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Standing up for clean indoor air

There is a widely-held belief that e-cigarettes are safe because there is no smoke involved. That's always been a dubious claim considering that the vapor they produce, like cigarette smoke, contains nicotine and other chemicals, but a new study led by researchers at Johns Hopkins Bloomberg School of Public Health offers important evidence of the risks involved.

That study, published last week, shows that mice exposed to e-cigarette vapor suffer damage to their lungs and immune systems and thus have a greater chance of contracting a respiratory disease. This was not some minor effect: About 20 percent of the test animals involved in the study ending up dying as a result of that lethal combination of weakened lungs and exposure to disease.

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The Hopkins findings join the growing evidence that these battery-powered devices that vaporize a liquid — including a chemical found in automotive anti-freeze — from a replaceable cartridge can't be regarded as safe. If they can do lethal damage to mice, what does this mean for humans? And what does it mean for people who inhale second-hand vapor?

It may be too early to know conclusively all the potential dangers associated with electronic cigarettes (particularly the long-term effects), but surely enough is already known that protections ought to be in place now. Better to put the burden on the tobacco industry to prove the safety of e-cigarettes than to use the general population as guinea pigs and see what happens as "vaping" becomes increasingly popular as an alternative to smoking.

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Legislation pending in Annapolis would take just such an approach. House Bill 26, sponsored by Del. Aruna Miller, a Montgomery County Democrat, would treat electronic smoking devices the same as traditional cigarettes under the 2007 Clean Indoor Air Act. In other words, people would no longer be able to use them in public indoor spaces such as restaurants, public transportation or their workplaces and thus would not subject colleagues or bystanders to second-hand vapor.

Most importantly, it would be a standard applied statewide. Last November, Baltimore adopted restrictions on the use of e-cigarettes in public places but left a giant loophole giving restaurants and bars the ability to opt out of restrictions merely by posting warning signs. Such warnings might spare their customers (or, rather, former customers), but they don't do much good for their employees who have no choice but to breathe polluted air.

Uniform statewide restrictions make much more sense. And it's become increasingly difficult to argue that e-cigarettes are benign simply because the chief component in their vapor is water. The vapor may not contain the 5,000 chemicals that have been documented in cigarette smoke, but there are plenty of byproducts to be concerned about, including, as the Hopkins researchers noted, formaldehyde, nitrosamines, metals, carbonyls, volatile organic compounds and polycyclic aromatic hydrocarbons.

Lawmakers can't afford the luxury of waiting around another year to find out what other health risks might be associated with e-cigarettes. These products have grown increasingly popular, with an estimated $1.7 billion in sales in 2013. And they've clearly been aimed at young people, with flavors like bubble gum, chocolate, strawberry and mint. According to researchers, use of e-cigs by teens doubled between 2011 and 2012 to 1.7 million middle and high school students. Another recent study suggests e-cigarettes have now become more popular than the traditional variety among young people and may, in fact, provide a gateway to smoking rather than discouraging it.

The fast-growing youth market is just one of the reasons why the U.S. Food and Drug Administration has proposed regulating e-cigarettes like other tobacco products. Such an approach would require companies to get pre-market approval for their products, which is exactly how they should have been regulated in the first place.

How many studies documenting adverse health effects from electronic cigarettes will it take to spur lawmakers to action? Enough questions have been raised to suggest this isn't a theoretical problem. E-cigarette vapor may not be as toxic as regular cigarette smoke, but using these devices, even briefly, can obviously have damaging effects, as the Hopkins study demonstrates. This is one area of regulation where even Gov. Larry Hogan should see the need for government intervention.

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