The jury’s no longer out on vaping.

Mountains of research in recent years have shown inhaling high doses of nicotine and heavy metals in e-cigarettes can lead to similar damage to the heart and lungs as smoking traditional cigarettes.

And now, researchers are beginning to warn of the dangers of second-hand nicotine vapor, which likely prompted a new law in Alabama banning residents from vaping in cars with children under 14 present.

Yet as millions of workers will attest, their colleagues are still vaping en masse in offices and other workplaces such as bars and restaurants across the country.

The ease of use and lack of smell means staff can subtly puff at their desks or in the break room without letting off plumes of pungent smoke, which can be odorless or sweet-smelling.

Experts told DailyMail.com society has been slow to catch up to the reality that these devices pose a serious risk to people’s health.

Seeing co-workers vape surreptitiously in the office is commonplace – nearly 62 percent of workers see it daily. 

A study published in the Journal of Occupational and Environmental Medicine found that 76 percent of e-cigarette users reported vaping at work.

And this is a real concern. The aerosolized byproducts of vapes pollute the surrounding air, potentially endangering workers. And non-vapers are fed up, with 74 percent supporting a vape-free workplace. Even vape users – at least 53 percent – support an indoor vaping ban at work.

Those points represent just one set of findings pointing to a growing sense that vaping at work, in bars, and in restaurants should be outlawed, yet in many places it’s not.

Thomas Carr, the Director of National Policy at the American Lung Association told DailyMail.com: ‘The fact that they’re using them indoors, it’s very troubling to hear about this, that workplaces are just turning a blind eye to this because it’s not acceptable to allow vaping indoors.’ 

He added that a shift to working at home full time during the pandemic, when people could vape without disrupting anyone around them, certainly added to the devices widespread use once people returned to their offices in person. 

Mr Carr said: ‘Not being in a workplace and understanding some of the norms that need to exist there and that your vaping is bothering other people. Because there are probably employees in these in places where this is happening that are tolerating it silently, and or maybe even not silently. And I think it’s just that things aren’t being done about it.’ 

A survey conducted in the fall of 2018 reported that, overall, more than 78 percent supported a policy to keep tobacco products out of view in stores where children can shop. More than 63 percent supported a policy to ban the sale of flavored e-cigarettes altogether.

The majority of participants – 76 percent – also supported prohibiting the use of e-cigarettes in bars, 83 percent supported a ban in all indoor public places such as offices and casinos, and 87 percent want a ban in restaurants.

Many workplaces have no rules in place governing vape use in the office, which gives employees tacit permission to puff on the devices at their desks. 

Dr Ashley Merianos, a professor at the University of Cincinnati with expertise in tobacco control, told DailyMail.com that the lack of hard and fast rules is a problem: ‘There may be confusion about whether vapes are covered by tobacco-free policies in work environments if there is no written policy addressing vaping, especially since these products became available on the market after combustible tobacco products.

She added: ‘Even if there is no tobacco-free law that prohibits tobacco use in the work place, it is encouraged that employers enact a strict, comprehensive tobacco-free policy that covers combustible tobacco products and non-combustible tobacco products, including vapes.’

But the days of being able to puff on e-cigarettes with impunity in bars, casinos, college campuses, and work spaces could be coming to an end amid an expanding body of scientific research that shows vaping could be as dangerous to one’s heart and lung health as cigarette smoking.

Societal attitudes toward vaping and how innocuous – or not – it might be have changed noticeably over the past decade.

Part of the shift in perspective came after an outbreak of e-cigarette- or vaping-use-associated lung injury (EVALI) that began in 2019 and by February 2020 had reached a total of more than 2,800 hospitalizations and 68 deaths.

Dr Jason Rose, a physician who specializes in lung injuries, told DailyMail.com that the EVALI outbreak of 2019 finally brought dangers of vaping into the mainstream. 

He said: ‘That did create a situation where it really got publicized that, hey, you know, these might not be completely safe. And that was probably a moment where it’s like, these can actually cause a problem, a clear and present problem.

