Adult smokers and ex-smokers are majorly boosting sales of e-cigarettes and vape in this region
Ronald Bayer, a Columbia University professor, told CBS News in 2013 that "the evidence of a risk to people in open-air settings is flimsy." In a 2013 study published in Health Affairs , Bayer and Kathleen Bachynski, now a public health professor at Muhlenberg College, found that the evidence for outdoor smoking bans was "far from definitive and in some cases weak." The impetus for these bans, meanwhile, is "the imperative to denormalize smoking." The paper also concludes that, while denormalizing smoking may prove effective in the short term, "it is hazardous for public health policy makers, for whom public trust is essential." If San Francisco lawmakers are concerned with improving public health outcomes, the evidence-based solution would not be draconian bans, but harm reduction
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Furthermore, the indirect method of estimating cigarette butt densities from total anthropogenic litter introduces some uncertainty, as it may not fully capture the variation in cigarette butt accumulation, particularly in areas with distinct litter compositions or disposal patterns
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