- Posted Tuesday July 8, 2014
E-cigarettes are battery-powered devices that are designed to look and work like a real cigarette. They usually contain a rechargeable lithium battery, a nicotine cartridge and an LED light that gives that recognisable burning glow when you puff on it. The battery will heat up the liquid which produces an inhalable vapour - users don’t smoke, they “vape”.
They come close enough to the real thing to have over a million users in the UK alone, and their popularity is due to the fact that there is no tar or other additives, offering the nicotine-addicted a range of flavours for what is regarded as a safer alternative to smoking tobacco.
An alternative to Smoking?
Compared with regular tobacco products, they are certainly the lesser of two evils, but they are relatively new, and there is still a need for them to be assessed and monitored over a long period of time. Some studies have only used a small group of 40 smokers and some animal testing, so there is little conclusive evidence to work from. The BMA calls for stronger controls on where e-cigarettes can be used, and that the existing smoke-free legislation in the workplace should be extended to include vapour from e-cigarettes.
E-Cigarette Regulation, Legislation and Safety
In the US, there is currently no regulation on the manufacture, sale or marketing of e-cigarettes or related products. This means there is no regulation on the amount of nicotine that can be in different flavours (or “juices”) that vapers buy. The nicotine doses differ between devices, and have been found to vary from the advertised dose on the label - while the ingredients in e-liquid are also not listed.
Draft legislation in the EU will restrict the sale of e-cigarettes and bring them within medical regulation, and from 2016 they will be regulated and licensed as a medicine in the UK. Manufacturers will need to be licensed, and the components labelled clearly with their precise nicotine content. There are concerns that using exotic flavours will tempt the younger population to start using them, and the health claims only encourage smokers to switch their product instead of quitting altogether.
Unlike tobacco products, e-cigarettes are not covered by the 2006 Health Act, which prohibits smoking in the workplace – this includes manufactured & hand-rolled cigarettes, pipes (including Shisha & hooka water pipes), cigars and herbal cigarettes. The Health Act’s definition of smoking refers to tobacco and other substances “in a lit form” which are capable of being smoked. It may be argued that an e-cigarette releases vapour instead of smoke, and that with the absence of tobacco, they fall outside the existing definitions of drugs in their drugs and alcohol policies. Still, it has prompted other countries such as Canada, Denmark and Australia to ban them or incorporate them into their current smoking restrictions.
This means that right now, it is at the discretion of the employer how to handle their use or presence in the workplace. Allowing the use of E-cigarettes may generate complaints of second-hand vapour, unpleasant smells and potential health risks. An employer might want to consider whether it will upset other workers or members of the public, particularly if they are pregnant or trying to quit the habit themselves, or whether it gives a professional image, especially if patients or members of the public are likely to be a visiting.
Since the ban on smoking in public places, it has been coupled with break times rather than work times. Employers might be reluctant to allow e-cigarettes into a working environment and would prefer to treat them as you would the conventional cigarette break and restrict their use to break periods. An employer should be aware that there is a common law and statutory duty to protect the health and safety of employees, and by allowing them in the workplace presents a potential health hazard for staff. The argument by users and supporters is that e-cigarettes are a supportive measure to help them kick the habit, and lead to a healthier lifestyle
Another factor is the risk of fire from incorrect use or faulty e-cigarettes. The heating element is the source of the ignition which could set fire to bedding or clothing. Using the wrong chargers or over-tightening connections have caused battery powered electronic versions to explode while charging. Some versions have a USB charging connection which, if plugged into work PC devices could result in a breach of the employers’ IT Policy.
If you want to take any action regarding the use or presence of E-cigarettes in the Practice, it would be worth considering some of these factors;
- Do you want to expressly prohibit e-cigarettes everywhere in the Practice (all practice sites and where staff are working on patient premises), or take a more informal approach?
- Can you designate a separate area for e-cigarette use if you already have a smoking area?
- Will you allow staff to use e-cigarettes in certain social contexts (home visits, work organised events)?
- Will you apply this to locums and other agency workers who are not your employees?
- Are you going to provide additional support to employees struggling with addictions, including nicotine?
Whilst using e-cigarettes in the workplace is not prohibited and employers do not have to ban their use, they equally do not have to agree to their use in the workplace, and therefore must decide what approach best fits with the ethos of the organisation. The BMA seems supportive of employers implementing policies prohibiting the use of e-cigarettes in their workplaces.