Glantz letter to LA City Council supporting their ordinance to include e-cigs in smokefree law

March 3, 2014
 
Mayor Eric Garcetti
Members, Los Angeles City Council
via email
 
Dear Mayor Garcetti and Council Members,
 
I am writing to support pending legislation you are considering that would include e-cigarettes in Los Angeles' current smokefree ordinance.  This is a sensible piece of legislation that mirrors what cities large and small are doing all over the country (and the world).
 
Last December two colleagues at UCSF and I prepared an extensive review of the scientific evidence at the request of the World Health Organization, "Background Paper on E-cigarettes (Electronic Nicotine Delivery Systems)." 
 
While the scientific evidence is still accumulating, there is no question that e-cigarettes pollute the air breathed by bystanders with nicotine, ultrafine particles, volatile organic compounds, and other pollutants and that bystanders take these chemicals into their bodies.  Having spent decades cleaning up the indoor air, there is no reason to reintroduce a new form of indoor air pollution.
 
In particular, it is my understanding that you have been provided with a technical report prepared for the e-cigarette advocacy group CASAA by Igor Burstyn entitled "Peering through the mist" that concludes that "there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces." 
 
The problem with this study is that it employs occupational threshold limit values (TLVs) to evaluate the potential risks posed by various toxins in e-cigarettes.  TLVs are used to assess health effects for occupational chemical exposures that are generally much higher (often orders of magnitude higher) than levels considered acceptable for ambient or population-level exposures. (Employing an occupational standard to evaluate risk to the general population is the same approach to risk assessment as those conducted for secondhand smoke by those affiliated with the tobacco industry decades ago, which also concluded that secondhand tobacco smoke could not produce any adverse health effects.)  TLVs also do not consider exposure to sensitive subgroups, such as people with medical conditions, children and infants, who might be exposed to secondhand e-cigarette emissions, most notably nicotine.  You should not rely on this study as justification for allowing  the citizens of Los Angeles to be involuntarily exposed to e-cigarette pollution.
 
Another common claim is that e-cigarettes are helping people quit smoking and any restriction on where people can use e-cigarettes would undermine this benefit.  The evidence from large population-based studies is just the opposite:  overall e-cigarette use is associated with less quitting cigarettes.  Moreover, even if the claims that e-cigarettes help people quit smoking were true, there is absolutely no evidence that creating e-cigarette zones would interfere with quitting smoking.
 
I am also very concerned about two exceptions in the legislation, one for theatrical productions and another for vaping lounges. 
 
The seemingly minor amendment to exempt theatrical productions will have big effects given the fact that LA is a center for producing television programs and motion pictures, because it will make it legal to use ecigarettes in these venues, which could end up influencing youth all over the world to start using e-cigarettes and begin a life of nicotine addiction.  And the e-cigarette companies have been very aggressive in using Hollywood to promote their products.
 
In terms of vaping lounges, it is important to ensure that all they are selling is e-cigarettes and associated paraphernalia and that they not be allowed to sell food or drinks so as to prevent opening up a serious loophole in the law.  Even better, I suggest that you consider grandfathering existing vaping lounges (as long as they only sell e-cigarettes) and prohibit opening new such businesses.
 
I had the privilege of appearing before the Los Angeles City Council decades ago when it was considering legislation to limit and, eventually, prohibit smoking in workplaces and  public places.  I have to say that the current debate over e-cigarettes makes me feel like I have got in a time machine and returned to the 1980s.  There are calls for "more science" and "protecting rights," pro-tobacco interests are hiring political consultants, running advertisements and placing robocalls and well-organized "vapers' rights" groups are pressuring the Council.
 
The fact is that Los Angeles, like hundreds of other places, saw past the controversy that pro-tobacco forces generated (and today the e-cigarette companies are being taken over by the tobacco industry) and passed its smokefree legislation.  And the public loved it.
 
Now is the time to do the same thing and take the simple step of adding e-cigarettes to your smokefree ordinance.
 
If I can provide any additional information, feel free to contact me.
 
Best wishes,
      
Stanton A. Glantz, PhD
Professor of Medicine
American Legacy Foundation Distinguished Professor of Medicine
Director, Center for Tobacco Control Research and Education