Tuesday, December 03, 2013

New York City Council To Consider Ban on Vaping in Parks Despite Lack of Evidence that This is a Significant Public Health Problem

Tomorrow morning, the New York City Council will hold a public hearing on a proposed ordinance that would ban vaping in public parks, as well as all other places where cigarette smoking is banned. The hearing will take place before the Committee on Health at 10:00 am.

The Rest of the Story

As a strong proponent of comprehensive workplace smoking bans that include bars, restaurants, and even casinos, I have long argued that to justify smoking bans, there must be strong evidence that smoking in the workplace and public places poses a significant hazard to nonsmokers. In fact, years ago, I testified before the New York City Council itself, speaking in support of the City's 100% smoking ban for bars and restaurants. I supported my testimony with abundant scientific evidence of the devastating health effects of secondhand smoke on the lives and health of bar and restaurant workers, including my own studies showing that bar workers face an increased lung cancer risk because of their high levels of secondhand smoke exposure. We even heard from actual bar workers who had suffered severe health effects due to their workplace exposure to tobacco smoke.

So what is the similar scientific evidence that exposure to a vaper in park poses a significant health threat to the public?

A comprehensive articulation of the evidence that vaping in parks poses a health threat to the public is presented on the following web page:

Comprehensive Articulation of Scientific Evidence that Vaping in Parks Poses a Health Risk to the Public

As it turns out, there is currently no evidence that "secondhand vaping" poses any significant health risk to bystanders. And there is certainly no evidence that secondhand vaping in a park poses any significant health threat.

Apparently acknowledging the lack of any scientific evidence that exposure to "secondhand" vapor from electronic cigarettes poses a significant public health problem, supporters of this ordinance have instead justified the proposal on other grounds. Specifically, they argue that the ordinance is necessary to protect children from seeing vapers, because by seeing someone using an electronic cigarette, it might lead a youth to experiment with electronic cigarettes, become addicted to nicotine, go on to become a cigarette smoker, and then suffer the consequences of a lifelong addiction to smoking.

The ordinance itself provides the following justification for its draconian interference with individual freedoms: "The use of electronic cigarette devices in places where smoking is prohibited may increase the social acceptability and appeal of smoking, particularly for youth, potentially undermining the enormous progress that has been made over the years in discouraging smoking, and could send a message to adults and youth that these potentially harmful products are in fact safe."

The ordinance argues that the prohibition on smoking in parks is necessary to "protect youth from observing behaviors that could encourage them to smoke."

City Health Commissioner Dr. Thomas Farley reiterated this same justification, telling the New York Post that electronic cigarettes "may introduce a new generation to nicotine addiction, which could lead to their smoking combustion cigarettes."

The same article notes that Speaker Christine Quinn offered the same justification, supporting the ban on electronic cigarette use in parks because "their use has exploded among kids."

But there are three major problems with this justification for this sweeping ban:

1. There is No Evidence that Electronic Cigarettes are a Gateway to Youth Smoking

First, there is no evidence that electronic cigarette use is leading to smoking addiction among youth. In fact, there is some evidence that this is not the case. Dr. Theodore Wagener and colleagues at the Oklahoma Health Sciences Center surveyed 1300 young college students and were able to find only one youth who initiated nicotine use with electronic cigarettes and went on to become a smoker.

A comprehensive summary of the current evidence that experimentation with electronic cigarettes leads to cigarette smoking among youth is presented on the following web page:

Comprehensive Summary of Current Evidence that E-Cigarette Experimentation Leads to Smoking

As you can see, the amount of evidence that supports the hypothesis that electronic cigarettes are a gateway to smoking is precisely the same as the amount of evidence that electronic cigarette use in public parks poses a threat to the health of nonsmoking bystanders.

2. If the Council Doesn't Want Youth to See People Vaping, Then Why Allow Vaping on Streets, Sidewalks, and Other Places?

If the City Council is serious about protecting youth from seeing someone use an electronic cigarette, then why limit the ban to public parks? Why not also ban vaping on the streets and sidewalks around those parks, and for that matter, on streets and sidewalks throughout the City? To be sure, parks are not the only place where youth see people vaping. If this is such a significant public health problem and there is truly a risk that a substantial proportion of youth are going to become addicted to smoking from seeing vapers in public, then why not simply ban vaping in public, period?

Either the supporters of this ordinance aren't as sincere about their concern for the health of children as they pretend to be, or even they realize that their contention that youth are going to see a vaper and then end up becoming a lifelong smoker is unsupported by any evidence.

3. The Purpose of Smoking Bans is to Protect Nonsmokers, Not to Prevent People from Seeing Smokers

The purpose of smoking bans, and their only justification, is to protect nonsmokers from exposure to the significant hazards associated with tobacco smoke inhalation. If the purpose of these laws were to prevent youth from ever having to see a smoker, then there would be no reason not to simply ban smoking in public. But public health advocates like myself never supported smoking bans on the grounds that the government had a substantial interest in making sure that no  youth ever sees someone smoking. We advocated smoking bans because of the scientific evidence that secondhand smoke kills tens of thousands of people each year.

Why It is Essential that Public Health Legislation Be Supported by Solid Scientific Evidence

If the City Council is concerned that youth might not understand what vapers are doing and may not understand that electronic cigarettes are not safe and should not be used by youth or by nonsmokers, then the Council should implement a public education campaign to achieve this end. In doing so, the Council might direct the Department of Health to emphasize to youth the tremendous hazards of cigarette smoking and explain that so many smokers want to quit that electronic cigarettes have been developed as a way to help them quit. This could be a great opportunity to teach kids how addictive smoking is by pointing out that many smokers can only quit if they use a product that simulates the exact behaviors of smoking.

However, to respond to this issue by enacting a law that is completely unsupported by scientific evidence is not only unjustified, but it undermines the very practice of public health. We in public health pride ourselves on only intervening in personal freedoms when there is scientific justification that such intervention is necessary to respond to a substantial public health problem. And we rely on scientific evidence to determine whether a substantial public health problem exists.

To deviate from this model by banning a behavior simply because we think it might have a particular effect, even though there is no evidence to support that contention, undermines the practice of public health. And it leaves us open to attack when there really is a substantial public health problem to which we need to respond with legislation that interferes with individual behavior.

When I testified at more than 200 city and town council meetings throughout the country in support of 100% smoke-free legislation, I was consistently berated by opponents, who argued that I was simply an anti-smoking zealot and that I would support banning smoking in public places even without evidence that it was a serious public health hazard. That charge was not true. However, by enacting this ordinance, the New York City Council would essentially be demonstrating that our smoke-free legislation opponents were right all along and that our movement is based on zealotry rather than on solid science.

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