Why Ban Use of
E-Cigarettes in No-Smoking Areas
Action on Smoking and Health (ASH), America’s first
antismoking organization, strongly supports the need for legislation to
prohibit the use of e-cigarettes, e-cigars, and e- pipes [e-cigs] in
workplaces, public places, and other areas where smoking is not
permitted in order to protect the overwhelming majority of the public
who do not use such devices from exposure to chemicals in the e-cig
vapors, and the potential attendant health risks to nonusers.
This document very briefly explains the need, rationale, and justification for banning the use of e-cigs where smoking is prohibited; summarizes some of the evidence about their potential dangers to bystanders; and notes how a growing number of jurisdictions are enacting such protections.
In summary, laws currently banning smoking in workplaces and public places should be amended to also prohibit the use of e-cigs because these new products apparently present some of the same deadly health risks (including heart attacks from nicotine) to nearby nonusers as tobacco products, as well as a new and potentially worrisome threat from propylene glycol.
Medical Evidence Related to Nicotine and Propylene Glycol
More specifically, although exhaled e-cig vapors apparently contain smaller amounts than cigarette smoke of nitrosamines and other cancer-causing chemicals which are the apparent cause of about 3,000 nonsmoker deaths each year from lung cancer, nicotine – which is a major factor in tobacco smoke causing about 50,000 annual nonsmokers’ deaths from heart attacks – is found in abundance in e-cig exhaled vapors.
Also, the other major component of e-cig vapors is propylene glycol, a respiratory irritant used in antifreeze, and known to cause respiratory tract infections.
The impact of long-term inhalation of this substance – particularly by infants and young children, older Americans, and those who already have respiratory problems or other conditions making them especially susceptible – is unknown, but is unlikely to be negligible.
As the U.S. Surgeon General has declared, there is no safe level of exposure to tobacco smoke, and presumably there is no safe level of exposure to many of the major chemical components of tobacco smoke, including the drug nicotine.
Nicotine is a deadly drug (used to make insecticides) which is a very powerful stimulant which constricts and (also over the long term) damages) blood vessels, and triggers an immediate increase in heart rate, blood pressure, and respiration.
Thus, even if (as claimed) e-cig vapors contain fewer carcinogens than tobacco smoke, nicotine – a major cause, along with carbon monoxide, of causing the overwhelming majority of secondhand smoke deaths (about 50,000 a year) – is still present in abundance.
In short, even if e-cigs largely eliminate the risk of lung cancer in nonsmokers, it appears that they may do little to reduce the risk which is much larger – by a factor of about 15-to-1 – of heart attacks.
The ability of secondhand tobacco smoke to cause heart attacks in nearby nonsmokers is important for at least two reasons.
FIRST, the number of heart attack deaths caused by secondhand tobacco smoke is about 15 times that caused by secondhand tobacco smoke due to lung cancer, and is the third major cause of death in the U.S. – second only to primary smoking (i.e., to smokers) and obesity. Indeed, the estimated 50,000 annual deaths from heart attacks triggered by secondhand smoke is larger than the number of deaths from all automobile accidents, from all crimes, from all guns, from AIDS, or from all illegal drugs.
The second reason is that extensive research has demonstrated that only minute amounts of the chemicals in drifting secondhand tobacco smoke are sufficient to trigger potentially fatal heart attacks in nonsmokers. These chemicals are believed to include nicotine and carbon monoxide.
While e-cigs apparently emit no carbon monoxide, they do emit (and users exhale) large amounts of nicotine – amounts and concentrations which may be even higher than that emitted by cigarette smokers, depending upon how the e-cig is loaded, and how it is used by the purchaser.
Thus, the Centers for Disease Control has warned: “Could eating in a smoky restaurant precipitate an acute myocardial infarction in a nonsmoker? . . ., a growing body of scientific data suggests that this is possible . . . laboratory data suggest that even 30 minutes of exposure to a typical dose of secondhand smoke induces changes in arterial endothelial function in exposed non-smokers of a magnitude similar to those measured in active smokers.”
This warning was based in large part on an article in Circulation, a prestigious peer-reviewed medical journal, entitled “Cardiovascular Effects of Secondhand Smoke – Nearly as Large as Smoking” which reported: “the effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.”
