Electronic Cigarettes and Hookah

Effects on Indoor Air Quality and the Smoke-Free Ordinance

The Problem

Louisville Metro’s current Smoke-Free Ordinance prohibits smoking tobacco in indoor public places and worksites. However, electronic cigarettes and hookah are not explicitly restricted in the 2008 Ordinance.

Electronic cigarette emissions are not a “harmless water vapor,” and it is not as safe as clean air. Emissions can contain nicotine, ultrafine particles, and chemicals that are known toxicants, carcinogens, and respiratory irritants. Some of the most commonly identified chemicals from electronic cigarettes include propylene glycol, formaldehyde, metals, particulate matter, and nicotine.

Smoke from a hookah contains many of the same harmful and carcinogenic components as cigarette smoke. A typical hour-long hookah smoking session involves breathing in 100-200 times the volume of smoke inhaled in a single cigarette. Secondhand smoke from a hookah contains a significant amount of tar, nicotine, carbon monoxide, and heavy metals.

Electronic cigarettes and hookah:

Are tobacco products
Negatively affect indoor air quality
Expose non-users to harmful chemicals
Undermine enforcement efforts and create confusion

The Solution

By making a simple revision to the language in the current ordinance, the use of such products can be restricted in public indoor spaces where smoking and/or tobacco use is already prohibited.

Expanding the Smoke-Free Ordinance to include electronic cigarettes and hookah aligns with the Healthy Louisville 2020 goals of reducing and eliminating exposure to smoking related health hazards and reducing exposure to environmental health hazards. The revised Smoke-Free Ordinance, without any exemptions, would promote clean and smoke-free environments in all public indoor settings and protect Louisville Metro’s clean air standards, reduce exposure to indoor air pollutants, protect non-users and employees against exposure to harmful chemicals, and assist with enforcement of the Smoke-Free Ordinance.

Support for Expanding Smoke-Free Laws

As of January 2, 2017:

589 communities nationwide include electronic cigarettes in their smoke-free laws
14 communities in Kentucky include electronic cigarettes in their smoke-free laws
302 communities nationwide include hookah in their smoke-free laws
11 communities in Kentucky include hookah in their smoke-free laws
Local, state, national, and worldwide health and advocacy organizations recommend that electronic cigarettes and hookah not be used in public indoor settings
12 local organizations have already stepped up to show their support for including electronic cigarettes and hookah in the Smoke-Free Ordinance
Over 30 local businesses, healthcare facilities, educational institutions, sports facilities, and entertainment venues in Louisville have proactively prohibited the use of electronic cigarettes and hookah indoors as a part of their smoke-free or wellness policy.

Electronic Cigarettes or E-Cigarettes

Electronic cigarettes, or e-cigarettes, are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. The devices are metal or plastic tubes that contain a cartridge filled with a liquid that is vaporized by a battery-powered heating element. The aerosol is inhaled by the user when they draw on the device, as they would a regular tobacco cigarette, and the user exhales the aerosol into the environment.

E-cigarettes do not just emit “harmless water vapor.” Second hand aerosol from e-cigarettes contains nicotine, ultrafine particles and toxins that are known to cause cancer. The nicotine inside the cartridges is addictive. When you stop using it, you can get withdrawal symptoms including feeling irritable, depressed, restless and anxious. E-cigarettes can have the adverse health consequences as conventional cigarettes.

Hookah

Hookah pipe

Hookah is a popular method of smoking flavored tobacco or other substance in a waterpipe. While some may believe this form of smoking is less harmful than cigarettes, studies from the American Lung Association and the World Health Organization indicate that it may be even more harmful. Compared to cigarettes, hookah waterpipe users inhale higher carbon monoxide levels and 1.7 times the dose of nicotine.

Hookah smoking presents a danger to nonusers through secondhand exposure to toxins. Hookah smoke emits dangerous levels of fine particulate air pollution and carbon monoxide from the heat source (often charcoal). Both national and local air quality studies in hookah lounges have found levels of aerosolized breathable particulate matter (PM2.5) directly comparable to those in establishments that allow cigarette smoking which far exceed the ambient air quality standards established by the EPA.

Hookah Fact Sheet

Hookah Smoking: Dangers and Policy Implications