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- Electronic nicotine delivery devices
- Secondhand smoke
- Non-cigarette tobacco products
- Public policy
While some early examples of smoke-free policy were introduced because of community preferences for clean indoor air and fire safety, smoke-free policy today is predicated on a large body of evidence that has accumulated since the early 1970s about harm to others from secondhand smoke.1 ,2 In contrast, those advocating for vaping to be allowed in smoke-free public places centre their case on gossamer-thin evidence that vaping emissions are all but benign and therefore pose negligible risks to others akin to inhaling steam from showers, kettles or saunas.3
Not just water vapour
This is likely to be baseless. Unlike vapourised water, electronic nicotine delivery system (ENDS) emissions comprise nicotine, carbonyls, metals, organic volatile compounds, besides particulate matter,4 and putative carcinogenic polycyclic aromatic hydrocarbon.5 ,6 Moreover, the high concentrations of nanoparticles in vape, despite their small mass, may have significant toxicological impact.7 This is likely due to their increased ability for deep penetration into the pulmonary and cardiovascular systems.5
Importantly, the short time span since the advent of ENDS and the latency of candidate respiratory and cardiovascular diseases that may be caused or exacerbated by ambient exposure to ENDS emissions preclude definitive risk inference.7 Taking the current immature evidence as a proof of safety and using it to advocate for policy that allows ENDS indoors could prove reckless.
Recent reports of rapid-onset changes in aortic stiffness after exposure to vape,8 of mice exposed to vape with nicotine developing features of chronic obstructive pulmonary disease9 and a 2014 report of increases in fractional …
Contributors All three authors contributed to writing the paper.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.