Another published medical study reports that: “While the dose of smoke delivered to passive smokers is approximately 100 times smaller than that delivered to an active smoker, the effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80–90%) as chronic active smoking.”
All of this evidence, and far far more – including an explanation of how even small amounts of the chemicals in drifting tobacco smoke can trigger heart attacks, especially in nonsmokers who might be especially susceptible (e.g., seniors, the obese, those with high blood pressure or high cholesterol or diabetes, those with family or personal history of cardiovascular problems, etc.) – can be found in the following ASH report: http://ash.org/30minutes
Potential Problems from Toxic and Carcinogenic Chemicals
Although e-cig makers and supporters initially claimed that their products contained no cancer-causing chemicals, a study by the FDA found that the e-cigs it tested contained detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed. More specifically, the FDA said the “toxic” chemicals included diethylene glycol [in addition to propylene glycol], “an ingredient used in antifreeze, [which] is toxic to humans;” “certain tobacco-specific nitrosamines which are human carcinogens;” and that “tobacco-specific impurities suspected of being harmful to humans – anabasine, myosmine, and B-nicotyrine – were detected in a majority of the samples tested.”
Unfortunately, no agency currently is testing to see what other impurities or other chemicals might be found in e-cigs, many of which are made in China where quality control and inspections may be less rigorous than in the U.S.
Also, at least one manufacturer has been found to have been deliberately adding Cialis as well as nicotine to its e-cigarettes.
In short, it appears that bystanders are being exposed to a wide variety of chemicals in addition to nicotine and propylene glycol when e-cigs are used in public places. While the amounts of these toxins, carcinogens, and other chemicals may be small, ASH respectfully suggests that no person should be able to force others to unnecessarily inhale any potentially dangerous chemicals, regardless of the amount of toxins or carcinogens present.
The State of the Evidence
While the Internet is being flooded (largely by e-cig companies) with claims by individual doctors, professors of medicine (many of whom do not even do research in this field), and even some small organizations to the effect that the vapors from e-cigarettes are not dangerous, there appear to be no studies published in reputable peer-reviewed scientific or medical journals to back up that claim, and no governmental body or major scientific or medical organization supports it.
Indeed, considering the very small number of e-cigs (compared with tobacco cigarettes) which are currently in use, and the very small period of time during which they have been in use, it is hard to see from this very small sample size and limited time duration how anyone could say with any certainty that frequent exposure to nicotine (an addictive stimulant drug), propylene glycol (a respiratory irritant known to cause respiratory tract infections), and other miscellaneous toxins and carcinogenic impurities which apparently are present, is completely harmless.
This is especially a concern for bystanders such as seniors, those with conditions (such as asthma, hay fever, lupus, sinusitis, etc.) which may make them particularly sensitive to even small amounts of airborne pollutants, those with a personal or family history or risk factors for cardiovascular problems, etc.
Remember, it took dozens of years to demonstrate that cigarettes caused cancer in smokers, and at least a dozen more years to show that it caused cancer in nonsmokers – despite the tens of millions of smokers and exposed nonsmokers, and exposure periods measured in years.
The uncertainty as to the level of potential risks to nonsmokers from e-cigs was summed up by a government authority at a recent news conference sponsored by the expert and unbiased FDA.
Matthew McKenna, M.D., director of the CDC’s Office of Smoking and Health, noted that the e-cigs can also be used in environments that are smoke-free and therefore weaken the health benefits of the antismoking efforts (i.e., clean indoor air laws).
But perhaps the real problem – the very human problem – is best expressed by letters which our organization receives about e-cigarettes. One read:
“My first exposure to e-cigarettes was last year in a hospital; smokers were made to go outside but three e-smokers plus two staff were using the e-cigarettes inside . . . I have lupus and the vapor irritated my nose, eyes, throat, and chest, plus the nicotine was making me feel nauseous so there must have been significant quantities in the side-vapor. I am told I had no rights to stop the use of these cigarettes indoors. It makes a mockery of the new laws.”
What Other Governments Are Doing
E-cigs have already been banned outright in Australia, Brazil, Canada, Israel, and Mexico, among other places, and restricted in Finland, Malaysia, and Singapore. The use of e-cigs is prohibited in Suffolk Country, New York in any area in which tobacco smoking is prohibited.
