TOBACCO FREE CAMPUS POLICY ON ELECTRONIC CIGARETTES FREQUENTLY

Multnomah County Tobacco Free Campus Policy Email Intro
A PPLICATION AND NOTICE FOR LICENSE TO SELL TOBACCO
A SECTION A — HUMAN NECESSITIES FOODSTUFFS TOBACCO A21

ANNEXURE 1 STANDARD QUANTITIES OF ALCOHOL AND TOBACCO PRODUCTS
COMMONWEALTH OF KENTUCKY CERTIFICATION OF TOBACCO PRODUCT MANUFACTURERS (REVISED
DBPR ABT6014 – DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO

HSE Policy on e-cigarettes

Tobacco Free Campus Policy on Electronic Cigarettes

Frequently Asked Questions – Managers


Q: What is an electronic cigarette?

A: An electronic cigarette, e-cigarette, or ENDS (electronic nicotine delivery system) is a device whose function is to vaporise and deliver to the lungs of the user a chemical mixture typically composed of nicotine, propylene glycol and other chemicals, although some products claim to contain no nicotine. Often designed to look and feel like a cigarette, an e-cigarette usually consists of a battery, a cartridge containing a liquid of nicotine and other chemicals, a heating element and a mouthpiece. When the user draws on the mouthpiece it activates the heating element, which vaporises the liquid, and the vapour is then inhaled.


Q: Are electronic cigarettes safe?

A: At present we cannot say that e-cigarettes are safe. The World Health Organization (WHO) is of the view that the safety of electronic cigarettes has not been scientifically demonstrated and the potential risks they pose for the health of users remain undetermined. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver and it is very difficult for consumers to find out what is actually delivered by the product they have purchased.


Q: Why is the HSE banning the sale of e-cigarettes?

A: The HSE has a legitimate concern that because e-cigarettes resemble ordinary tobacco, their use may promote or re-normalise smoking and make it harder to implement our tobacco free campus policy. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver. At present we cannot say that e-cigarettes are safe; WHO is of the view that the safety of e-cigarettes has not been scientifically demonstrated and the potential risks they pose for the health of users remains undetermined. Manufacturers of oxygen supplies for hospitals have advised the health system that e-cigarettes pose a potential fire hazard in proximity to oxygen sources.


Q: Does the Hospital/Health Service have the authority to enforce such a policy?

A: Yes. The HSE is now updating the National Tobacco Free Campus policy to reflect that in the absence of any regulation, the use of Electronic Cigarettes (e-cigarettes) is not permitted within HSE facilities or on HSE campuses. As and from 1st May 2014, Electronic Cigarettes should not be advertised, promoted or sold in any healthcare establishment. In addition, their use by patients, staff and visitors is prohibited in all healthcare settings and campuses until further notice. The HSE will continue to provide smoking cessation counseling and tobacco dependence treatments to help service users deal with their nicotine dependence and to support quitting. Concern around the growing use of E-Cigarettes is worldwide. A number of states in the US including New York and Los Angeles have banned the use of E-Cigarettes in outdoor areas and a number of countries have banned E-Cigarettes.


Q: What’s in the vapour that they emit?

A: We estimate that there are over 90 types of products on the market and we are unsure of the content of the cartridges in these products and of the vapour. There is no reliable information on product quality for e-cigarettes at this time.





Q: Are non-users at risk from electronic cigarettes?

A: The aerosols produced by various e-cigarette products have been shown to contain large amounts of propylene glycol, nicotine, flavours, tobacco-specific nitrosa­mines, volatile organic compounds, acetone, formaldehyde, acetaldehyde, benzo(a)pyrene and particulate matter, as well as silicate and various metal particles . Several of these constituents are carcinogenic (cancer-causing). Although levels of most substances measured are lower in the mist of electronic cigarettes than in conventional cigarette smoke, they do pollute indoor air. Four of the metals measured (sodium, iron, alumi­nium and nickel) are present at higher levels than those known in cigarette smoke; five others (copper, magne­sium, lead, chromium, manganese) are present in the same amounts; and two (potassium, zinc) at lower levels. Nickel and chromium are carcinogenic, and lead is suspected to be carcinogenic.


