The relationship between smokers and nonsmokers is tenuous at best, adversarial at worst. It has given rise to 50 years’ worth of legislation designed to help the two groups co-exist in public spaces.
That satisfying cigarette after a meal at your favorite restaurant? Play it safe, and adjourn to the parking lot. Squeamish about flying? Light up at 20,000 feet, and you’ll likely get a first class ticket to security upon landing.
If smokers feel like they do not enjoy the same rights as their nonsmoking neighbors, relief may have arrived in the form of an alternative product called an electronic cigarette (e-cigarette). The e-cigarette phenomenon has sparked a new wave of debate among regulatory agencies, health officials and the general public.
Are e-cigarettes healthier than traditional cigarettes? Do they present a secondhand smoke risk to non-users? And how should employers handle e-cigarettes in the workplace? Before we attempt to answer those questions, let’s start with some context.
Calling “big tobacco” to the carpet
In 1964, the U.S. Surgeon General released the first formal recognition by a governmental agency that cigarettes are harmful. Society has been waging a very public assault on “big tobacco” ever since. Here are just a handful of milestones in the war against smoking, courtesy of the American Lung Association (1):
1966 - Health warnings first appear on cigarette packs in response to congressional legislation. The warnings read, “Caution—cigarette smoking may be hazardous to your health.”
1975 - The Minnesota Clean Indoor Air Act becomes the first statewide law that requires separate smoking areas in public places.
1986 - The Surgeon General issues a report officially acknowledging and emphasizing the harmful effects of secondhand smoke.
1989 - Congress bans smoking on all domestic airlines.
1993 - A U.S. Environmental Protection Agency report concludes that secondhand smoke is responsible for approximately 3,000 lung cancer deaths each year in nonsmoking adults and impairs the respiratory health of hundreds of thousands of children.
1999 - The U.S. Department of Justice announces it is suing the tobacco industry under the RICO statute – the same statute used to prosecute the Mafia – claiming the tobacco industry engaged in a “coordinated campaign of fraud and deceit.”
2006 - Judge Kessler releases her final ruling in the U.S. Department of Justice’s federal suit against the tobacco companies. She finds that the tobacco industry lied for 50 years and deceived the American public on health issues and marketing to children.
2014 - Major parts of the Patient Protection and Affordable Care Act are implemented as of Jan. 1, including new health insurance options and requirements that most plans cover quit-smoking treatments as a preventive service.
All of these lawsuits, regulations and public education campaigns appear to be working. In 1964, when the Surgeon General released its report, nearly half of Americans smoked. Today, that number has dropped to 18 percent (2).
The tobacco industry fights back – and thrives
The tobacco industry has not taken its lumps lying down. It has fought back with legal muscle, relentless lobbying and slick marketing campaigns. Evidence of the industry’s longevity is in the numbers (2):
• More than 50 million Americans smoke.
• More than 16 million suffer from a disease caused by smoking.
• Smoking claims 480,000 lives a year.
• Today, tobacco maintains its dubious distinction as the leading cause of preventable disease and death in the world.
What are e-cigarettes?
E-cigarettes are battery-charged devices that turn liquid nicotine into a vapor that users, called “vapers,” inhale. Flavors include the traditional menthol and regular, as well as more palatable flavors like cherry, peach and vanilla. E-cigarettes are shaped like cigarettes, and they emit a white smoke that mimics that of traditional cigarettes.
Some smokers turn to e-cigarettes as a socially acceptable way of lighting up in public. Others rely on them as a safe way to kick their tobacco habit, though a study by the Center for Tobacco Control Research and Education found that use of e-cigarettes was not associated with “greater rates of quitting cigarettes or reduced cigarette consumption” after one year (3).
Whatever your opinion, the e-cigarette trend is unlikely to flame out anytime soon, with sales already reaching $2 billion a year.
Are they safe?