The State of Virginia has also ruled that e-cigs are included in the state's existing smoking ban: "Are electronic cigarettes banned under the new law? Electronic cigarettes are considered cigarettes and are banned in the same locations affected by the new law." Link
Perhaps most importantly, legislators in New Jersey recently voted overwhelmingly to ban the use of e-cigs wherever smoking is likewise prohibited.
As this is written, a number of jurisdictions are considering bans on the use of e-cigs in public places. Other jurisdictions are considering banning the sale of e-cigs, a move largely designed to protect potential users of e-cigs, but one which would also help protect innocent nonsmokers from exposure to the vapors.
Such a ban on sales is also already partially in effect in Oregon as a result of legal action by the Attorney General. The Attorney General has filed a similar law suit against a major manufacturer of e-cigs, and the Attorney General of Connecticut has announced similar actions in the near future.
In short, the movement to prohibit the use of e-cigs around innocent bystanders is a strong and growing one supported by strong evidence and backed by precedent.
The Rationale/Arguments for an E-cigarette Ban in Public Places
One important role of governments is to protect citizens from unnecessary dangers, including unnecessary and involuntary exposure to dangerous substances.
Some exposure – e.g., to power plant or diesel fuel emissions – may be necessary (unavoidable) in modern society, especially since the benefits are shared by all. But for the same reasons that tobacco smoking is banned because those exposed neither consent to nor benefit from the exposure to dangerous chemicals, e-cigs should be added to the products which may not be used in no-smoking sections.
Just as no one is free to pollute everyone else’s indoor air (e.g., in public restaurants) with other dangerous substances like benzene, asbestos, or polonium (even in minute concentrations) for their own enjoyment, e-cig users should not be permitted to deliberately release into the air a deadly addictive drug and a respiratory irritant, simply because it brings them satisfaction, or even because it may even help them to quit smoking.
After all, those using nicotine replacement therapy [NRT] to help quit smoking and end their nicotine addiction entirely need not use e-cigs, but rather may ingest nicotine by using patches, gum, inhalers, lozenges, and sprays, all of which are approved and tested by the FDA, and all of which present no health risks whatsoever to bystanders.
The same NRT products are also available to – and may easily be used by – those who are willing to remain addicted to nicotine, but who wish to replace smoking with another method of ingesting nicotine which is arguably somewhat less hazardous to themselves than smoking. Unlike the use of e-cigs, these NRT products – e.g., nicotine patches or gums – may be used unobtrusively in the workplace without endangering or even distracting fellow workers.
The major claimed advantage of an e-cig over these other NRT products is that – by allowing users to exhale a smoke-like substance while sucking on a white stick lit up at one end – it allows them to pretend to smoke. But that “advantage” to themselves is hardly necessary for quitting or for their continued ingestion of nicotine. In any event, e-cigs may be used outdoors or in private where their use does not pollute the air with toxins which others must then breathe.
After all, we would not let heroin addicts publicly use fake hypodermic needles to pretend to inject their drug of choice, even if it helped them cope or quit, and even though it does not endanger bystanders.
ASH respectfully suggests that any uncertainties about the dangers of e-cig vapors must be resolved in favor of the health of innocent citizens now being involuntarily subjected to it, rather than in favor of a very tiny minority who wish to pretend to smoke in public places.
The burden of proof should be upon those who wish to sell or use the product to produce proof – in the form of studies published in reputable peer-reviewed journals – that the vapors are completely harmless, even to those who may be especially susceptible, and to exposure over a long period of time.
Those studies, in turn, can and should be reviewed (as they have been with regard to cigarettes, and nicotine patches, gums, inhalers, sprays, etc.) by impartial governmental bodies and well-respected national health organizations before users should be free to use innocent people around them in hospitals, nursing homes, offices, stores, restaurants, and other public places as human guinea pigs.
Surely we have learned from cigarettes that dangers to others – even deadly dangers – are not always immediately apparent, and cannot be discounted or disproved with studies involving small samples in brief periods of time.
Summary
ASH respectfully suggests that, until proven completely safe for all bystanders – including those who are especially susceptible – the use of e-cigs in public places must be prohibited just as the use of ordinary tobacco cigarettes is.
