Merchants in unincorporated Coconino County may soon need to move colorful e-cigarettes and other vapor devices away from easy-to-reach places and into enclosed cases or behind-the-counter displays.

The county’s public health services district is proposing changes to two ordinances that regulate e-cigarettes and other “vapor products,” including where they are allowed to be smoked and how they are displayed in stores.

One proposal would update the county’s smoke-free ordinance that prohibits smoking in public places or places of employment. In 2011 the board of supervisors added e-cigarettes to that smoking ban. The new language would expand the ban to include any sort of vapor product including e-pipes, e-hookahs and vape pens.

The number of new vapor products on the market has risen quickly in the last 10 years, so the goal is to create a definition that would include all of them, Coconino County’s chief health officer Marie Peoples told the Coconino County Board of Supervisors during a presentation last month.

“Now is a good time to be proactive,” she said.

As a part of that ordinance change, the health district also is proposing to require all hotel rooms in the unincorporated county to be 100 percent smoke free.

The other ordinance change would prohibit vapor products from being stored in “an area or manner that is accessible to the public without employee assistance.”

That would mean moving the products, many of which are packaged in bright colors and advertise tempting, kid-friendly flavors, into display cases or behind counters, said Candice Koenker, the health district’s program manager for tobacco and chronic disease prevention.

A major goal is to limit youth access, Peoples said. Putting the products out of reach of customers helps prevent theft by youth and puts an extra step of interaction between the clerk and the buyer.

Nationally, youth use of vapor products is growing, rising from 4.5 percent to 13 percent between 2013 and 2014, Koenker said.

Koenker also pointed to a 2015 study that found high school students in Los Angeles who used e-products were much more likely to go on to use combustible tobacco products over the next year than students who didn’t use e-products.

Health research

When it comes to the health impacts of e-cigarettes and other vapor products, Koenker emphasized that research has just begun on the devices.

Current studies have found vapor products to have lower levels of harmful chemicals than  combustible cigarettes, she said.

But “we have no idea about the long term,” she said.

One recent study by researchers at the Harvard School of Public Health found that diacetyl, a flavoring chemical linked to cases of severe respiratory disease, was found in more than 75 percent of flavored electronic cigarettes and refill liquids that were tested.

The researchers also found two other potentially harmful compounds in e-cigarette liquids that had flavors like cotton candy, fruit squirts and cupcake.

In her presentation, Peoples pointed out that in Maricopa County the number of nicotine poisoning cases caused by people ingesting too much of the e-liquid rose from five people in 2011 to 48 people in 2014. In Coconino County, there was one nicotine poisoning case in 2014 and two in 2015.

Koenker did point out that because there is no burning end of an e-cigarette, much more of the vapor, or smoke, is inhaled into the users’ lungs as opposed to what is emitted from a combustible cigarette.

However, studies have shown that people exposed to secondhand vapor have some level of nicotine in their blood, proving that people nearby are exposed to chemicals the user is inhaling, she said.

“When the products came out, there was a lot of talk about it just being water vapor that is harmless,” Koenker said. “That has been shown not to be true.”

Additionally, the Food and Drug Administration found that some vapor products claiming to be nicotine free did contain nicotine.

The FDA is in the midst of the process to begin regulating e-cigarettes. After proposing regulations in April 2014, then collecting comments and holding workshops, the agency sent its proposal to the White House in October for review.

Ordinance would go to cities

Three other municipalities in Arizona -- Tempe, Gilbert and Guadalupe -- have public smoking bans that include vapor devices, Koenker said. Coconino is the only county in the state to have passed regulations covering the devices.

In the case of both ordinance changes the county is proposing, cities and towns in Coconino County would have 30 days to decide whether to adopt the new ordinance language, change it and adopt that different version or decide not to adopt the ordinance, keeping their own regulations as they are, according to discussion among the board.

If Flagstaff and Page adopted the ordinances, for example, vapor lounges in both places would be prohibited.

Currently, the city of Flagstaff’s ordinances do not prohibit vaping in public places or places of employment. It is, however, prohibited in city buildings and on Flagstaff Unified School District property as well as at school-sponsored events on or off campus.

The health district is planning to touch base with other municipalities in the county about the ordinance changes before it brings the issue back to the board of supervisors in January or February. Before that time, the health district also will conduct a survey of business owners in the county to gauge their opinions about vapor products, determine what they know about them and gather their input on proposed ordinance changes.

At this point, Koenker said she doesn’t have a good idea of whether the general public is aware of the vaping regulations in Coconino County.

Emery Cowan can be reached at (928) 556-2250 or