NSW vaping ban in smokefree areas may cause more harm than good

Posted by DrMendelsohn on 19 February, 2018

The Australian.JPG

By Colin Mendelsohn
The Australian (paywall)
12:00AM February 20, 2018

The decision to ban vaping in smoke-free and indoor areas in NSW is well-meaning but not evidence-based and may harm public health.

State Health Minister Brad Hazzard intends to protect bystanders from passive exposure to vapour. But a comprehensive review by British government body Public Health England last week concluded that “to date there have been no identified health risks of passive vaping to bystanders”. This is not surprising as most of the 7000 chemicals and toxins in tobacco smoke are released by burning tobacco and are absent from vapour. Those present in vapour are mostly at levels less than 1 per cent of those in tobacco smoke.

Furthermore, unlike smoking, vaping does not release side-stream emissions between puffs. Vapour is expelled by the vaper only after most of the chemicals have already been absorbed. Bystanders are exposed to very low levels of nicotine and other chemicals. Vapour also dissipates much faster from the ambient air than cigarette smoke.

Research has identified very low levels of chemicals in the air from vaping. Studies of vaping in homes found no discernible effect on air quality, and concentrations of vaping chemicals in vape shops were well below occupational exposure limits and nicotine was undetectable.

Second-hand vapour is not entirely risk-free and more research is needed. If there is a negative health effect, it is likely to be very small indeed.

While there is little to be gained from a blanket ban, there are potentially harmful negative consequences of over-regulating vaping. Unnecessary restrictions create a perception that vaping is harmful in the same way as smoking and may discourage smokers from switching to vaping. In fact, Public Health England says vaping poses only a small fraction of the risks of smoking and switching completely to vaping conveys substantial health benefits.

Governments should be promoting vaping as a potentially lifesaving alternative for smokers who are unable to quit. Millions of smokers globally have quit by switching to e-cigarettes. Australia is one of the few OECD countries to effectively ban vaping with nicotine. Opponents argue that vaporisers will be a gateway to smoking among youth, will “renormalise” smoking and may delay quitting. Experience suggests the opposite.

There is no good evidence that e-cigarettes are luring children to smoke. Smoking rates in countries where e-cigarettes are available are continuing to fall. Research suggests it is likely that e-cigarettes are contributing to this rapid decline in smoking.

We need more research, but there is enough scientific evidence available now to make rational decisions. Although there are small and potential risks from vaping, they are far outweighed by the benefits. An estimated 500,000 premature deaths from smoking could be averted in Australia if two in three smokers switch to vaping in the next 10 years.

In the absence of material harm to bystanders, it is hard to see any reasonable justification for government interference. There is an issue of nuisance or etiquette. Some bystanders may find the aerosol annoying, as with strong perfume or body odour. We manage these issues with courtesy and consideration for others — not legislation.

Under British guidelines, the decision whether to allow vaping is left to individual business owners. Managers may choose to limit the use of vaporisers because customers or employees may be annoyed by them. A supermarket may choose to not allow vaping, but a bookshop keen to attract browsers may decide otherwise.

Public health policy should be guided by the best available evidence. A blanket ban on vaping in smoke-free areas is lazy policy and is likely to have unintended harmful consequences.

Colin Mendelsohn is chairman of the Australian Tobacco Harm Reduction Association.

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