There is no moral or legal right to force others to inhale deadly chemicals in any concentrations, and the vapor from e-cigs includes not only nicotine (a deadly and addictive drug which can trigger heart attacks) and propylene glycol (a respiratory irritant known to cause respiratory tract infections), but also (according to the FDA) detectable amounts of various toxins and carcinogenic compounds.
This document very briefly explains the need, rationale, and justification for banning the use of e-cigs where smoking is prohibited; summarizes some of the evidence about their potential dangers to bystanders; and notes how a growing number of jurisdictions are enacting such protections.
In summary, laws currently banning smoking in workplaces and public places should be amended to also prohibit the use of e-cigs because these new products apparently present some of the same deadly health risks (including heart attacks from nicotine) to nearby nonusers as tobacco products, as well as a new and potentially worrisome threat from propylene glycol.
Medical Evidence Related to Nicotine and Propylene Glycol
More specifically, although exhaled e-cig vapors apparently contain smaller amounts than cigarette smoke of nitrosamines and other cancer-causing chemicals which are the apparent cause of about 3,000 nonsmoker deaths each year from lung cancer, nicotine – which is a major factor in tobacco smoke causing about 50,000 annual nonsmokers’ deaths from heart attacks – is found in abundance in e-cig exhaled vapors.
Also, the other major component of e-cig vapors is propylene glycol, a respiratory irritant used in antifreeze, and known to cause respiratory tract infections.
The impact of long-term inhalation of this substance – particularly by infants and young children, older Americans, and those who already have respiratory problems or other conditions making them especially susceptible – is unknown, but is unlikely to be negligible.
As the U.S. Surgeon General has declared, there is no safe level of exposure to tobacco smoke, and presumably there is no safe level of exposure to many of the major chemical components of tobacco smoke, including the drug nicotine.
Nicotine is a deadly drug (used to make insecticides) which is a very powerful stimulant which constricts and (also over the long term) damages) blood vessels, and triggers an immediate increase in heart rate, blood pressure, and respiration.
Thus, even if (as claimed) e-cig vapors contain fewer carcinogens than tobacco smoke, nicotine – a major cause, along with carbon monoxide, of causing the overwhelming majority of secondhand smoke deaths (about 50,000 a year) – is still present in abundance.
In short, even if e-cigs largely eliminate the risk of lung cancer in nonsmokers, it appears that they may do little to reduce the risk which is much larger – by a factor of about 15-to-1 – of heart attacks.
The ability of secondhand tobacco smoke to cause heart attacks in nearby nonsmokers is important for at least two reasons.
FIRST, the number of heart attack deaths caused by secondhand tobacco smoke is about 15 times that caused by secondhand tobacco smoke due to lung cancer, and is the third major cause of death in the U.S. – second only to primary smoking (i.e., to smokers) and obesity. Indeed, the estimated 50,000 annual deaths from heart attacks triggered by secondhand smoke is larger than the number of deaths from all automobile accidents, from all crimes, from all guns, from AIDS, or from all illegal drugs.
The second reason is that extensive research has demonstrated that only minute amounts of the chemicals in drifting secondhand tobacco smoke are sufficient to trigger potentially fatal heart attacks in nonsmokers. These chemicals are believed to include nicotine and carbon monoxide.
While e-cigs apparently emit no carbon monoxide, they do emit (and users exhale) large amounts of nicotine – amounts and concentrations which may be even higher than that emitted by cigarette smokers, depending upon how the e-cig is loaded, and how it is used by the purchaser.
Thus, the Centers for Disease Control has warned: “Could eating in a smoky restaurant precipitate an acute myocardial infarction in a nonsmoker? . . ., a growing body of scientific data suggests that this is possible . . . laboratory data suggest that even 30 minutes of exposure to a typical dose of secondhand smoke induces changes in arterial endothelial function in exposed non-smokers of a magnitude similar to those measured in active smokers.”
This warning was based in large part on an article in Circulation, a prestigious peer-reviewed medical journal, entitled “Cardiovascular Effects of Secondhand Smoke – Nearly as Large as Smoking” which reported: “the effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.”
Another published medical study reports that: “While the dose of smoke delivered to passive smokers is approximately 100 times smaller than that delivered to an active smoker, the effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80–90%) as chronic active smoking.”
