Truths Behind Hookah and E-cigarettes

The Smoke-Free Air Act was passed in 2006 in New Jersey. This act bans any action that creates smoke, which includes cigars and hookahs, and aims to prevent smoke exposure in work places to protect all employees. It is important to be aware of this act in order to avoid any fines associated with violation.

In September 2015, John E. Biegel, III, MA, the Health Officer of the City of Clifton, gave a presentation on the smoke-free air legislation and its enforcement, including information about the dangers and health concerns of e-cigarettes and hookahs, A streaming video of the presentation is provided below:

In February 2018, Mr. Biegel was joined by Ms. Layal Helwani, CHES, health educator for the City of Clifton, and Mr. Vinny Smith, health educator for Horizon NJ Health, to conduct a presentation on “Electronic Cigarettes and Tobacco Products: Hidden dangers and implications for public health”, at the regular public meeting of the Essex-Passaic Wellness Coalition:

• A talk addressing issues in schools by Vinny Smith, MA, health educator, Horizon NJ Health, and co-coordinator, EPWC; and
• A presentation (as a self-contained PowerPoint show, slides only in PDF format, or slides with presenter’s notes pages in PDF format) by John E. Biegel, III, MA, HO, REHS, health officer, Cities of Clifton and Passaic and Township of Little Falls, and Adjunct Professor of Environmental Health, Department of Public Health, College of Education and Human Services, Montclair State University, and Layal Helwani, BS, CHES, health educator, City of Clifton Health Department.

Hookah

Contrary to many beliefs, hookahs are not a safe alternative to cigarettes. Hookah smoking is the use of water pipes to smoke a special type of tobacco with various flavors. It has health risks similar to cigarette smoking. A brief description of these health risks is shown in the image below.

Here are some additional recently published articles and links to other resources that provide more information on what hookahs are and the truths counteracting some of the misconceptions associated with hookah smoking:

• Clifton Merchant June 2015 Article: This article provides brief background information on hookahs.
• Clifton Merchant July 2015 Article: Read this article to learn about the many health risks associated with hookah smoking.
• CDC Factsheet on Hookahs
• The Dangers of Hookah Smoking: Information provided by the CDC
• Hookah Use Among US High School Seniors: Freely available article published in Pediatrics, Vol. 134, No. 2, August 1, pp. 227-234

E-cigarettes

E-cigarettes, or electronic cigarettes, are battery-operated that vaporize a chemical-filled liquid that is toxic and contains nicotine. This toxic vapor is then inhaled by the user.

Below are some articles that shed light on the negative aspects of e-cigarettes and on commonly misled beliefs:

• Clifton Merchant August 2015 Article: This article provides explanations correcting some of the common myths surrounding e-cigarettes.
• Clifton Merchant September 2015 Article: This is a brief article providing background information about e-cigarettes, as well as hookahs.
• Electronic Cigarette Use Among Adults: United States, 2014: Statistics on the use of e-cigarettes in the United States. A copy of this CDC report is also available here.
• The Health Effects of Electronic Cigarettes, a review article in The New England Journal of Medicine, published on 06 October 2016. Note that the full text of this informative article is not freely available from The N. Engl. J. Med’s web site, but you may be able to access it through libraries or employer subscriptions.
• Explosion of Injuries from E-Cigarettes: This letter to The New England Journal of Medicine, published on 06 October 2016 and freely available from The N. Engl. J. Med’s web site documents an overlooked hazard of e-cigarettes, namely explosions caused by overheating of their lithium-ion batteries.
• The 2016 U.S. Surgeon General’s Report on e-cigarette use among youth and young adults is the first report issued by a Federal agency that comprehensively reviews the public health issue of electronic cigarettes and their impact on our nation’s young people. Evidence was gathered from studies that included one or more of three age groups: young adolescents (11-14 years of age); adolescents (15-17 years of age); and young adults (18-25 years of age). Details of this report are available on the report’s Resources page.
• (no longer available) With the Jury Out on Vaping, Clinicians Pause to Identify the Cons of E-Cigarettes, a blog post from Georgetown University School of Nursing & Health Studies’ Online FNP Program, published on 29 May 2018. This focuses on e-cigarettes as an entry into tobacco use, especially among youth.

Smoke-free outdoor air ordinances in New Jersey

Many New Jersey counties and municipalities have passed smoke-free outdoor air ordinances, which prohibit smoking in parks and recreation areas. In addition to reducing exposure to second-hand smoke, these have the salutary effect of making smoking unacceptable in large public areas, thus reducing the availability of spaces in which youth can try, and become addicted to, tobacco products.

You can find out whether your New Jersey county and municipality have passed smoke-free outdoor aid ordinances in an online database of smoke-free outdoor air ordinances.

Other useful tobacco-related resources

• Tobacco Use Among Middle and High School Students – United States, 2011-2015. This is also available in PDF format here.
• Tobacco Product Use Among Adults – United States, 2013-2014. This is also available in PDF format here. This report provides the most recent data on tobacco use among U.S. adults, highlighting the increasing use of emerging tobacco products such as hookahs and e-cigarettes and documenting differences in the use of tobacco products among subsets of the U.S. population.