Second- and thirdhand exposure
Concerning e-cigarettes impact on pediatric population, an
often-underestimated aspect is second- and third-hand smoke.
Approximately 20% of parents using e-cigarettes follow strictly
enforced vape-free home and car policies; among dual users, 64% has a
smoke-free and only 26% a vape-free home policy, which implies a
general misperception about e-cigarettes safety. Furthermore, younger
parents are more likely to lack a home and car
policy100. There is evidence that nicotine metabolites
in serum, as well as saliva and urine cotinine levels, are
superimposable among non-using adults secondhandedly exposed to
e-cigarettes and conventional cigarettes101. Even
secondhand particular matter exposure levels can equal that of
traditional smoking102 and appear to be greater in
nicotine-free devices103.