Members of the Vestavia Hills City Council:
Since tobacco smoke pollution poses public health risks, I encourage you to ban smoking inside workplaces and public places, and at outdoor public locations near building entrances and where people congregate in close proximity (e.g. service lines, boarding areas, stadia, restaurant serving areas).
But since electronic cigarettes emit no smoke, and since there is no scientific or empirical evidence indicating the electronic cigarettes (e-cigarettes) have ever harmed any of the estimated million users or anyone else, it is inaccurate and disingenuous to include the use of e-cigarettes in the proposed ordinance's definition of "smoking", and there is zero public health justification for banning usage of these products at thousands of public places in Vestavia Hills.
In sharp contrast to indoor smokefree policies/laws (which are largely self enforced because of broad public support), enforcing an e-cigarette usage ban is impossible (since the products can be used discreetly without anyone else knowing) and it is very difficult and expensive to enforce outdoor smoking bans at locations where other people aren't directly exposed to smoke. Enacting unwarranted and unenforceable regulations also would reduce the public credibility of the council.
In 2006, I coauthored a comprehensive scientific report "Tobacco harm reduction: an alternative cessation strategy for inveterate smokers" at
HRJ | Full text | Tobacco harm reduction: an alternative cessation strategy for inveterate smokers and in 2007 the Royal College of Physicians
issued a similar report "Harm reduction in nicotine addiction; Helping people who can't quit" at
http://www.rcplondon.ac.uk/pubs/contents/e226ee0c-ccef-4dba-b62f-86f046371dfb.pdf Epidemiology studies have consistently found that cigarette smoking poses 100 times greater morbidity and mortality risks than use of smokeless tobacco products in the US and Sweden, and the available evidence indicates that all noncombustible tobacco/nicotine products (including e-cigarettes, nicotine gums, lozenges, patches) are also about 99% less hazardous alternatives to cigarettes.
Smokers who switch to smokefree tobacco/nicotine products reduce their health risks nearly as much as smokers who quit all tobacco/nicotine usage, and several million smokers have already switched to smokeless tobacco products, e-cigarettes and/or NRT products. Besides, usage of e-cigarettes or other noncombustible tobacco/nicotine products poses no known risks for nonusers because they emit ZERO smoke.
Approximately one million smokers have quit smoking or sharply reduced their cigarette consumption by switching to or substituting smokefree e-cigarettes. To date, there is no evidence that e-cigarette usage has harmed anyone, which is logical since the products emit a tiny amount of vaporized nicotine (similar to nicotine inhalers that are marketed as smoking cessation aids) and water vapor. Of the dozen plus laboratory tests conducted on e-cigarettes, only one (conducted by the FDA in 2009) found a trace (and well below toxic) level of one so-called toxic chemical in just one of eighteen samples tested, and levels of nitrosamines in e-cigarettes are nearly identical to those in nicotine gums and patches.
http://www.healthnz.co.nz/RuyanCartridgeReport30-Oct-08.pdf
http://www.starscientific.com/404/stepanov tsna in.pdf
http://www.healthnz.co.nz/DublinEcigBenchtopHandout.pdf
http://cdn.johnsoncreeksmokejuice.com/downloads/JCE_GCMS_Report.pdf
http://www.libertystix.com/LibertyStixLabAnalysis072309.pdf
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http://www.hsph.harvard.edu/centers-institutes/population-development/files/article.jphp.pdf
http://www.jstage.jst.go.jp/article/seikatsueisei/55/1/55_59/_article
E-cigarettes also have been found to contain/emit similar or lower levels of nicotine than nicotine gums and lozenges
http://www.healthnz.co.nz/2010 Bullen ECig.pdf
http://www.e-cigarette-forum.com/fo...eissenberg-study-vindicates-e-cigarettes.html
This indicates that e-cigarettes emit enough to satisfy the cravings of smokers, but may not emit enough nicotine to addict nonsmokers. Several published surveys have confirmed that e-cigarettes satisfy the cravings of smokers, and provide many health benefits to users who switched from cigarettes.
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http://www.biomedcentral.com/content/pdf/1471-2458-10-231.pdf
THR2010. (tobaccoharmreduction.org) (see chapter 9)
Other public health organizations that have extensively studied e-cigarettes have also endorsed their use by smokers, including The American Association of Public Health Physicians
Service Temporarily Unavailable and the American Council on Science and Health.
