Electronic Cigarettes

We recently had a patient smoke an “electronic cigarette” in his isolation room.  I have researched the issue and, as you can imagine, FDA is against them and the manufacturers are pro.  FDA got a recent ruling that they can regulate the device as a drug administration item and not as a tobacco item.  What is the official stance on "electronic cigarettes"?

It appears as though this matter is still up-in-the-air. I’m not aware that TJC standards specifically address this issue. Therefore, I recommend that  your hospital perform a risk assessment and if necessary, modify the hospital’s smoking policy and/or any related medication management policies, depending on the outcome of the risk assessment.

If the electronic cigarette is a battery operated “electronic device”, I would have concerns about it being used in an “oxygen-enriched” environment. Below is info  from the 2012 NFPA 99 for hyperbaric conditions. I couldn’t find anything else on battery powered non-patient care equipment. 

NFPA 99, 2012

14.2.7.3.17.5  Battery-Operated Devices. Battery-operated devices shall meet the following requirements:

(1) Batteries shall be fully enclosed and secured within the equipment enclosure.

(2) Batteries shall not be damaged by the maximum chamber pressure to which they are exposed.

(3) Batteries shall be of a sealed type that does not off-gas during normal use.

(4) Batteries or battery-operated equipment shall not undergo charging while located in the chamber.

(5) Batteries shall not be changed on in-chamber equipment while the chamber is in use.

(6) The equipment electrical rating shall not exceed 12 V and 48 W.

(7) Lithium and lithium ion batteries shall be prohibited in the chamber during chamber operations, unless the product has been accepted or listed for use in hyperbaric conditions by the manufacturer or a nationally recognized testing agency.