ELECTRONIC CIGARETTES, HOOKAH AND LOUISVILLE’ S SMOKE-FREE ORDINANCE
Sarah Moyer, MD, MPH & Judah Skolnick, MD
When Louisville enacted its comprehensive Smoke-Free ordinance in 2008, it was one of the strongest such laws in the country. Although we were once the home of big tobacco, we took a legal stand and prohibited smoking in all indoor public places and worksites.
Since that time, however, new products have come on the market, notably electronic cigarettes and hookah. These products pose new health dangers to non-users from secondhand exposure in public places. Their increasing use, particularly among young people, also threatens to reverse the trends of making nicotine addiction less socially acceptable, and that of falling smoking rates.
Electronic cigarettes( also known as electronic nicotine delivery systems, electronic smoking devices, e-cigarettes, e-cigs, vape pens) are battery-powered devices that provide aerosolized doses of nicotine and other additives to the user. The devices are metal or plastic tubes that contain a cartridge filled with a liquid that is vaporized by a heating element.
While manufacturers and sellers often claim that these products emit a“ harmless water vapor” the fact is that the secondhand aerosol from electronic cigarettes contains nicotine, propylene glycol, formaldehyde, ultrafine metal and silicate particles, and toxicants that are known to cause cancer. Other toxicants in electronic cigarettes include diacetyl, a chemical linked to serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin and lead. Studies have also found increased dynamic pulmonary airway resistance in e-cigarette users. Several e-cigarette refill fluids were shown to be cytotoxic to pulmonary fibroblasts, human embryonic stem cells and mouse neural stem cells.
Electronic cigarette use in public places can have serious adverse health consequences to non-users. A Federal Food and Drug Administration( FDA) analysis found that almost one-third of adverse-event reports from e-cigarettes were related to secondhand exposure. The researchers examined the 90 adverse-event reports submitted to the FDA from January 1, 2012 to June 30, 2014. Of these, 33 were related to non-users.
Similarly, hookah smoking in public places also poses a health danger from secondhand inhalation to non-users, including employees.
A hookah is a single or multi-stemmed instrument for vaporizing and smoking flavored tobacco or herbs called shisha in which the vapor or smoke is passed through a water basin before inhalation.
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