A Literature Review for Glycerol and Glycols for Entertainment Services & Technology Association also found no health risks to humans
http://tsp.plasa.org/tsp/working_groups/FS/docs/HSE.pdf, while new pharmacology, pharmacokinetic and toxicology studies at
http://www.sciencedirect.com/science/article/pii/S0300483X11002095 found that laboratory animals were not harmed by far greater levels of propylene glycol aerosol than e-cigarettes emit..
Another reason to eliminate e-cigarettes from to proposed smoking ban is that a ban on e-cigarette use is impossible to enforce since the products can be used discreetly without anyone else knowing). By simply waiting three seconds after inhaling and before exhaling, there is no visible or otherwise detectable vapor. Nobody can even tell if a person is using an e-cigarette or simply holding a pen (which look like most e-cigarettes) to their mouth. Enacting an unwarranted and unenforceable e-cigarette usage ban would reduce the public credibility of the Indianapolis/Marian County Council.
Many published surveys have confirmed that e-cigarettes provide many health benefits to smokers by satisfying their cravings and by helping many smokers quit and/or sharply reduce cigarette consumption. Also, there are no known cases of any youth or nonsmoker becoming a daily user of e-cigarettes.
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http://www.biomedcentral.com/content/pdf/1471-2458-10-231.pdf
THR2010. (tobaccoharmreduction.org) (see chapter 9)
http://ectoh.org/documents/3B.5 Ett...ation satisfaction and perceived efficacy.pdf
http://www.ajpmonline.org/webfiles/images/journals/AMEPRE/AMEPRE3013.pdf
Electronic cigarettes (e-cigs): views of af... [Int J Clin Pract. 2011] - PubMed - NCBI
Electronic Cigarettes
A recently published e-cigarette study at
http://www.casaa.org/news/article.asp?articleID=197&l=a&p= found that 22.5% of participating smokers remained smokefree after 24 weeks and another 32.5% of participants reduced daily cigarette consumption by 50%, including 12.5% who reduced daily cigarette consumption by 80%. A Japanese study similarly found e-cigarettes effective for decreasing cigarette consumption
http://www.jstage.jst.go.jp/article/seikatsueisei/55/1/55_59/_article, while a recent case study found e-cigarettes effective for smoking cessation among depressed patients
IJCM_Medicine & Healthcare_Journal_SCIRP.
Other public health organizations that have extensively studied e-cigarettes have also endorsed their use by smokers, including The American Association of Public Health Physicians
Service Temporarily Unavailable and the American Council on Science and Health
Blog. Former FDA Commissioner David Kessler has also acknowledged the benefits of smokeless tobacco, dissolvables and e-cigarettes as less hazardous alternatives for cigarette smokers at
http://www.westport-news.com/busine...-Commissioner-talks-about-tobacco-1735433.php by stating "there's no doubt that in terms of risk of death there are some advantages to that substitution."
Former FDA Commissioner David Kessler has also acknowledged the benefits of smokeless tobacco, dissolvables and e-cigarettes as less hazardous alternatives for cigarette smokers at
http://www.westport-news.com/busine...-Commissioner-talks-about-tobacco-1735433.php by stating "there's no doubt that in terms of risk of death there are some advantages to that substitution."
Other public health organizations that have extensively studied e-cigarettes have also endorsed their use by smokers, including The American Association of Public Health Physicians
Service Temporarily Unavailable and the American Council on Science and Health
Blog.
Once again, please remove e-cigarettes from the definition of "smoking" in the proposed smoking ban ordinance.
Since 1990, Smokefree Pennsylvania has advocated public policies to protect people from tobacco smoke pollution, reduce tobacco marketing to youth, increase cigarette tax rates, preserve civil justice remedies for injured smokers, increase funding for smoking prevention and cessation programs, and inform smokers that smokefree tobacco/nicotine products are far less hazardous alternatives to cigarettes. For disclosure, neither Smokefree Pennsylvania nor I have ever received any funding from tobacco, drug or e-cigarette companies or their trade associations.
Sincerely,
William T. Godshall, MPH