Changes in 2010 to WI Clean Indoor Air Act and Its Effect
on E-Cigarettes in Nursing Homes
PDF Version
of DQA 10-014 (PDF, 91 KB)
| Date: |
June 8, 2010 -- DQA Memo 10-014 |
| To: |
Nursing
Homes NH 05 |
| From: |
Paul Peshek, Director
Bureau of Nursing Home Resident Care |
| Via: |
Otis Woods, Administrator
Division of Quality Assurance
|
Changes in 2010 to WI Clean Indoor Air Act and Its Effect
on E-Cigarettes in Nursing Homes
Background
Effective July 5, 2010 the Wisconsin Clean Indoor Air Act (section
101.123, Wis. Stats.) prohibits smoking in all inpatient health care
facilities, including nursing homes, within the state of Wisconsin. Nursing
homes with a current policy that allows smoking in designated area(s) within
the facility will need to change the policy and notify all residents of the
change.
Nursing homes that allowed indoor smoking before July 5, 2010 have two
options: (1) to allow smoking in an outdoor designated smoking area or (2)
to designate the entire campus as non-smoking. More details can be obtained
in DQA memo 09-047, located on-line at: http://www.dhs.wisconsin.gov/rl_DSL/Publications/pdfmemos/09-047.pdf
Nursing homes that may have to change their smoking policies should
include the use of e-cigarettes in these policies. Electronic cigarettes are
not tobacco products, although they are designed to look and feel like
traditional cigarettes. E cigarettes have been marketed as an alternative
nicotine delivery device for use in places where smoking is not permitted
since they do not produce smoke.
A typical e-cigarette consists of three components: a battery, an
atomizer and a cartridge containing nicotine. Most replaceable cartridges
contain nicotine suspended in propylene glycol and water.
There are claims that these devices are safe to use. However, in limited
studies there are concerns that the nicotine that is inhaled may contain
carcinogens and other unknown toxic chemicals. There is limited information
concerning these devices and whether the inhaled nicotine is safe.
Many organizations, including the Department, support banning e-cigarette
sales until more is known about the risks of this product. The American
Cancer Society Cancer Action Network, the American Heart Association, the
American Lung Association and the Campaign for Tobacco Free Kids have a
policy that may provide helpful information to facilities, links provided
below.
Due to safety concerns facilities have asked whether e-cigarettes should
be banned. As described in DQA memo 09-047, nursing homes fall into one of
the following four scenarios with respect to smoking and e-cigarettes:
- Facility has a policy that currently prohibits smoking within
the nursing home and on facility grounds. The Wisconsin Clean
Indoor Air Act will have no impact on these facilities. However these
facilities may wish to address e-cigarettes which may not fit under the
definition of smoking. Although the changes to the Wisconsin Clean
Indoor Air Act [section 101.123(4)(a)1, Wis. Stats.] do not explicitly
ban the use of e-cigarettes, facilities may implement specific
e-cigarette bans.
- Facility policy currently allows smoking only in a designated
outdoor smoking area and the facility wishes to continue this practice.
These facilities may choose to limit the use of e-cigarettes to the same
outdoor designated area. Facilities that implement an e-cigarette ban
will need to update their policy to specifically reflect the e-cigarette
ban.
- Facility policy currently allows smoking in designated areas
within and outside the facility, and the facility wishes to continue to
allow smoking outside. Effective July 5, 2010, smoking within
the nursing home is prohibited for all staff and residents. Current
residents may not be grandfathered to allow them to smoke inside the
building. Residents and staff may continue to smoke in designated areas
outside the facility. As facilities develop, communicate and implement
the new smoking policies, a specific e-cigarette ban can be included in
such policies.
- Facility policy currently allows smoking but the facility wishes
to become a nonsmoking campus. If a nursing home changes past
policy by prohibiting smoking altogether on facility grounds and
includes specifically banning e-cigarettes, this must be clearly stated
in a revised admission agreement.
The facility should notify the community, potential visitors, referral
sources, and current residents of the change in smoking policy and
e-cigarette ban. Residents who are admitted on or after the effective
date of the policy are subject to the restrictions of the smoking policy
and e-cigarette ban. Once again e-cigarettes can be part of the change
in the facility policy. Additional guidance for implementing a change in
policy can be found in DQA memo 09-047, located on-line at: http://www.dhs.wisconsin.gov/rl_DSL/Publications/09-047.htm
Facility Smoking and E-cigarette Policies
As facilities consider changes to smoking policies that include
e-cigarettes, the Bureau of Nursing Home Resident Care encourages facilities
to develop written policies and procedures that clearly identify:
- whether smoking or the use of e-cigarettes is allowed on facility
grounds and, if so, where it is allowed;
- what accommodations for smoking and e-cigarettes are provided; and
- the type of staff assistance that will be provided with smoking or
with the use of e-cigarettes.
These policies and procedures should be clearly explained orally and in
writing to all new or prospective admissions. A facility policy that clearly
articulates smoking and e-cigarette bans or restrictions will allow
potential residents considering admission to determine if they can abide by
the conditions of the policy. An explicit policy will also help deter or
settle issues that might arise concerning smoking or the use of
e-cigarettes.
Smoking Cessation Programs
See DQA memo 09-047 at: http://www.dhs.wisconsin.gov/rl_DSL/Publications/09-047.htm
If you have questions, please contact your Regional Field Operations
Director (RFOD) at the location and phone number below.
- Southern Regional Office - Juan Flores RFOD (608) 266-9422
- Southeastern Regional Office - Jean Rucker, RFOD
(414) 227-4563
- Northeastern Regional Office - Dolores Zwiers, Interim RFOD (920)
983-3185
- Northern Regional Office - Jessica Radtke, Interim RFOD
(715) 365-2801
- Western Regional Office - Kathy Lyons, Interim RFOD
(715) 836-3030
Action of Smoking
(ASH) Health Briefing (PDF, 137 KB)
American Heart
Association and American Lung Association Policy Guidance Document Regarding
E-Cigarettes (PDF, 92 KB)
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Last Updated: September 30, 2011
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