Subject: Clearing the Air About Electronic Cigarettes
Dear Members of the Indianapolis City Council:
I am a professor, tobacco control researcher, and smoke-free air advocate at the Boston University School of Public Health. I am a physician with more than 25 years of experience in the area of tobacco science research. I have published numerous articles on the dangers of secondhand smoke and have testified throughout the nation in support of 100% smoke-free bars and restaurants. I am writing to correct some misinformation that has been circulating about the health risks associated with electronic cigarettes.
At the Rules and Public Policy Committee meeting on April 3rd, several councilmembers asserted that the FDA has detected cancer-causing agents in electronic cigarette vapor, and that therefore, these devices pose a cancer risk to users and potentially, to bystanders as well. This assertion is misleading. The truth is that the FDA detected only trace levels of carcinogens in electronic cigarettes. The level of these carcinogens was comparable to that present in all other nicotine delivery devices, including the nicotine patch and nicotine gum. The reason why products like the nicotine patch and nicotine gum contain trace levels of carcinogens (known as tobacco-specific nitrosamines) is that the nicotine is derived from tobacco, and it is impossible to obtain 100% pure nicotine from this process. There are going to inevitably be trace levels of tobacco-specific nitrosamines.
In fact, the level of carcinogens in electronic cigarettes, as confirmed by the FDA and another laboratory study, was about 1400 times lower than that present in Marlboro cigarettes. And again, it was comparable to the level of carcinogens present in the nicotine patch and nicotine gum. In other words, what the FDA laboratory study confirmed is that electronic cigarettes are much safer than regular cigarettes, that they pose a drastically reduced carcinogenic risk, and that this risk is negligible (it is essentially the same as the risk of getting cancer from nicotine gum or the nicotine patch). Thus, the truth is that electronic cigarettes pose no known cancer risk, either to users or to bystanders.
I have attached my article, published in the Journal of Public Health Policy, which reviews the studies which have assessed the health risks of electronic cigarette use. From a scientific perspective, there simply is no evidence at this time that electronic cigarette use poses any significant risk to nonsmokers.
In my opinion, one of the necessary pre-requisites to enact government regulations that intrude into private business by regulating the conditions within those establishments is that scientific evidence must first be presented that documents a significant hazard. This has simply not been done yet with respect to electronic cigarettes.
Please understand that I am a strong supporter of 100% smoke-free laws and that I fully support the main ordinance, which bans smoking in all workplaces. In fact, I have repeatedly spoken out against the exemptions in the ordinance, although I agree that passing a bill that the Mayor will sign is better than having no protection at all for nonsmoking workers. Nevertheless, I do not see any scientific rationale for including electronic cigarette use in this ordinance.
One thing to remember is that people using electronic cigarettes are those who are trying to quit smoking and to reduce their exposure to tobacco smoke. By banning e-cigarette use in public places, we are essentially forcing these individuals to use them in places where smoking is allowed - possibly designated smoking areas or areas directly outside of bars where smokers congregate. This could expose them to secondhand smoke and to a powerful trigger to resume smoking. The proposed policy could actually have detrimental health effects.
Many thanks for allowing me the opportunity to share this information. Of course, if you have any questions about the science, please do not hesitate to contact me.
Michael Siegel, MD, MPH
Department of Community Health Sciences
Boston University School of Public Health
801 Massachusetts Avenue, 3rd floor
Boston, MA 02118