A generation after public health advocates started the fight for a ban on smoking in public places another battle over exposure to cigarette use has commenced. This time the dispute centres not on smoking but on vaping. Proponents of e-cigarettes claim that vaping is safer than smoking, both for the vapers themselves and those around them.
However, Professor Simon Chapman disputes these claims and in the article below cites a range of evidence which demonstrates that both primary and secondary exposure to vaping can pose serious health risks. He argues that therefore vaping should be subject to the same public policy response as tobacco use and banned in public places.
Simon Chapman writes:
Over the 30 years between the time we banned smoking in cinemas, buses and trains and when it was finally banned in all public indoor spaces, we saw many truly bizarre attempts to justify its continuation in offices, then in restaurants and finally in the last bastions, pubs and bars.
Tobacco industry sponsored “courtesy” campaigns told us that smokers would be considerate and not smoke near others. That worked so well. Then it was proposed that the laws of physics did not apply to smoke: it would simply not cross a magic line two metres from the bar so it couldn’t harm bar staff.
Breathing it 2.02 metres away for the rest of us was OK, apparently. Secondhand smoke from very wealthy gamblers in high roller rooms where smoking is sometimes still allowed (as when the Barangaroo casino opens) is not harmful to others. It’s only harmful when it comes from ordinary mortals’ cigarettes, apparently.
Significant toxicological impact
Today we are seeing the same sort of nonsense being rehearsed to twist the arms of state governments to allow vaping in spaces where smoking is banned. Vaping advocates first tried to argue that vape was as benign as exposure to steam in your shower, a sauna or from a kettle. The sometimes massive cumulonimbus-like billows you see blown by vapers consist of yes, water vapour, but also particles and nanoparticles of partially vapourised flavouring chemicals, propylene glycol (PG), nicotine and traces of metals shed from the battery-activated metal heating coil that vapourises this brew.
Despite their small mass, such particles may have significant toxicological impact because of their increased propensity for deep penetration into the pulmonary and cardiovascular systems.
Vaping has only been widespread in some nations for 6-8 years. Chronic respiratory and cardiovascular diseases typically have latency periods of 30 or 40 years between the beginning of exposure to noxious agents and the first clinical signs of disease.
So it is far too soon for anyone to be making calls that any apparent absence of health impacts from active or passive vaping means they are either benign or dangerous.
The recent 680 page door-stopper report on e-cigarettes from the US National Academies of Science, Engineering and Medicine repeatedly describes the extent and quality of the evidence about vaping as scant, immature and often of poor quality.
However, it noted that “there is conclusive evidence that e-cigarette use increases airborne concentrations of particulate matter and nicotine in indoor environments compared with background levels.”
Advice from Dow
The Dow chemical company which makes PG advises “Dow does not support or recommend the use of Dow’s glycols where breathing or human eye contact with the spray mists of these products is likely”. Compared head-to-head, cigarette smoke emits far more of most of these ingredients than does vape from an e-cigarette. But when you get lots of vapers in a room, particle concentrations can build significantly.
When researchers counted particles in the air of 4023 cubic meter room at a vaping convention on six occasions with between 59 and 86 people vaping, particle counts were 125-330 times higher than in the same room when it was empty, with concentrations higher than those recorded in bars where cigarette smoking was allowed.
E-cigarette advocates like to paint folksy scenes of one or two “considerate” vapers having a quiet and discreet vape in the corner of a pub. But occupational health and clean air regulations are not drafted to accommodate a little bit of asbestos or an occasional excess of carbon monoxide.
Public policy needs to deal with the diverse densities of patrons who might vape indoors. If vaping were allowed indoors, would any restrictions apply? Would bar staff be required to limit the number of people vaping, or request or order them to be discreet or “considerate” with their exhalations as with the ineffective approaches that were once made to smokers? Will arguments occur about whether a plume is excessive? How might “clouding” be forbidden? Will airlines allow a maximum of five passengers to vape but not 50? Good luck with all of that.
Vaping advocates also claim that indoor vaping bans will cause former smokers who now vape to go outside, where exposure to sensory cues from exiled cigarette smokers will trigger their relapse back to smoking. This would be all the fault of non-smokers selfishly putting their own health and comfort ahead of vapers and contributing to their exiled stigmatisation.
If e-cigarette emissions were really benign, indoor vaping advocates should take courage and call for vaping to be also allowed in classrooms, crèches, operating theatres and neonatal wards. If they know it’s harmless after just a few years of accumulated often poor evidence, why hold back redressing these heinous attacks on freedoms?
With delightful irony, the 2016 Global Forum on Nicotine held in Warsaw, banned ENDS use by delegates in the conference rooms. The organisers’ plea that delegates in public areas “please be discreet and considerate. Use low powered devices as it helps to keep the amount of vapour created to a minimum” could not have been more revealing.
NSW Health Minister Brad Hazzard tweeted over the weekend that NSW would not be allowing vaping where smoking was banned. This is prudent, responsible health policy that will be very welcomed by the 85% of adults who don’t smoke.