The short answer is it’s too early to tell. E-cigarettes have only been on the market for about seven years. For perspective, it took 50 years to uncover the harmful effects of traditional cigarettes, which include cancer, heart disease, stroke, emphysema, bronchitis and chronic airway obstruction. (2)
What we do know is that e-cigarettes include nicotine, propylene glycol, glycerin and nitrosamines, all of which could adversely affect users.
E-cigarette advocates champion them as safer alternatives to tobacco cigarettes because they do not produce tar. The American Vaping Association website touts testimonials from smokers who used the product to wean themselves off traditional cigarettes. And a study by the Consumer Advocates for Smoke-Free Alternatives Association says e-cigarettes pose no health concerns for the average person. (4)
E-cigarette opponents counter with warnings of dangerous chemicals and carcinogens. Bolstering that claim is a recent CDC report that noted calls to poison control centers about the nicotine in e-cigarettes rose dramatically in the past several years. More than half the calls involved children under age 5, and about 42 percent involved people age 20 and older. (5)
What are regulators doing about it?
E-cigarettes were unregulated until April 2014, when the Federal Drug Administration (FDA) passed a rule extending its jurisdiction over them. Along with the rule, the FDA proposed regulations that would:
• Prohibit anyone under 18 years of age from buying e-cigarettes.
• Ensure e-cigarettes include health warnings and a list of ingredients.
• Ban vending machine sales and free samples.
• Require manufacturers to register with the FDA.
The FDA is allowing a 75-day public comment period on the proposed regulations. The agency will follow up with a final ruling. If passed, the ban on sales to minors will go into effect 30 days from the ruling. Manufacturers will have 24 months to comply with the other regulations. (6)
What can you do?
Only a handful of states that ban smoking at work - New Jersey, Utah and North Dakota - include e-cigarettes in those bans. More than 100 cities forbid "vaping" in public areas where regular smoking is prohibited; however, most of those cities have not outlined how employers should handle the issue. (7)
In the absence of regulatory guidance, some employers have taken a proactive approach. Home Depot, WalMart, Target and General Electric are among the large corporations that treat e-cigarettes the same as traditional cigarettes. (8) If you’re wrestling with whether to follow their lead, follow these tips.
Check local ordinances. Chicago and New York are among a growing list of cities that have passed laws restricting e-cigarette use in public spaces. Find out whether there are local ordinances in place that address e-cigarette use.
Consult an attorney. Similarly, consult an attorney before you implement a vaping policy to ensure you do not violate workers’ rights.
Understand the risks of fires/explosions. An Atlanta woman plugged her e-cigarette into her computer’s USB port to charge. Without warning, the cigarette exploded, shot flames across the room and burned a hole in her rug. Just like any product that plugs into a power source, e-cigarettes present a potential fire hazard. When creating your workplace vaping policy, consider the risks associated with allowing employees to charge e-cigarettes on the premises.
Don’t mix the three elements. Three things must be present for a fire to occur: heat, oxygen and fuel. A recent case in New York City illustrates what can happen when those three things are combined. A hospital patient was on oxygen and puffing on an e-cigarette. Suddenly, a fire erupted, causing second- and third-degree burns across her face and body. Before you allow vapers to light up, find out if there are any flammable elements (fuel) in the atmosphere. For example, oil field workers are surrounded by fumes that, when exposed to an ignition source, could cause a fire.
Consider designated vaping areas. Most vaping liquids contain nicotine, but scientists say e-cigarettes emit far fewer toxins than traditional cigarettes. Still, the jury is out on the effects of secondhand smoke from e-cigarettes. While health officials study the issue, many employers are treating e-cigarettes the same way they treat regular cigarettes. In most workplaces, that means relegating smokers to designated areas. Those areas should be clear of the building and grassy spots that could pose fire hazards.
Enforce the policy fairly and consistently. Employers should enforce all aspects of their safety program fairly and consistently. Rules addressing e-cigarette use are no exception. Everyone, from the president to front-line workers, should comply or face consequences.