How are SNFs handling residents who use e-cigarettes?

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Q: We have a new resident who is smoking the e-cigarette. What are facilities doing with it?

A: An electronic cigarette, or e-cigarette, is an electrical device that simulates the act of tobacco smoking by producing an inhaled mist bearing the physical sensation, appearance and often the flavor and nicotine content of inhaled tobacco smoke; though without its odor, it is intended to eliminate health risks. The device uses heat (or in some cases, ultrasonics) to vaporize a liquid solution into an aerosol mist. 

In speaking with a dozen or more facilities, the e-cigarette seems to be handled in an individual facility- or corporate-wide policy. Many facilities are not allowing it at all; others allow it after the resident is deemed by the doctor or advanced practice nurse to be safe at handling the device.

It does seem that all of the facilities allowing the e-cigarette keep the charging device at the nurses' station, just to keep an eye on how often it is smoked, and to monitor on an ongoing basis for safety.

As far as purchasing the device, it seems to fall upon the family or POA, if the resident is unable to order one.

As of April 2010, The American Association of Public Health Physicians (AAPHP) supports e-cigarettes sales to adults “because the possibility exists to save the lives of four million of the eight million current adult American smokers who will otherwise die of a tobacco-related illness over the next 20 years.”

Still, the e-cigarette is controversial. Laws governing the use and sale, as well as the accompanying liquid solutions, currently vary widely, with pending legislation and ongoing debate in many regions. If your facility decides to allow the e-cigarette, as with all other devices, you will need a policy on it that is reviewed and updated regularly.