The surging popularity of e-cigarettes and the recent spate of illnesses associated with them have caught public health officials and health care providers by surprise and left many employers wondering whether to allow their use in the workplace and what kind of policies are needed to manage the practice.
An e-cigarette is an electronic device that heats up small amounts of liquid nicotine and other substances into an aerosol that can be inhaled, also known as vaping. E-cigarette use among teenagers has skyrocketed in recent years, but others see vaping as a safe alternative to smoking and a tool to quit, an issue that is up for debate.
“Given the recent stories, employers are catching up with how to think about vaping,” said Dr. Mary Kay O’Neill, senior clinical adviser in Mercer’s Total Health Management practice. “E-cigarettes kind of exploded. An early sales pitch was that it’s a safer way to use tobacco than smoking but I think that was more marketing than science. We’re finding a lot problems with that theory.”
While the Food and Drug Administration has not found e-cigarettes to be a safe or effective smoking cessation method, a 2019 study in the New England Journal of Medicine found that smokers who vaped were more likely to quit smoking than people who used nicotine patches, gum or similar products. On the downside, those who quit often became hooked on e-cigarettes.
The largest group of e-cigarette users, however, is teenagers — a trend that has alarmed school and public health officials. In 2018, 37 percent of high school seniors reported vaping, compared to 28 percent in 2017, according to a University of Michigan study.
In response to health concerns, a number of states have banned e-cigarettes and vaping in workplaces and public areas. So far, 17 states have passed general workplace bans — most recently Minnesota, South Dakota, Florida and New Mexico. In June, San Francisco officials voted to ban the sale of e-cigarettes in the city. San Francisco is the headquarters of Juul Labs, the nation’s largest producer of vaping devices.
While most employers ban smoking, few have policies around e-cigarettes, according to Amanda Graham, head of the Innovations Center at Truth Initiative, a national public health organization that also offers a smoking cessation program, called the EX Program, to employers.
“There’s a lot of interest and questions from employers around what to do with vaping,” Graham said. “Do we add it to our smoking policy? What if we have a senior leader who believes in vaping? How do we handle that? It’s important to have consistency in the handling of all tobacco products.”
Mark Johnson, an employment law attorney with Ogletree Deakins in Milwaukee, advises employers to review their current smoking policy and make sure that it complies with state and local laws and that it clearly addresses vaping. Some employers add the use of electronic smoking devices to the definition of “smoking” in an existing no-smoking policy, according to Johnson. A separate policy is not always necessary, he said.
“The number of states and municipalities that have banned vaping in the workplace continues to grow and even if applicable law does not expressly ban vaping in the workplace, laws prohibiting smoking in the workplace may be interpreted to include vaping, Johnson said in an email. “For other locations, it may not be clear whether vaping is regulated. There does not appear to be any location that requires employers to permit vaping at work.”
For employers weighing whether to allow vaping at work, the effects of second-hand exposure to e-cigarettes also need to be addressed, according to Graham.
Much about the health effects of vaping remains unknown and for that reason employers must educate themselves on the risks, O’Neill said.
“We’ve studied tobacco for a long time but not what’s in the liquids found in vaping,” she said. Employers should consider offering smoking-cessation programs to help employees quit through methods that are safer and more effective, according to O’Neill.