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Canadian Journal of Public Health

, Volume 106, Issue 8, pp e467–e469 | Cite as

Victimless vapour? Health care organizations should restrict the use of e-cigarettes

  • Sally T. Bean
  • Maxwell J. Smith
Commentary

Abstract

Electronic cigarettes (e-cigarettes) are battery-powered devices that heat a liquid containing either vegetable glycerin or propylene glycol in combination with nicotine and/or flavours; an aerosol is produced that is inhaled by the user. Health Canada currently prohibits the importation, marketing or selling of e-cigarettes containing nicotine, although they can be easily purchased. Because of the availability of e-cigarettes, patients and visitors to health care organizations (HCOs) are inquiring about their use within and on the grounds of those facilities. We contend that in provinces or municipalities where e-cigarette use has not been restricted, HCOs should develop institutional policies to do so. We argue that the following reasons collectively justify measures to restrict the use of e-cigarettes within HCOs: unknown long-term safety, uncertain effectiveness in harm reduction, the conflict with the mission of HCOs to promote health, the potential negative health impacts on vulnerable patients with a compromised health status, and the risk of re-normalization of smoking. However, because of the rapidly developing evidence base in this area, HCOs should remain responsive to emerging evidence regarding the status of e-cigarettes as an effective harm reduction tool.

Keywords

Public health electronic cigarettes health policy bioethics nicotine 

Résumé

Les cigarettes électroniques sont des dispositifs à piles qui réchauffent un liquide contenant soit de la glycérine végétale, soit du propylèneglycol combinés avec de la nicotine et/ou des arômes; le dispositif produit un aérosol qui est inhalé par l’utilisateur. Santé Canada interdit encore l’importation, la commercialisation et la vente des cigarettes électroniques contenant de la nicotine, mais celles-ci s’achètent quand même facilement. En raison de la disponibilité des cigarettes électroniques, les patients et visiteurs des organismes de soins de santé (OSS) s’interrogent sur leur usage à l’intérieur et sur le terrain de ces établissements. Nous soutenons que dans les provinces ou les municipalités où l’usage de la cigarette électronique n’est pas contrôlé, les OSS devraient élaborer des politiques internes pour ce faire. Selon nous, les raisons suivantes justifient collectivement que l’on prenne des mesures pour contrôler l’usage des cigarettes électroniques dans les OSS: leur innocuité inconnue à long terme; leur efficacité incertaine en matière de réduction des méfaits; la contradiction avec la mission des OSS, qui est de promouvoir la santé; les effets sanitaires négatifs possibles sur les patients vulnérables à la santé fragile; et le risque de renormalisation du tabagisme. Cependant, vu l’évolution rapide des fondements scientifiques dans ce domaine, les OSS devraient rester ouverts aux nouvelles données probantes sur le statut de la cigarette électronique comme outil efficace de réduction des méfaits.

Mots Clés

santé publique cigarettes électroniques politique sanitaire bioéthique nicotine 

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Copyright information

© The Canadian Public Health Association 2015

Authors and Affiliations

  1. 1.Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada
  2. 2.Dalla Lana School of Public Health and Joint Centre for BioethicsUniversity of TorontoTorontoCanada
  3. 3.Institute of Health Policy Management and EvaluationUniversity of TorontoTorontoCanada

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