In the JournalsPerspective

Many adults unaware of risks from secondhand exposure to electronic vapors

According to 2015 CDC survey data, nearly 40% of U.S. adults think exposure to secondhand aerosol from electronic vapor products causes only “some” or “little” harm to children, and 33.3% remain ignorant of the risk factors of exposing nonusers to harmful substances such as aerosolized nicotine, heavy metals, volatile organic compounds and ultrafine particulates, indicating a need to educate the public of the dangers of secondhand aerosol exposure from electronic vapor products.

“The potential for involuntary secondhand exposure to [electronic vapor products (EVP)] aerosol among nonusers, children and adults alike, in public indoor environments is of increasing concern given that the use of EVPs has increased considerably among U.S. youths and adults in recent years,” Kimberly H. Nguyen, MS, MPH, from the Office of Smoking and Health at the CDC’s National Center for Chronic Disease Prevention and Health Promotion, and colleagues wrote. “However, to our knowledge, no national study has examined perceived harm from secondhand EVP exposure in the United States among either adults or children.”

Using data from the 2015 Styles, an internet panel survey of 4,127 U.S. adults aged 18 years or older, researchers assessed respondents’ perceptions of harm related to children’s exposure to EVP aerosol. They examined harm perceptions overall, as well as by cigarette smoking, EVP use and sociodemographic characteristics, then used multinomial logistic regression to determine the odds of perceived harm.

In total, 5.3% of adults responded that secondhand EVP exposure caused “no harm” to children, while 39.9% responded “little harm or “some harm,” and 33.3% responded “don’t know.” Only 21.5% of surveyed adults responded that the exposure caused “a lot of harm.” Men, current/former cigarette smokers and current/former EVP users were more likely to respond that secondhand EVP exposure caused “no harm” compared with women, never smokers and never users. Odds of a “no harm” response were lower among non-Hispanic blacks, Hispanics and non-Hispanic other races compared with non-Hispanic whites.

In addition, men, current cigarette smokers and current/former EVP users were more likely to respond “don’t know;” these odds were lower among adults aged 45 to 64 years compared with those aged 18 to 24 years, and lower among non-Hispanic other races and Hispanics compared with non-Hispanic whites.

“EVP use potentially exposes nonusers, including children, to aerosolized nicotine and other harmful substances. Therefore, clean air — free of both smoke and EVP aerosol — remains the standard to protect health,” Nguyen and colleagues wrote. “In coordination with a comprehensive approach to prevent and reduce secondhand smoke exposure and tobacco use by young people, efforts are warranted to educate the public, particularly current and former cigarette smokers and EVP users, about the potential health risks of secondhand EVP aerosol exposure among children.” – by Savannah Demko

Disclosures: The researchers report no relevant financial disclosures.

 

According to 2015 CDC survey data, nearly 40% of U.S. adults think exposure to secondhand aerosol from electronic vapor products causes only “some” or “little” harm to children, and 33.3% remain ignorant of the risk factors of exposing nonusers to harmful substances such as aerosolized nicotine, heavy metals, volatile organic compounds and ultrafine particulates, indicating a need to educate the public of the dangers of secondhand aerosol exposure from electronic vapor products.

“The potential for involuntary secondhand exposure to [electronic vapor products (EVP)] aerosol among nonusers, children and adults alike, in public indoor environments is of increasing concern given that the use of EVPs has increased considerably among U.S. youths and adults in recent years,” Kimberly H. Nguyen, MS, MPH, from the Office of Smoking and Health at the CDC’s National Center for Chronic Disease Prevention and Health Promotion, and colleagues wrote. “However, to our knowledge, no national study has examined perceived harm from secondhand EVP exposure in the United States among either adults or children.”

Using data from the 2015 Styles, an internet panel survey of 4,127 U.S. adults aged 18 years or older, researchers assessed respondents’ perceptions of harm related to children’s exposure to EVP aerosol. They examined harm perceptions overall, as well as by cigarette smoking, EVP use and sociodemographic characteristics, then used multinomial logistic regression to determine the odds of perceived harm.

In total, 5.3% of adults responded that secondhand EVP exposure caused “no harm” to children, while 39.9% responded “little harm or “some harm,” and 33.3% responded “don’t know.” Only 21.5% of surveyed adults responded that the exposure caused “a lot of harm.” Men, current/former cigarette smokers and current/former EVP users were more likely to respond that secondhand EVP exposure caused “no harm” compared with women, never smokers and never users. Odds of a “no harm” response were lower among non-Hispanic blacks, Hispanics and non-Hispanic other races compared with non-Hispanic whites.

In addition, men, current cigarette smokers and current/former EVP users were more likely to respond “don’t know;” these odds were lower among adults aged 45 to 64 years compared with those aged 18 to 24 years, and lower among non-Hispanic other races and Hispanics compared with non-Hispanic whites.

“EVP use potentially exposes nonusers, including children, to aerosolized nicotine and other harmful substances. Therefore, clean air — free of both smoke and EVP aerosol — remains the standard to protect health,” Nguyen and colleagues wrote. “In coordination with a comprehensive approach to prevent and reduce secondhand smoke exposure and tobacco use by young people, efforts are warranted to educate the public, particularly current and former cigarette smokers and EVP users, about the potential health risks of secondhand EVP aerosol exposure among children.” – by Savannah Demko

Disclosures: The researchers report no relevant financial disclosures.

 

    Perspective
    Harold J. Farber

    Harold J. Farber

    The 2016 U.S. Surgeon General Report found that “e-cigarette aerosol is not harmless. It can contain harmful and potentially harmful constituents, including nicotine.” Bystanders can be harmed by the irritating, carcinogenic, and toxic compounds in the emissions.

    In an internet panel survey of U.S. adults, Nguyen et al found that a surprising number (5.3%) of adults believed that exposure to electronic nicotine delivery systems (electronic vapor products, e-cigarettes, others) emissions by children was harmless. Another 33.3% said they did not know if the exposure to the emissions was harmful to children.

    It is not surprising that much of the general public would underestimate the dangers of exposure to the emissions of electronic nicotine delivery systems given the promotion as “smoke anywhere” and “just vapor.” A parent who would never think of smoking in front of their child may not hesitate to use their electronic nicotine delivery system around their child. These findings raise concern about the misperceptions about these products and highlight the need to clearly communicate how harmful chemicals in the emissions from these products can involuntarily expose and harm the non-user.

    Reference:

    U.S. Department of Health and Human Services. “E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.” Atlanta. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016.

     

    • Harold J. Farber, MD, MSPH
    • Associate professor, pediatrics pulmonary section, Baylor College of Medicine/Texas Children’s Hospital

    Disclosures: Farber reports serving as chair of the American Thoracic Society Tobacco Action Committee and as associate medical director for Texas Children’s Health Plan.