CDC makes case for including e-cigarettes in clean indoor air laws

The CDC published a "State Laws Prohibiting Sales to Minors and Indoor Use of Electronic Nicotine Delivery Systems — United States, November 2014," in MMWR that makes the point (consistent with our paper) that prohibiting sales of e-cigs to youth is a necessary, but not sufficient, step in controlling use and mentions industry interference.  It comments on how industry-favored youth access laws are passing but not state laws integrating e-cigarettes into clean indoor air laws.
 
The CDC makes several important statements (quoted verbatim below, but broken into bullets) that public health authorities can cite to support including e-cigarettes in clean indoor air laws:
 

• Prohibitions on ENDS [electronic nicotine delivery systems, another name for e-cigarettes] use in public places might be beneficial in multiple ways.
• First, prohibitions could preserve clean indoor air because ENDS aerosol can contain harmful and potentially harmful constituents, including nicotine and other toxins, and some ENDS can be modified to deliver marijuana and other psychoactive substances.
• Second, based on the experience that smoke-free policies result in diminished social acceptability of smoking (9), restrictions on ENDS use in public might help support tobacco-free norms.
• Third, such restrictions could support smoke-free law enforcement because some ENDS use can be difficult to distinguish from conventional smoking, thus complicating smoke-free policy enforcement. Accordingly, it is important that efforts to integrate ENDS into smoke-free laws uphold or strengthen, not weaken, existing protections against secondhand smoke exposure.
• Some marketing suggests that ENDS can be used in places where smoking is not allowed or refers customers to advocacy groups that oppose indoor ENDS use prohibitions. These groups contend that ENDS emit fewer toxins than combustible tobacco, and that public use could encourage smokers to switch to ENDS. However, ENDS aerosol is not as safe as clean air. Nicotine is a psychoactive chemical with known harms and irritant effects .
• Research has documented the presence of secondhand nicotine exposure using environmental monitoring and the measurement of biomarkers among exposed nonusers.

 
CDC also discusses other problems contained about e-cigarette marketing and industry activirties.