Should Duke Ban E-Cigarettes? The Academic Council Offers Debate

As Duke approaches implementation of a university-wide smoke-free policy in 2020, several faculty and other community members are pushing for the policy to include a ban on e-cigarettes and vaping.

But at last week’s Academic Council meeting, it became clear there is not unanimity on the issue, as other faculty raised concerns that banning e-cigarettes will hinder the larger goal of cutting cigarette smoking rates.

In less than a year, on July 1, 2020, the university will become a smoke-free campus. Smoking is already banned in the health system, and in campus buildings. As it stands, the policy does not include a ban on e-cigarettes. But Dr. James Davis, director of the Duke Smoking Cessation Program, told the council that rising concerns have Duke officials rethinking that decision.

“There’s still a lot about e-cigarettes that remains unknown; they just haven’t been around long enough,” Davis said. “When (last year) we decided on the smoke-free policy, the evidence is e-cigarettes had 5 to 10 percent of the toxicity of cigarettes. They weren’t as addictive as cigarettes, and they were seen as a way of getting people to stop smoking.”

But new evidence is coming in. Juul, the industry leader, created a device that increases nicotine levels that may be as addictive as conventional cigarettes, Davis said.  As companies launched social media advertising initiatives targeting a younger non-smoking audience, youth smoking rates have tripled in five years, according to respected surveys.

Likewise, concerns about toxicity are also increasing, in part because of a well-publicized increase in vaping-related lung injuries. Duke is currently treating five patients with this condition, Davis said.

In October, eight Duke faculty wrote a letter to the Duke Chronicle calling for a ban on e-cigarettes, citing these concerns about youth smoking and rising toxicity. Most of the faculty conducted research on toxins. But the letter brought a response from other faculty members, including Dr. Jed Rose, who has studied smoking cessation, saying such a ban “was unwise.”

At the council meeting, Fuqua professor Campbell Harvey noted that in Great Britain, the National Health System opposed banning e-cigarettes because of their value in helping smokers break their addiction.  “They see that anything you can do to reduce the intake of toxins saves lives and saves money,” Harvey said.

But other faculty members said the calculus of the policy decision has changed with new information, even in the past few months.

The purpose of the discussion was to collect comments about the smoke-free policy to advise officials setting the policy. No vote was taken.

Davis also discussed plans for implementing the smoke-free policy next July, in particular treatment options for campus smokers. Duke’s Smoking Cessation Program is available to the campus community, either directly or through services at Employee Health or Student Health.

The smoking ban is not meant to be punitive, he said. While some smoking policies involve exceptions or smoking zones to accommodate smokers, Davis said years of research show that “a simple and clear smoking ban” has been most successful.

“Creating smoking zones doesn’t decrease smoking rates,” Davis said. “The question we faced is do we want to decrease smoking in our community or did we just want to reduce the effects of second-hand smoking? We decided we wanted to decrease smoking. We believe this ban will reduce smoking rates around 50 percent.

“We are not trying to get people in trouble. We are going to create programs that go to people where they work in campus and lead them from smoking to not smoking.”

In other council discussions, former Academic Council chair Craig Henriquez presented a faculty salary equity study, which is conducted every two years. Henriquez, who chairs the council’s Faculty Compensation Committee (FCC), said the study found no evidence of statistically significant systematic salary bias for race and gender.

However, he added that there are statistical and anecdotal hints that problems may exist that are beyond the abilities of the statistical model used. Some of the challenges relate to small sizes of certain populations studied. For example, in small departments or in large departments with few women, one or two salaries can have a large effect on computed gender equity.

In a third discussion, David Kennedy, Duke’s vice president for University Development & Alumni Affairs, discussed how to involve faculty in university plans to develop a global alumni network that more strongly connects alumni to the university. He also discussed preliminary planning for the next university capital campaign.