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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 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 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 ploynenf? 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 No comments: Post a Comment Comment as. Select profile. Lwfuu Publish Preview Links to this post Create a Link Newer Post Horne Older Post Subscribe to: Post Comments (Atom) 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).