chemicals can be detected, but, when in an 8 cubic meter test chamber or similar room, for a half
hour or more, e -cigarette use does not measurably increase the trace quantities of these chemical!
substances above background levels, while cigarettes cause dramatic rapid increases. Perhaps the
most interesting finding in these studies is that persons not using any form of tobacco routinely
exhale trace amounts of acetone, ethane, pentane and isoprene and other endogenous volatile`
!organic compounds: [9], [ 101, [ 111, f12]
s
Review of Allegations in the ANR February 2014 E -Cigarette Paperf jj
"E -cigarette aerosol is made up of a high concentration of ultrafine particles, and the particle
concentration is higher than in conventional tobacco cigarette smoke." This allegation is based
on a recently published paper by Fuoco et al consisting of a laboratory analysis of machine -
generated mainstream (not exhaled) e -cigarette vapor, with multiple mathematical corrections,
bearing no relationship to the vapor that might be exhaled by a real live human e -cigarette user.
"Exposure to fine and ultrafine particles may exacerbate respiratory ailments like asthma, and
constrict arteries which could trigger a heart attack." This is based on a literature review by
Grana, et al, speculating on illness and symptoms that might be caused by similar particulate
matter far higher in concentration than could ever be expected from inhaled or exhaled e -
cigarette vapor.
Regarding "10 chemicals in e -cigarette aerosol" — the data in the Goniewicz paper show the,
concentrations in indoor air as so small that they are not measurable above baseline. The _ _
Goniewicz paper concluded that levels of toxicants were similar to the reference pharmaceutical)
nicotine inhaler. The Williams paper deals only with vapor as inhaled by the user, with no;
reference to metals in exhaled vapor.,
Regarding propylene glycol — while inhaled e -cigarette vapor can cause throat irritation in e -
cigarette users, the tiny amounts of propylene glycol in exhaled vapor is unlikely to be noticed
by bystanders. The references quoted to justify this statement reflect industrial concentrations of
propylene glycol and consistent long term exposure. The reference quoted relative to degradation
of propylene glycol producing small amounts of a carcinogen deals with "heat degradation
studies of solar heat transfer fluids."
The reference to metals in e -cigarette aerosol, as noted above, related only to the vapor inhaled
by the user, not exhaled e -cigarette vapor.
The reference to nitrosamines and dietyhylene glycol in e -cigarette vapor are from the same 200
analysis, reflecting the vapor inhaled by the user, not exhaled vapor, making no comparison to
the FDA approved nicotine inhalers, and, in one of 20 samples, detecting a trace of diethylene
glycol so small, that the e -cigarette user would have to use the e -cigarette equivalent of 1,500
cigarettes in a single day to reach the minimal toxic dose!
Regarding nicotine exposure — yes, e -cigarettes are designed to deliver nicotine, and traces of
nicotine are exhaled. There is no reference to any bystander ever being harmed by such nicotine
exposure from cigarettes or e -cigarettes. It is also important to note that nicotine is routinely
consumed in trace amounts in tomatoes, eggplants and other vegetables, with no known adverse
consequences'
Allegations of respiratory distress and other ill effects are theoretical speculations based on
exposures far in excess of those to be expected from e -cigarette use.
In conclusion, there is no public health justification for banning e -cigarette use in no -
smoking areas. Such bans will be harmful to the health of the public to the extent that they
suggest that e -cigarettes may be as hazardous as combustible cigarettes, and, by that
means, inhibit inveterate smokers from switching to these far lower risk nicotine delivery
products.
Dr. Joel Nitzkin is public health physician. He has been a local health director, a state health
director and President of two national public health organizations.
