I sent the following letter this morning.
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Members of the Ohio County Board of Health:
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 Clean Air Regulation's definition of "smoking", and there is zero public health justification for banning usage of these products at tens of thousands of public places in Ohio County.
Also, there is no public health justification for banning smoking at all outdoor property of healthcare facilities or all outdoor property owned by government agencies in Ohio County since smoking at many of these locations poses no health risks to others, walking into or across streets to smoke a cigarette poses public safety risks for smokers (especially patients at healthcare facilities), and because automobiles (which are driven/parked at many outdoor areas of healthcare facilities and government owned property aren't included in the proposed Clean Air Regulation) emit greater levels of air pollution than a cigarette.
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 Board of Health.
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
CASAA.org
http://www.hsph.harvard.edu/centers-institutes/population-development/files/article.jphp.pdf
SEIKATSUEISEI : Vol. 55 (2011) , No. 1 p.59-64
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
Regulations.gov and the American Council on Science and Health.
Once again, please remove e-cigarettes from the definition of "smoking" in the proposed Clean Air Regulation, and eliminate the total ban on outdoor smoking at properties owned by healthcare facilities and government agencies.
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
Executive Director
Smokefree Pennsylvania
1926 Monongahela Avenue
Pittsburgh PA 15218
412-351-5880
smokefree@compuserve.com