Rhode Island joined 13 other states in prohibiting the use of e-cigarettes and similar vaping devices in most enclosed public spaces after a bill was signed into law by Gov. Gina Raimondo this July. Advocates of this effort cited health concerns that secondhand vapor poses for the general public, said bill co-sponsor and R.I. Senator and Senate Committee on Health and Human Services Chairman Joshua Miller, D-Cranston, Providence.
The legislation — which increases the reach of Rhode Island’s 2005 workplace smoking ban — prohibits the use of e-cigarettes and other vaporizers in spaces including “private businesses, restaurants, most bars (and) public restrooms,” according to the Senate’s press release.
“It has been discussed … whether the impacts of (e-cigarettes) overall was a positive or negative,” Miller said. “A consensus has been reached by those who are both advocates of legislators and health advocates that there’s enough negatives in (e-cigarettes) to warrant further legislation.”
The e-cigarette — a small smoking device that heats up a liquid composed of nicotine and other additives — has been on the market for over ten years but has just recently gained popularity in the past five years, said Jennifer Tidey, professor of behavioral and social sciences and psychiatry and human hehavior. This new technology has been widely utilized as a safer alternative to smoking combustible cigarettes, and many of these users have an end goal of quitting smoking entirely, Tidey added.
However, Tidey notes that while e-cigarettes are “much less risky” than traditional cigarettes, they are not entirely “risk free.”
“I think banning (e-cigarrettes) indoors is appropriate,” Tidey said, noting the lack of sufficient research on the risks of e-cigarette vapor exposure to those who are pregnant, elderly or asthmatic. “When we think about it, we have to think about these special populations who are vulnerable.”
New research — such as in the January “Public Health Consequences of E-Cigarettes” report by the National Academies of Sciences, Engineering and Medicine — indicates there are other toxins present in the use of e-cigarettes. While the quantities of these materials are “mostly” small, there are emissions of propylene glycol, which may damage the respiratory system when inhaled, and e-cigarette vapor contains traces of heavy metals such as nickel and chromium, which are linked to diseases such as cancer, said Professor of Behavioral and Social Sciences and Medicine Jasjit S. Ahluwalia.
Preliminary research has found toxic substances in e-cigarette vapor, Ahluwalia said, adding that Rhode Islands’ e-cigarette bill follows a greater nationwide trend to legally treat e-cigarettes and traditional cigarettes the same way.
In addition to the health risks of e-cigarettes to the general public, there is concern among some experts that e-cigarettes are a “gateway drug” to combustible cigarettes and other drugs, Ahluwalia said. But the evidence for this is mixed, he added. The Food and Drug Administration addressed that concern Wednesday when it sent over 1,300 warning letters and fines to e-cigarette manufacturers demanding that youth sales decline within 60 days, according to a Sept. 12 FDA press release.
Miller considers this growing alarm surrounding youth e-cigarette usage as another reason to keep e-cigarettes out of public places.
Yet Miller admits that enforcing the ban on e-cigarettes is “a little more complicated” than regulating combustible cigarettes, since it is not as easy to identify someone smoking an e-cigarette — which omits a vapor that quickly dissipates. He notes that formally restricting e-cigarettes is an important step nonetheless.
At the Providence Place Mall, the security procedures adhere to the bill’s guidelines.
“We treat (e-cigarettes) just like cigarettes,” said Senior General Manager of Providence Place Mark Dunbar. “We have it on our rules of conduct, and we deal with it accordingly,” adding that a patron using an e-cigarette at Providence Place would be asked to “put it out” or “leave the property” just as they would if they had been using a combustible cigarette.
The use of e-cigarettes continues to be a contentious issue among researchers, Tidey said.
The School of Public Health is currently conducting research on e-cigarette usage as a means of mitigating cigarette addiction — which includes a lab study on adolescent users and studies on long-term smokers with psychiatric disorders and smokers with HIV.
Tidey, while a proponent of the legislation, does warn against conflating e-cigarette users with traditional cigarette smokers. In cases where public spaces may have a designated space to smoke, a user of e-cigarettes with the goal of quitting smoking could have a relapse when exposed to “all the cues” of smoking, she said. E-cigarette users should ideally have their own space, and she added that stigmatizing e-cigarettes must be avoided given their role in kicking cigarette addictions.
