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Last week, Yellowstone County joined 13 states and 710 other American communities that prohibit use of e-cigarettes in buildings open to the public. The no vaping rule is intended to protect public health, particularly youth.

Today, the journal of the American Association of Pediatrics published a study that found elevated levels of 10 cancer-causing chemicals in teens who vape. The vaping teens had lower levels than teens who both vaped and smoked tobacco cigarettes, but teens who neither smoked nor vaped had zero level of the tested volatile organic compounds.

The Pediatrics article authors Mark L. Rubinstein, Kevin Delucchi, Neal L. Benowitz and Danielle E. Ramo concluded: “Although e-cigarette vapor may be less hazardous than tobacco smoke, our findings can be used to challenge the idea that e-cigarette vapor is safe, because many of the volatile organic compounds we identified are carcinogenic. Messaging to teenagers should include warnings about the potential risk from toxic exposure to carcinogenic compounds generated by these products.”

The health effects of e-cigarettes require much more study, and there must be a sense of urgency about this research because these relatively new products have so quickly become popular among adolescents. The Pediatrics study participants had an average age of 16.

The journal article notes that in 2016, more than twice as many U.S. 10th graders reported using e-cigarettes in the past month than used traditional cigarettes — 11 percent versus 4.9 percent. Peer influence, enticing flavors and extensive marketing presenting e-cigarettes as safer contributed to the increased use by adolescents, the authors said.

Here’s the problem: E-cigarettes use aerosolized nicotine rather than burning tobacco, so they do produce fewer toxins than smoking cigarettes. But additives and solvents in e-cigraettes – even in e-cigarettes without nicotine — can form carcinogenic compounds when heated.

In a letter sent last month to 7,200 Yellowstone County businesses, RiverStone Health President John Felton explained the rationale for bringing e-cigarettes under the Montana Clean Indoor Air Act of 2005. The use of e-cigarettes in public places “renormalizes tobacco use among youth,” Felton wrote. “The number of youth using e-cigarettes has skyrocketed. In Montana, nearly 47 percent of young people have tried electronic nicotine delivery products.”

In addition to banning indoor public use of e-cigarettes, the new Yellowstone City-County Board of Health rule prohibits smoking or vaping within 20 feet of the entrances or windows of a public building or business open to the public. A draft rule proposed a 30-foot no smoke/no vape zone, but that was revised after the board received public comments pro and con. The 20-foot setback is intended to prevent smoke and vapor from getting inside the building.

As the county’s health agency, RiverStone (not the police or sheriff) has responsibility for enforcing the Clean Indoor Air Act. The health officials aren’t going to be out looking for violations. Instead, RiverStone will respond to complaints by trying to resolve violations with education and changes that work for a particular place and situation. The last resort after three violations and warnings within three years would be a misdemeanor charge against the business that remained in violation.

Other Montana communities that have for years enforced no vaping/smoking indoors or near doors have seen few violations. We expect that will be the case in Yellowstone County.

When you see the small aqua and white signs saying “no smoking, no vaping,” please thank the business for protecting public health. RiverStone provides these signs at no charge to businesses. For more information on the new rule or other questions about Montana’s Clean Indoor Air Act, call a RiverStone Health Tobacco Prevention specialist at 247-3200.