Fri Feb 24

Passive vaping – time we see it like secondhand smoke and stand up for the right to clean air

Written by: Renee Bittoun, Conjoint Professor of Nicotine Addiction, Avondale University and, University of Notre Dame Australia

A medical student of mine recently said he loved the smell of vanilla in the house he shared with friends who vaped. “That’s OK, right?” he asked. “Well no,” I said, “If you can smell the vanilla you are probably getting nicotine as well.”

Nicotine ^[1] is colourless and odourless, and is extremely well absorbed through your respiratory tract, including your nose, mouth, airways and even your ears ^[2].

Vapers exhale ^[3] nicotine and chemicals, including the sweet-smelling flavourings. Bystanders ^[4] can then breathe them in. The lung defences of smokers, vapers and bystanders are overwhelmed ^[5] by repeated exposure.

There is a lot of vaping going on ^[6] in young people aged between 18 and 24. Despite a good amount of debate about the health effects of vaping, there is scant discussion ^[7] around the risk of passive vaping and the consequences for the health and wellbeing of non-vapers and their right to inhale clean air.

Breathing out, breathing in

Researchers have examined the content of exhaled vapour from users in confined spaces, like cars ^[9], and larger venues. Although levels were lower than for tobacco cigarettes, they described ^[10] levels of the exhaled toxic substances as “ambient air pollution” that should be avoided to protect the health of non-smokers and non-vapers.

The evidence for the effects of passive vaping on the heart ^[11] is emerging but researchers have compared it to passive smoking, which can clog arteries and cause clotting problems. Publications that demonstrate the harmful respiratory effects ^[12] of passive vaping are growing ^[13].

Australian state laws prohibit vaping in smoke-free areas. Richard Mundl (CTK via AP Images)^[14]

Lessons from passive smoking

In the late 1980s, passive smoking became the impetus to change legislation around tobacco use.

Health professionals had learnt decades earlier from a study of British doctors who smoked that tobacco smoking caused immense harm and early death in smokers ^[16]. But later they began to understand that living with a smoker, working with smokers or having close repeated exposure to someone else’s smoke could cause lung cancer, chronic bronchitis, worsen asthma and heart diseases in a non-smoker ^[17]. The effects of passive smoking on children too were very concerning ^[18].

Advocacy groups began defacing or “refacing” billboard tobacco advertising and ridiculing their advertising. In 1982, I wrote a paper published in the Medical Journal of Australia called A Tracheostomy for the Marlboro Man ^[19] about these efforts, the legal repercussions and the challenges from the tobacco industry.

By the 1990s, people had started suing ^[20] hospitality venues and workplaces for putting them in harms’ way by exposing them to “secondhand smoke”. Successes led to changes in legislation ^[21].

Attitudes ^[22] changed and non-smokers’ rights came to the fore. We were all able to live in a smoke-free environment in Australia for decades.

What does the law say about secondhand vapour?

In Australia, vaping restrictions are in line with laws around smoke-free areas ^[23] and World Health Organization ^[24] recommendations.

For example, New South Wales legislation says ^[25] people cannot use e-cigarettes in smoke-free areas under the Smoke-free Environment Act 2000. These include:

all enclosed public places
within ten metres of children’s play equipment
public swimming pools
spectator areas at sports grounds or other recreational areas used for organised sporting events
public transport stops and platforms, including ferry wharves and taxi ranks
within four metres of a pedestrian access point to a public building
commercial outdoor dining areas
in a car with a child under 16.

Vaping on public transport vehicles such as trains, buses, light rail, ferries is also banned ^[26].

But people are still vaping ^[27] in their homes and other places where it’s permitted. The attitudinal change ^[28] that made tobacco smoking around others socially unacceptable ^[29] is yet to develop.

young person with cloud of smoke or vapour around her head

You can breathe in nicotine and flavourings from others’ vaping. Shutterstock ^[30]

Are smoke-free areas enough?

Though debate continues about vaping, its safety and efficacy as a quitting aid, we cannot wait for years, to see the full effects of passive vaping.

Based on the public health precautionary principle ^[32], today’s challenge is to engage and inform non-vapers, particularly young non-vapers, about their rights to be “vape free”, breathe in clean air and take a stand.