title: Victimless vapour? Health care organizations should restrict the use of e-cigarettes.
abstract: Electronic cigarettes (e-cigarettes) are battery-powered devices that heat a liquid containing either vegetable glycerin or propylene glycol in combination with nicotine and/or flavours; an aerosol is produced that is inhaled by the user. Health Canada currently prohibits the importation, marketing or selling of e-cigarettes containing nicotine, although they can be easily purchased. Because of the availability of e-cigarettes, patients and visitors to health care organizations (HCOs) are inquiring about their use within and on the grounds of those facilities. We contend that in provinces or municipalities where e-cigarette use has not been restricted, HCOs should develop institutional policies to do so. We argue that the following reasons collectively justify measures to restrict the use of e-cigarettes within HCOs: unknown long-term safety, uncertain effectiveness in harm reduction, the conflict with the mission of HCOs to promote health, the potential negative health impacts on vulnerable patients with a compromised health status, and the risk of re-normalization of smoking. However, because of the rapidly developing evidence base in this area, HCOs should remain responsive to emerging evidence regarding the status of e-cigarettes as an effective harm reduction tool.
authors.affiliation: Ethicist & Policy Advisor, Sunnybrook Health Sciences Centre. sally.bean@utoronto.ca.
authors.forename: Sally T
authors.initials: ST
authors.lastname: Bean
authors.forename: Maxwell J
authors.initials: MJ
authors.lastname: Smith
mesh_terms: D002170:Canada; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects; D006291:Health Policy; D006801:Humans