He has been involved with tobacco control since the late 1970's. From early 2007 through mid -
2010, he served as Co-chair of the Tobacco Control Task Force of the American Association of
Public Health Physicians. During that period, when the Tobacco Control Act was making its way
through Congress, he, and his AAPHP colleagues decided to do our own independent literature
review to determine the best way for the USA to reduce tobacco -attributable addiction, illness
and death. It was that literature review that drew our attention to tobacco harm reduction as the
most promising of public health interventions, and to e -cigarettes as possibly the most promising
of tobacco harm reduction modalities.
The views expressed herein are entirely his own, they do not reflect position statements formally
adopted by AAPHP, R Street or any other organization he is affiliated with. Neither Nitzkin nor
AAPHP have ever received any financial support from any tobacco, e -cigarette or
pharmaceutical enterprise. Dissemination of this statement is supported by the R Street Institute,
a Washington -DC based libertarian think tank that respects the role of government in regulating
industry to protect health and the environment, but strongly opposes undue governmental
interference with market forces. R Street designated tobacco harm reduction as one of their
priority issues after FDA attempted to remove e -cigarettes from the market by declaring them to
be an unapproved drug -device combination subject to the provisions of the drug law.
Additional bibliographic references dealing with these and other issues are available on request
from Dr. Nitzkin at jlnitzkin@gmail.com
References
1. Americans for Nonsmokers' Rights, 2014, Feb, Electronic (e-) Cigarettes and Secondhand
Aerosol < http://no-smoke.org/pdf/ecigarette-secondhand-aerosol.pdf5 (Accessed 21 February
2014).
2. Office of the Surgeon General U. The health consequences of smoking – 50 years of progress,
2014.
3. Centers for Disease Control and Prevention, 2013, 1/August, Tobacco -Related Mortality, in
CDC Fact Sheet -Tobacco Related Mortality Smoking and Tobacco Use o.
4. Centers for Disease Control and Prevention, 2008, 14 November, Smoking -Attributable
Mortality, Years of Potential Life Lost, and Productivity Losses — United States, 2000-2004.
Morbidity and Mortality Weekly Report;57(45) <> (Accessed 26 September 2010).
5. Nitzkin JL, 2013, November, R Street Policy Study No. 11: The Promise of e -Cigarettes for
Tobacco Harm Reduction (Accessed 21 February 2014).
6. Schripp T, Markewitz D, Uhde E, Salthammer T. Does e -cigarette consumption cause passive
vaping? Indoor Air 2013;23:25-31.
7. Czogala J, Goniewicz M, Fidelus B, Zielinska-Danch W, Travers M, Sobczak A. Secondhand
exposure to vapors from electronic cigarettes. Nicotine & Tobacco Research 2013.
8. Romagna G, Zabarini L, Barbiero L, Bocchietto E, Todeschi S, Caravati E et al.
Characterization of chemicals released to the environment by electronic cigarettes use
(ClearStream-AIR project): Is passive vaping a reality? 14th Annual Meeting of the Society for
Research on Nicotine and Tobacco. Helsinki, Finland, 1/Sep, 2012.
9. Larstad M, Toren K, Blake B, Olin AC. Determination of ethane, pentane and isoprene in
exhaled air — effects of breath-holding, flow rate and purified air. Acta Physiol (Oxf) 2007
Jan;189(1):87-9.
10. Smith D, Spanel P, Enderby B, Lenney W, Turner C, Davies J, 2010, Isoprene Levels in the
Exhaled Breath of 200 Healthy Pupils Within the Age Range 7-18 Years Studied Using SIFT -
MS. Journal of Breath Research;4(1) (Accessed 8Dec2013).
11. King J, Koc H, Unterkofler K, Mochalski P, Kupferthaler AT G, Teschl S et al. Physiological
modeling of isoprene dynamics in exhaled breath. J Theor Biol 2010 21/Dec;267(4):626-37.
12. King J, Kupferthaler A, Frauscher B, Hackner H, Unterkofler K, Teschl G et al., 2012,
Measurement of Endogenous Acetone and Isoprene in Exhaled Breath During Sleep. Physiol
Meas;33(3) (Accessed 8Dec2013).