Snails - Response on Threads Part 4

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CES

optimistic cynic
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Morning Fran and Tibs,

I've heard of ordinances that restrict "dangerous breeds" by not allowing licenses for them, but never one that planned to take the dogs away and destroy them. Cocker spaniels and chihuahuas can be pretty bitey, but you never see them included. hmph. I moslty agree with Katya, it's the people, not the dogs.
 

CES

optimistic cynic
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Jan 25, 2010
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Birmingham, Al
here's what i've been doing on this rainy morning. It's just a draft and i need to let it sit for awhile so that i can come back and see the inevitable typos, lapses in logic, things i've left out and incomplete sentences. But at least it's a start. I also updated my full reference list and sent it out to the people who wanted copies of it.

Please do not include smokeless tobacco products in the proposed campus smoking policy. The proposed changes in the policy do not contribute to the welfare of the student body, faculty or staff of UAB.

The rationale for smoking bans is to protect bystanders from the actions of others. However, no form of smokeless tobacco or vapor products pose any threat to bystanders (Romagna et al, 2012; Etter et al, 2013; Flouris et al., 2013; Schripp et al., 2013; Burstyn, 2014; Tayyarah et al 2014; Geiss et al, 2014), thus the result is restricting the free choice of adults for legal, freely available commercial products. In fact, the state of Alabama defines vapor products as distinct from smoking, and the city of Birmingham has excluded e-cigs from the city smoking ordinance.

Harm reduction:
The harm associated with smoking is due to the smoke from combustion. There is no firsthand or second hand smoke associated with vapor products because there is no combustion. All evidence to date suggests that vapor products are orders of magnitude safer than combustible cigarettes and have negligible risk to either the user or bystanders (Romagna et al, 2012; Etter et al, 2013; Flouris et al., 2013; Schripp et al., 2013; Burstyn, 2014; Tayyarah et al 2014; Geiss et al, 2014).

While electronic cigarettes are consumer products not marketed for smoking cessation, they are frequently used for tobacco harm reduction. These products are least as good, and may be better, than nicotine replacement therapies for long term smoking cessation. Preliminary clinical trials show that first generation electronic cigarettes are at lease as effective as nicotine replacement therapies ( 7-10% long term abstinence; Caponnetto et al., 2014). Other studies with second generation, open systems report 30-80% effectiveness, even among smokers with no intent to quit (Bullen et al, 2010; Siegel et al 2011, Adriaens et al., 2014, Caponnetto et al., 2011 a, Caponnetto et al., 2011b; Caponnetto et al., 2013). Further, there is no requirement for use/inclusion of nicotine, and even the use of nicotine free e-cigs can help reduce cigarette cravings (Bullen et al., 2010; Caponnetto et al., 2013), prevent relapse to smoking, or to reduce snacking on sugary snacks as part of maintaining a healthy diet.

Enforceability:
The smoking policy as it stands is almost impossible to enforce on an open campus that has public streets and walkways, throughout campus. The difficulty in enforcement is compounded by inclusion of smokeless tobacco and vapor products. It is not possible to tell if someone is using snus or tobacco lozenges, and there is no requirement that visible vapor be produced when using vapor products. Even when visible vapor is produced, it is easy to discriminate between vapor (low order, fast dissipation) and smoke.

Further the unintended consequences of further limits on smoking including forcing individuals to stand on sidewalks or in the street. The former has the potential to interfere with pedestrians, the latter to expose people to the risk automobile traffic and inhalation of automobile exhaust. If the purpose is to improve the appearance of UAB rather than improve health, then having smokers huddled on sidewalks and street corners at the edge of university property will be even worse.

Including smokeless tobacco and electronic cigs/vapor products in the proposed campus smoking policy serves no public health protection purpose, restricts choices of lower risk alternatives to smoking, and is unenforceable. In fact, raising barriers to use of an arguably safer alternative to smoking has the potential to harm public health.
 
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