All of this evidence, and far far more – including an explanation of how even small amounts of the chemicals in drifting tobacco smoke can trigger heart attacks, especially in nonsmokers who might be especially susceptible (e.g., seniors, the obese, those with high blood pressure or high cholesterol or diabetes, those with family or personal history of cardiovascular problems, etc.) – can be found in the following ASH report: http://ash.org/30minutes
Potential Problems from Toxic and Carcinogenic Chemicals
Although e-cig makers and supporters initially claimed that their products contained no cancer-causing chemicals, a study by the FDA found that the e-cigs it tested contained detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed. More specifically, the FDA said the “toxic” chemicals included diethylene glycol [in addition to propylene glycol], “an ingredient used in antifreeze, [which] is toxic to humans;” “certain tobacco-specific nitrosamines which are human carcinogens;” and that “tobacco-specific impurities suspected of being harmful to humans – anabasine, myosmine, and B-nicotyrine – were detected in a majority of the samples tested.”
Unfortunately, no agency currently is testing to see what other impurities or other chemicals might be found in e-cigs, many of which are made in China where quality control and inspections may be less rigorous than in the U.S.
Also, at least one manufacturer has been found to have been deliberately adding Cialis as well as nicotine to its e-cigarettes.
In short, it appears that bystanders are being exposed to a wide variety of chemicals in addition to nicotine and propylene glycol when e-cigs are used in public places. While the amounts of these toxins, carcinogens, and other chemicals may be small, ASH respectfully suggests that no person should be able to force others to unnecessarily inhale any potentially dangerous chemicals, regardless of the amount of toxins or carcinogens present.
The State of the Evidence
While the Internet is being flooded (largely by e-cig companies) with claims by individual doctors, professors of medicine (many of whom do not even do research in this field), and even some small organizations to the effect that the vapors from e-cigarettes are not dangerous, there appear to be no studies published in reputable peer-reviewed scientific or medical journals to back up that claim, and no governmental body or major scientific or medical organization supports it.
Indeed, considering the very small number of e-cigs (compared with tobacco cigarettes) which are currently in use, and the very small period of time during which they have been in use, it is hard to see from this very small sample size and limited time duration how anyone could say with any certainty that frequent exposure to nicotine (an addictive stimulant drug), propylene glycol (a respiratory irritant known to cause respiratory tract infections), and other miscellaneous toxins and carcinogenic impurities which apparently are present, is completely harmless.
This is especially a concern for bystanders such as seniors, those with conditions (such as asthma, hay fever, lupus, sinusitis, etc.) which may make them particularly sensitive to even small amounts of airborne pollutants, those with a personal or family history or risk factors for cardiovascular problems, etc.
Remember, it took dozens of years to demonstrate that cigarettes caused cancer in smokers, and at least a dozen more years to show that it caused cancer in nonsmokers – despite the tens of millions of smokers and exposed nonsmokers, and exposure periods measured in years.
The uncertainty as to the level of potential risks to nonsmokers from e-cigs was summed up by a government authority at a recent news conference sponsored by the expert and unbiased FDA.
Matthew McKenna, M.D., director of the CDC’s Office of Smoking and Health, noted that the e-cigs can also be used in environments that are smoke-free and therefore weaken the health benefits of the antismoking efforts (i.e., clean indoor air laws).
But perhaps the real problem – the very human problem – is best expressed by letters which our organization receives about e-cigarettes. One read:
“My first exposure to e-cigarettes was last year in a hospital; smokers were made to go outside but three e-smokers plus two staff were using the e-cigarettes inside . . . I have lupus and the vapor irritated my nose, eyes, throat, and chest, plus the nicotine was making me feel nauseous so there must have been significant quantities in the side-vapor. I am told I had no rights to stop the use of these cigarettes indoors. It makes a mockery of the new laws.”
What Other Governments Are Doing
E-cigs have already been banned outright in Australia, Brazil, Canada, Israel, and Mexico, among other places, and restricted in Finland, Malaysia, and Singapore. The use of e-cigs is prohibited in Suffolk Country, New York in any area in which tobacco smoking is prohibited.
The State of Virginia has also ruled that e-cigs are included in the state's existing smoking ban: "Are electronic cigarettes banned under the new law? Electronic cigarettes are considered cigarettes and are banned in the same locations affected by the new law." Link
Perhaps most importantly, legislators in New Jersey recently voted overwhelmingly to ban the use of e-cigs wherever smoking is likewise prohibited.