Substances emitted into indoor air when electronic cigarette are used may be inhaled by non-users present in the same room. Therefore, adverse health effects for third parties due to second-hand exposure cannot be excluded.


Q: Are electronic cigarettes an effective way to quit smoking?

A: There are no properly conducted scientific studies to prove that e-cigarettes are an effective aid for sustained smoking cessation, or that they have a reliable safety profile over time. A study reported in the Lancet in September 2013 failed to show that e-cigarettes were better than nicotine patches as an aid to smoking cessation. One-third of participants allocated to e-cigarettes in the study reported continued use at 6 months, suggesting that they might have become long-term e-cigarette users .


Q: What should smokers do who wish to quit smoking?

A: Until such time as electronic cigarettes are deemed to be safe and effective by a competent regulatory authority, smokers should be advised to use other forms of properly regulated nicotine replacement therapies and other such medications as advised by their doctor. In addition, they should seek the help of their doctor, pharmacist, dentist or local smoking cessation adviser for advice on how to quit smoking, visit www.quit.ie or call the National Smokers Quitline at 1800 201 203.


Q: How should healthcare establishments deal with electronic cigarettes?

A: Apart from the health risks outlined above, there is a legitimate concern that, because e-cigarettes resemble ordinary cigarettes, their use may promote smoking. Accordingly, they should be prohibited in the same way that tobacco products are. Patients and members of the public should be advised that we cannot say that they are safe and so they may not be used within the bounds of any health service campus.


Q: Can E-Cigarettes be used by service users inside their private cars?

A: No, Use of E-Cigarettes is prohibited in all buildings and grounds owned or leased by the HSE, including in cars that are parked on HSE property.


Q: What is my responsibility as a manager in relation to the use of e-cigarettes?

A: Management responsibilities:

Communicate, support, implement and ensure compliance with the policy
Advise all employees, service users, visitors and contractors to comply with the policy Identify, support and encourage any staff member who is finding it hard to comply with the policy
Ensure that service users and employees are informed of smoking cessation supports available
Keep a record of all incidences of non compliance and complete an incident form if necessary, in line with national and local protocols.

Q: When will the policy come into effect?

A: 1st May 2014

Q: Is the use of e-cigarettes allowed anywhere on campus?

A: No, A designated area may be set aside for use in exceptional circumstances where an in-patient has been assessed and has received an exemption to smoke. The use of e-cigarettes will not be allowed in this designated area or anywhere on campus.


Q: What do I do if I see an employee who is violating the policy?

A: Remind them that the HSE has a Tobacco Free Campus Policy which includes the use of e-cigarettes and that all staff are obliged to comply with it. Ensure that they cease violating the policy forthwith, taking appropriate action as you would with any other breach of an HSE policy. Staff who are finding it difficult to adjust to the policy should meet with their line manager and can be offered support to manage their nicotine dependence through referral to cessation support services and/or their GP. Persistent breaches by employees will result in disciplinary action where appropriate under the Disciplinary Procedure for Employees of the HSE (2007).

Q: What do I do if I see service users violating the policy?

A: Any service user seen violating the policy should be politely advised that the campus is now smoke-free (including use of e-cigarettes) and offered assistance to support them to comply. Ongoing breaches of the policy by service users should be dealt with on a case by case basis by local management.


Q: How will visitors and service users be notified of the banning of e-cigarettes?

A: A communications plan will be deployed in the run up to the implementation date. Various methods of communication will be in place to ensure that visitors and service user are aware of the policy, e.g. media briefings, HSE website update, policy update circulation to GP’s and primary care teams etc. Some TFC signage will also be developed to include the prohibition on e-cigarettes use.


References


1. Tobacco Free Initiative. Questions and answers on electronic cigarettes or electronic nicotine delivery systems (ENDS): World Health Organization; 2013.

2. Katrin Schaller, Linda Ruppert, Sarah Kahnert, Christina Bethke, Urmila Nair, Martina Pötschke-Langer. Electronic Cigarettes–An Overview. Heidelberg: 2013.

3. Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. The Lancet. 2013.






DBPR ABT6020 – DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
DBPR ABT6029 – DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO
ETHNIC SPATIAL SEGREGATION AND TOBACCO CONSUMPTION A MULTILEVEL REPEATED


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