National No Smoking Day – Employers Need Clarity Over Vaping

With National No Smoking Day this month and a government-backed study endorsing vaping as an effective aid to quitting, employers need to consider carefully how they manage vapers in the workplace.

Employee health and wellbeing – employers could do with some clarity over vaping

March 14 is this year’s National No Smoking Day, the annual awareness day designed to encourage smokers to quit the habit.

Increasing numbers of smokers are turning to e-cigarettes and vaping as an aid to quitting, and this approach was strongly backed by a Public Health England-commissioned (PHE) independent evidence review published in February.

This concluded that vaping has only a small fraction of the risks of smoking, and switching completely from smoking to vaping can bring substantial health benefits.

It also argued that e-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more.

Public ‘poor understanding’

Yet the review also highlighted that many thousands of smokers incorrectly (it argued) believe vaping is as harmful as smoking, and that some 40% of smokers have not even tried an e-cigarette.

Professor John Newton, Director for Health Improvement at PHE said: “Every minute someone is admitted to hospital from smoking, with around 79,000 deaths a year in England alone. Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know.”

Professor Ann McNeill, the review’s lead Author and Professor of Tobacco Addiction at King’s College London, added: “It’s of great concern that smokers still have such a poor understanding about what causes the harm from smoking. When people smoke tobacco cigarettes, they inhale a lethal mix of 7,000 smoke constituents, 70 of which are known to cause cancer.

“People smoke for the nicotine, but contrary to what the vast majority believe, nicotine causes little if any of the harm. The toxic smoke is the culprit and is the overwhelming cause of all the tobacco-related disease and death. There are now a greater variety of alternative ways of getting nicotine than ever before, including nicotine gum, nasal spray, lozenges and e-cigarettes,” she said.

PHE also highlighted a recent US National Academies of Sciences, Engineering and Medicine (NASEM) report on e-cigarettes which, it said, had concluded that “e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.”

Lack of consensus

So, cut and dried in that case? Well, yes and no.

Certainly, the PHE evidence is compelling. But there nevertheless remain concerns within the medical community about PHE’s approach to vaping.

For example, a similar expert independent evidence review published by PHE back in 2015, which concluded that e-cigarettes were significantly less harmful to health than tobacco, was strongly questioned at the time by academics and medics.

A Swedish study last September also concluded that e-cigarettes containing nicotine could increase the risk of heart attacks and strokes.

You don’t have to look too far, either, to find more negative conclusions being drawn from the NASEM study, and here too is another example.

So there is, at the very least, a challenge for employers in terms of drawing hard-and-fast conclusions from the evidence base associated with vaping.

Challenge of managing vapers

There is also a practical challenge in terms of how should employers treat vapers within the workplace?

Clearly, encouraging employees to quit smoking is positive, and something most employers would want to be seen to be backing. But do you as a result allow people to vape in the office, even perhaps at their desks?

Irrespective of its health merits, vaping creates a lot of smoke which other employees, now used to more than a decade of smoke-free working environments, may not accept, enjoy or feel is appropriate.

Or do you banish vapers out the back along with the conventional smokers, with all the negative connotations this brings, not to mention the impact on productivity of vapers frequently leaving their desks for a “smoke”.

The difficulty for employers is that, even with PHE’s strong position, there is as yet no consensus or clarity around this.

The key therefore, as Dr Lucy Wright, Chief Medical Officer for Optima Health, emphasises, is for employers simply to take a position and ensure they are being clear and consistent in their policies and communication.

“Whether it is conventional cigarettes or e-cigarettes, what is important is that employees know where they stand. If your position on e-cigarettes is a separate ‘smoking’ room, fine. Or if it’s outside, fine. Even if it’s at their workstation – even though this is likely to be problematic for many –your position and policy need to be  clear, consistent and well-communicated.

“As it stands, e-cigarettes currently fall outside the scope of smoke-free legislation, and what many employers would find valuable is some guidance from the government around what ought to be best practice in this area. However, until that happens, it is up to employers to ensure that, whatever their decision, this is fairly and consistently enforced and communicated.”