Uncertainty and confusion over where electronic cigarettes can and cannot be used has increased in recent months with both members of the public and organisations uncertain how to manage this new phenomenon.  

Just this week a World Health Organization report included a recommendation to ban the use of these devices in workplaces, while elsewhere health organisations have supported the use of electronic cigarettes as an alternative to smoking.

Action on Smoking and Health (ASH) supports regulation of electronic cigarettes to ensure they are safe and effective, but we think organisations should be able to form their own policies on whether they can be used indoors. Smoking kills 100,000 people in the UK every year and smokers who switch to electronic cigarettes significantly reduce their health risks.

Electronic cigarettes are growing in popularity and many people say they are using them as a tool to quit smoking. Despite their popularity, it has been reported that over half of UK businesses don’t have a policy on “vaping” in the workplace.

A law to regulate the use of electronic cigarettes in the workplace is unlikely. So organisations need to make clear to staff and customers the approach they are going to take. Any approach should take into account the needs and health of everybody it could affect and consider the relative risks of electronic cigarettes compared to tobacco cigarettes.

What is an electronic cigarette?

Despite the name electronic cigarettes are totally different from cigarettes. Some, but not all, electronic cigarettes have been designed to look and feel like normal cigarettes and this can be confusing.

The most important difference between tobacco cigarettes and electronic cigarettes is that they do not contain or burn tobacco and do not create smoke. It is the inhalation of smoke that causes harm.

Typically an electronic cigarette is a battery powered device which delivers nicotine to the user.

The devices typically contain water and propylene glycol. The propylene glycol helps vaporise the liquid nicotine, so that it evaporates when a user sucks on the device enabling it to be delivered to the person using the electronic cigarette.

Isn’t vaping the same as smoking?

No. Using an electronic cigarette is not the same as smoking. Electronic cigarettes are not covered by smokefree legislation because they don’t produce smoke, which is extremely damaging to health.

Smoking cigarettes leads to many health problems including heart and lung disease, strokes and cancer and also poses a serious threat to non-smokers. In contrast, several studies have found no evidence to suggest that vapour from electronic cigarettes is harmful to bystanders. It will take time to assess the impact of long-term use by electronic cigarette users, however many experts believe that there will be far fewer health implications from electronic cigarettes than from smoking.

Like cigarettes, however, electronic cigarettes do contain nicotine. Although nicotine is a highly addictive substance, it is not usually harmful to health when consumed in low quantities.

In fact smoking tobacco is often called the “dirty needle” of nicotine delivery.

Any policy your organisation creates should take this distinction into account and consider the relative risks and safety of products.

For example, although the BBC has banned electronic cigarettes it is reported that the policy is “based solely on appearance and etiquette, not health and safety”.

Why does my organisation need a policy?

It is the interests of employers and businesses to promote the health and wellbeing of their employees and their service users or customers.

There are over two million regular electronic cigarettes users in Great Britain and the vast majority of these people have either stopped smoking or are trying to stop smoking. As such they are unlikely to be keen to share the same space as smokers and requiring them to do so could undermine their attempts to quit smoking.

However, some people may find vapour from others’ electronic cigarettes annoying or distressing and employers should take into account the needs of all staff and base policies on common sense and courtesy.

Not every organisation needs to take the same approach. Whilst, for example, it might be appropriate to ban electronic cigarettes in a school, in a care home, where adult smokers may find it difficult to go outside to smoke, it might be sensible to consider ‘vaping zones’. Likewise, in bars and restaurants vaping zone could be enforced with ‘‘vaping allowed’ or ‘vaping prohibited’ signs.

Well communicated guidance or policies could also improve employees’ knowledge about smoking and electronic cigarettes and provide an opportunity to signpost staff to stop smoking services.

What should the policy include?

Whilst the content of policy will be determined by the needs of your organisation, its workforce and customers, there are some common components which all policies should cover:

• An explanation of why your organisation has a policy on electronic cigarettes
• A summary of the current evidence
• Where electronic cigarette use will be allowed and why this decision has been taken
• Who the policy will apply to
• When the policy will apply, and in what circumstances
• Which products it will apply to
• In what ways recharging of devices will be permitted or prohibited
• Any exemptions to the rules
• Explanation of any penalties for non-compliance
• Date of when the policy or guidance will be reviewed
• Sign-posting for those looking to quit smoking

How do I go about forming a policy?

Firstly, you should think about who to involve and engage with during the policy making process. This should include all relevant staff, as well as smokers, non-smokers and vapers within your organisation. This will help build a clearer picture of the needs of your employees and customers. 

Next, you should think about the evidence that you will use to help shape the direction of your policy. This might include, ASH’s guidance, Public Health England information or the Faculty of Public Health’s policy statement. 

Thirdly, it is important to consider how you will communicate and enforce your policy. This could include clear signs and instructions to staff.

Finally, it is necessary to plan to review the policy you choose. This should take into account emerging and developing evidence surrounding the long term health effects of the products and the changing needs of your organisation. 

Images courtesy: Nicolas Chinardet, ASH