As this is written, a number of jurisdictions are considering bans on the use of e-cigs in public places. Other jurisdictions are considering banning the sale of e-cigs, a move largely designed to protect potential users of e-cigs, but one which would also help protect innocent nonsmokers from exposure to the vapors.
Such a ban on sales is also already partially in effect in Oregon as a result of legal action by the Attorney General. The Attorney General has filed a similar law suit against a major manufacturer of e-cigs, and the Attorney General of Connecticut has announced similar actions in the near future.
In short, the movement to prohibit the use of e-cigs around innocent bystanders is a strong and growing one supported by strong evidence and backed by precedent.
The Rationale/Arguments for an E-cigarette Ban in Public Places
One important role of governments is to protect citizens from unnecessary dangers, including unnecessary and involuntary exposure to dangerous substances.
Some exposure – e.g., to power plant or diesel fuel emissions – may be necessary (unavoidable) in modern society, especially since the benefits are shared by all. But for the same reasons that tobacco smoking is banned because those exposed neither consent to nor benefit from the exposure to dangerous chemicals, e-cigs should be added to the products which may not be used in no-smoking sections.
Just as no one is free to pollute everyone else’s indoor air (e.g., in public restaurants) with other dangerous substances like benzene, asbestos, or polonium (even in minute concentrations) for their own enjoyment, e-cig users should not be permitted to deliberately release into the air a deadly addictive drug and a respiratory irritant, simply because it brings them satisfaction, or even because it may even help them to quit smoking.
After all, those using nicotine replacement therapy [NRT] to help quit smoking and end their nicotine addiction entirely need not use e-cigs, but rather may ingest nicotine by using patches, gum, inhalers, lozenges, and sprays, all of which are approved and tested by the FDA, and all of which present no health risks whatsoever to bystanders.
The same NRT products are also available to – and may easily be used by – those who are willing to remain addicted to nicotine, but who wish to replace smoking with another method of ingesting nicotine which is arguably somewhat less hazardous to themselves than smoking. Unlike the use of e-cigs, these NRT products – e.g., nicotine patches or gums – may be used unobtrusively in the workplace without endangering or even distracting fellow workers.
The major claimed advantage of an e-cig over these other NRT products is that – by allowing users to exhale a smoke-like substance while sucking on a white stick lit up at one end – it allows them to pretend to smoke. But that “advantage” to themselves is hardly necessary for quitting or for their continued ingestion of nicotine. In any event, e-cigs may be used outdoors or in private where their use does not pollute the air with toxins which others must then breathe.
After all, we would not let heroin addicts publicly use fake hypodermic needles to pretend to inject their drug of choice, even if it helped them cope or quit, and even though it does not endanger bystanders.
ASH respectfully suggests that any uncertainties about the dangers of e-cig vapors must be resolved in favor of the health of innocent citizens now being involuntarily subjected to it, rather than in favor of a very tiny minority who wish to pretend to smoke in public places.
The burden of proof should be upon those who wish to sell or use the product to produce proof – in the form of studies published in reputable peer-reviewed journals – that the vapors are completely harmless, even to those who may be especially susceptible, and to exposure over a long period of time.
Those studies, in turn, can and should be reviewed (as they have been with regard to cigarettes, and nicotine patches, gums, inhalers, sprays, etc.) by impartial governmental bodies and well-respected national health organizations before users should be free to use innocent people around them in hospitals, nursing homes, offices, stores, restaurants, and other public places as human guinea pigs.
Surely we have learned from cigarettes that dangers to others – even deadly dangers – are not always immediately apparent, and cannot be discounted or disproved with studies involving small samples in brief periods of time.
Summary
ASH respectfully suggests that, until proven completely safe for all bystanders – including those who are especially susceptible – the use of e-cigs in public places must be prohibited just as the use of ordinary tobacco cigarettes is.
There is no moral or legal right to force others to inhale deadly chemicals in any concentrations, and the vapor from e-cigs includes not only nicotine (a deadly and addictive drug which can trigger heart attacks) and propylene glycol (a respiratory irritant known to cause respiratory tract infections), but also (according to the FDA) detectable amounts of various toxins and carcinogenic compounds.