‘These products really came out 10, 15 years ago, and they just more recently have been getting more publicity.’

In a recent report from the American Heart Association and co-authored by Dr Rose, it was determined vape devices contain a cocktail of nicotine, thickeners, solvents, and flavors that likely pose the same severe risks to cardiovascular health, including raising blood pressure levels and heart rate, as smoking traditional cigarettes.

The true extent of the health harms brought on by vaping, such as driving increased risk of Chronic Obstructive Pulmonary Disease (COPD), likely won’t become apparent for many more years, though.

Dr Rose said: ‘Biomedical science and research have advanced significantly in the last 120 years. I think we have an experience with what [health harms of] combustible cigarettes looked like historically, that we can use to try to understand a little bit better what these vaping practices have an effect on.

‘We have to be strategic about our research because developing a hard link between product use and COPD, which takes decades to develop, we’re just not able to see it. They’ve only been on the market for 10, 15 years.’

And secondhand aerosols from high-nicotine vape products, while not laced with the same thousands of carcinogens produced as a byproduct of burning tobacco in cigarettes, are not as innocuous as once thought.

The plumes that come from a vaping device such as a Juul or a PuffBar can smell fruity, sweet, or like nothing at all, which scientists believe has lulled users into a false sense of security.

Vapes spew out 22 times the safe level of microscopic toxins known as particulate matter, which is small enough that when inhaled can cause respiratory issues and enter the bloodstream.

Dr Rose said: ‘I would say we don’t have a lot of data on the health risks for secondhand vaping product inhalation. I think policies that follow where other inhaled tobacco products are prohibited (e.g. not allowing smoking in most enclosed workplaces) are prudent.’  

A separate 2019 study in the International Journal of Hygiene and Environmental Health sought to measure the lingering effects of taking in second-hand aerosol from e-cigarettes following exposure for about six hours at vaping conventions.

Researchers found chemical markers from exposure to nicotine and tobacco in the environment spiked in 28 people who did not regularly vape after attending in-person conferences where they were surrounded by vapor.

They did not, however, vape themselves. Yet their bodies showed signs of exposure to nicotine and how it is metabolized.

In their urine, levels of two substances, cotinine and trans-3′-hydroxycotinine, were elevated, while levels of cotinine, trans-3′-hydroxycotinine, 3-HPMA, and CEMA were higher in their spit. And concentrations of each varied depending on how much time had passed since the conferences.

The findings signaled that being around e-cigarettes without puffing on them can still lead to higher concentrations of these substances in the body.

They also poke a gaping hole in the argument held by millions who vape that passive exposure to the vapor emitted by the devices must be harmless because it does not leave behind the offensive odor of a traditional cigarette.

With that growing evidence, more people have become aware of this common fallacy and are willing to re-examine cultural norms around vaping.

As the research builds, more officials in states and local governments are implementing various limits on where people can vape.

New York added vaping to be included in the Clean Indoor Air Act in 2017, formally banning it in indoor places. It is one of several states to have passed similar bans, most of which are Democrat-run.

In 2016, California imposed its own ban on vaping in indoor public places, including work settings. Illinois passed a similar ban in 2014 while New Jersey passed one in 2010.

Delaware was the most recent to ban indoor vaping with a law in 2019.

As more research emerges pointing to the deleterious effects of vaping and the aerosol the devices produce, more states and localities are expected to pass restrictions on their use indoors.

‘Where the skies are so blue,’ the late Ronnie Van Zant sang in the country music classic Sweet Home Alabama, in a southern drawl full of conviction. Looking out from my seafront balcony, he certainly seems to have got that right.

As the beaming sun settles high in the sky above sugar-white sands and crystalline waters, it quickly becomes clear that the catchy tune is spot on about this much-maligned state – so often talked down because of its rural backwaters populated by tough, poor and sometimes rough-around-the-edges communities. Google ