Several research teams have begun to analyze the effect of secondhand vapor, if any, in order to better understand their place in society and acceptance in public places.This question seems of even more importance lately, as more and more counties, cities and now National Parks are banning the use of e-cigarettes, even before examining their secondhand effect.

Effects Of E-Cigarette On Passive Smokers

Variation in product contents, designs and emissions suggests that some produce little toxicant exposure, whereas others may pose greater risks. However, the risks to health appear likely to be far lower than from indoor exposure to tobacco smoke.

E-cigarette use produces a visible vapor that is usually able to be smelled, depending on the flavors and other contents of the fluid. The vapor is discharged into the air only when the user exhales (i.e. there is no sidestream vapor), in contrast to tobacco cigarettes that discharge smoke continuously while kept alight, and when the user exhales.

The emissions discharge water, volatile organic compounds (VOCs) and nicotine into indoor air at levels far lower than found with tobacco cigarettes (Schripp et al., 2013).

Schober et al. (2014) measured levels of potential e-cigarette pollutants in a ventilated room while volunteers consumed e-cigarettes with and without nicotine for two hours and found a change in air quality. The concentration of polycyclic aromatic hydrocarbons (PAH) in the indoor air increased by 20%, while particulate numbers also increased. The authors concluded that exposure to e-cigarette pollutants might be a health concern, as fine and ultrafine particles might be deposited in the lung.

What we know about Secondhand Vapor

There is a limited body of published research on the health effects of ‘second hand’ exposure to e-cigarette vapor. McAuley et al. (2012) assessed indoor air concentrations of common tobacco smoke by-products (VOCs, carbonyls, PAHs, nicotine, TSNAs, and glycols) emitted by generic e-cigarettes using four different high nicotine e-cigarette liquids (‘e-liquids’), and compared the results with those from analysis of tobacco cigarette smoke tests; they then undertook risk analyses based on dilution into a 40 m3 room and standard toxicological data. This assessment revealed no significant risk of harm to human health from e-cigarette emissions. In contrast, the tobacco smoke analyses mostly exceeded risk limits (McAuley et al., 2012). Flouris et al. (2013) exposed healthy volunteers to ‘second hand’ e-cigarette vapor for one hour and found small increases in serum cotinine but no significant changes in lung function.  No studies have been conducted on the impact of longer second-hand exposures, exposures in children or third-hand exposures.

Any risks to health from second hand e-cigarette vapor are likely to be far lower than from exposure to tobacco smoke, given the constituents, their toxicity and exposure times (Burstyn, 2014).

It is important to remember that scientifically you cannot ethically test humans for second-hand exposure; nor is there a way to determine long term effects, since e-cigarettes only hit the market back in 2007. You can, however, analyze the vapor that is emitted in an attempt to determine the potential health effects that may exist.

The overwhelming consensus is that second-hand vapor is not only safer, but some believe that it is even, for all intents and purposes, nonexistent. Varying studies have come up with different benchmarks to analyze vapor, but still most continue to confirm that the aerosol emitted in the action of vaping is not particularly harmful.

Most studies you find will agree, that there is a general benign quality with e-cigarette aerosol, or vapor, especially in the secondhand sense. A January 2014 study, published in BMC Central confirmed these beliefs when examining the idea of second-hand exposure in the workplace and beyond. In their findings, they share that, “There was no evidence of potential for exposures of e-cigarette users to contaminants that are associated with risk to health at a level that would warrant attention.” In fact, they predicted that secondhand exposures would be less than 1% of the threshold limit value that is placed on workplace air quality. While this study sees little harm in vapor, they still advise that more research should be done on first-hand exposure. The researchers conclude by reaffirming the safety of second-hand vapor emission, “Current state of knowledge about the chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns.”

Later in 2014, another study published in the International Journal of Environmental Research and Public Health more specially looked at the phenolic and carbonyl compounds that are found in e-cigarette vapor. Both of these chemical compounds can cause health problems in users who are overexposed to them. However, they do not seem to be a concern for second-hand exposure, finding that, “exhaled e-cigarette aerosol does not increase bystander exposure for phenolics and carbonyls above the levels observed in exhaled breaths of air.”

Another study published in the journal Nicotine & Tobacco Research looked specifically at the effects of secondhand e-cigarette vapor and their findings also suggest that secondhand vapor really shouldn’t be an issue. They actually criticize the idea of outdoor e-cigarette bans stating: “There is a large body of evidence suggesting that e-cigarettes are relatively harmless to the people who use them, making claims about the dangers of second-hand exposure even more spurious — especially in well-ventilated outdoor spaces where people can easily move away from someone using the product.”

E-Cigarette Vapor vs. Tobacco Smoke

e-cigarettes vs tobaccoIn a 2014 study published in the British Journal of Medical Practice researchers from University College London acknowledged the use of electronic cigarettes as replacements for traditional combustible cigarettes, and theorized about the potential benefit for the public health community. The researchers found that “the vapor contains nothing like the concentrations of carcinogens and toxins as cigarette smoke. In fact, toxin concentrations are almost all well below 1/20th that of cigarette smoke.”

In fact, the byproducts that are measured in e-cigarette vapor are across the board minuscule, especially in comparison to traditional cigarettes. Back in 2012, another study looked to determine the effect of e-cigarette vapor on indoor air quality.  “For all byproducts measured, electronic cigarettes produce very small exposures about tobacco cigarettes. The study indicates no apparent risk to human health from e-cigarette emissions based on the compounds analyzed.”

Also, one of the greatest benefits when it comes to cutting back on second-hand emissions is electronic cigarettes do not give off any standing emissions. Dr. Neal Benowitz is an MD and a former member of the FDA’s Tobacco Products Scientific Advisory Committee. He is not a staunch e-cigarette supporter, but he is quick to point out this very important fact. All of the second-hand exposure from e-cigarettes comes from the user’s exhaled breathe, which is, in most cases, considerably less than what was inhaled in the first place. Cigarettes, by contrast, pollute the atmosphere and others’ lungs in a continuous stream. According to Dr. Benowitz, “seventy-five percent of the smoke generated by cigarettes is side stream smoke, and that goes into the environment.” Even if e-cigarette aerosol were as dangerous as cigarette smoke, which we have seen it is nowhere near, just the sheer difference in the amount of emissions would make a huge dent in our overall public health.

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