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Ord.2164 Page 12 • A study published in the American Journal of Public Health found similar results to those identified in FDA testing and concluded that the electronic smoking devices tested demonstrated poor quality control, toxic contaminants, misrepresentation of the nicotine delivered and insufficient evidence of the overall public health benefit; and • A recent study found a total of 22 elements in vapors produced by electronic smoking devices, and three of these elements (lead, nickel, and chromium) appear on the FDA's "Harmful and Potentially Harmful Chemicals List"; and • Recent studies show that the aerosol emitted by electronic cigarettes contains 10 chemicals listed on the Proposition 65 list of chemicals known to the state to cause cancer, birth defects and reproductive harm;" and • Recent studies also show that the aerosol emitted by electronic cigarettes contains ultrafine particles that are inhaled and trapped in the lungs, absorbed by the blood stream and delivered to the brain and other organs; and WHEREAS, the confusion caused by the visual similarity between electronic smoking devices and traditional tobacco products may impact individuals and the owners of establishments seeking to comply with applicable smoke-free laws and will threaten the city's enforcement of these laws; and WHEREAS, secondhand marijuana smoke has been identified as a health hazard, as evidenced by the following: • The California EPA included marijuana smoke on the Proposition 65 list of chemicals known to the state of California to cause cancer; and • According to a 2009 California EPA study, marijuana smoke contains at least 33 known carcinogens and is associated with cancers of the lung, head and neck, bladder, brain, and testes; and • Based on the similar chemical composition of marijuana secondhand smoke and tobacco secondhand smoke, the well-established heart attack risk caused by exposure to tobacco secondhand smoke, and research demonstrating the negative effects of marijuana secondhand smoke on cardiovascular functions, a 2015 UCSF Division of Cardiology & Cardiovascular Research Institute report concluded that marijuana secondhand smoke and tobacco secondhand smoke likely have similar harmful effects on public health; and WHEREAS, there is no Constitutional right to smoke; and WHEREAS, the United States Department of Housing and Urban Development ("HUD") urges owners and management agents of HUD-assisted