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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