California E-Cigarette Bill Not Based On Evidence

Electronic cigarettes, commonly known as e-cigarettes, are battery-powered devices that vaporize liquid solutions containing nicotine and sometimes additives for flavors. Unlike cigarettes, no combustion is involved and only vapors are emitted. Research has suggested that many individuals currently use the smokeless devices to assist in smoking cessation.

To date, there has been limited research examining the health effects of e-cigarette use. While some studies have been done and found effects on the pulmonary system, research has focused primarily on acute effects. A June 2012 peer-reviewed study examined the acute effects of e-cigarette use on breathing resistance–a measure of respiratory inflammation. Relative to controls, study participants who used an e-cigarette device were found to have slightly higher lung resistance. The study found that there were “immediate adverse physiologic effects after short-term use that are similar to some of the effects seen with tobacco smoking.” However, the study authors cautioned “that although the differences within our study are of statistical significance, the clinical changes may be too small to be of major clinical importance,” and encouraged long-term research. They also suggested that “it is possible that if e-cigarette use were a short-term bridge to smoking cessation, the long-term health benefits associated with their use might outweight the short-term risks.”

Further research into effects on heart function prompted one researcher to state that “laboratory analyses indicate that it is significantly less toxic and our study has shown no significant defects in cardiac function after acute use.” Research on secondhand exposure to e-cigarettes has been even more limited. In contrast, there exists extensive evidence that cigarette smoking not only is associated with a litany of negative health outcomes, but that secondhand exposure can be harmful to others. In brief, there is still significant research that needs to be done to discern what the long-term health consequences are, and how extensively electronic cigarettes impair health functions in the short-term.

Currently, California does not have laws as to where an individual may use e-cigarettes. Restrictions on where an individual can smoke are presumably grounded in this empirical research.

Senate Bill 648, sponsored by Senator Ellen Corbett (D-East Bay) would extend existing restrictions on where cigarettes are smoked to e-cigarettes. Voting in support of the bill means that the State of California “finds and declares that regulation of smoking in the workplace is a matter of statewide interest and concern,” and that as a result, e-cigarettes must be treated the same as cigarettes.

Bill analysis for the Senate Committee on Health summarizes the goal of the bills thusly: “(a) to minimize the use of products that pose unknown health risks particularly unregulated products that deliver drugs such as nicotine to the user; and (b) to prevent confusion in the enforcement of smoke-free laws caused by the perception that e-cigarette smokers are actually smoking conventional cigarettes.”

The bill analysis cites opposition arguments that “electronic cigarettes have not been shown to cause harm to bystanders, and the evidence to date shows that health risk associated with electronic cigarettes is comparable to other smokeless nicotine products…” The only response to these claims are vague concerns over the “potential” negative health effects of e-cigarettes and e-cigarette exposure.

The limited amount of research done seemingly supports the idea that e-cigarette vapor really isn’t a significant risk. A 2012 study in Inhalation Toxicology sought to determine the impact on air quality that “high nicotine e-liquids” had compared to tobacco smoke. The study concluded that “electronic cigarettes produce very small exposures relative to tobacco cigarettes,” and that the study “indicates no apparent risk to human health from e-cigarette emissions based on the compounds analyzed.” A 2013 study published in Tobacco Control studied vapors from 12 brands of e-cigarettes for toxicants and carcinogens found in tobacco smoke. The researchers found that while some toxicants were found in the vapors, “levels of the toxicants were 9-450 times lower than in cigarette smoke” and concluded that “substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants.”

Despite this, the California Senate voted 21-10 anyway to expand cigarette restrictions onto e-cigarettes. The California Assembly is expected to take up the bill when they get back from summer recess in August.

The bill purports to be proactive in restricting the freedom of individuals to engage in what apparently, to the California Senate, “is a matter of statewide interest and concern.” Existing and proposed legislation infringing on the decision making of business owners as to whether or not certain (non-criminal) behaviors (e.g. e-cigarette uses) should be permitted on their property serve only to cheapen the value of law and extend government power into areas of life it doesn’t need to be involved with. Considering the lack of evidence that e-cigarette consumption is a “matter of statewide interest and concern” and that the only available evidence shows that it apparently poses “no apparent risk to human health,” we can only hope that California Assembly members ask themselves: Do we really need this law?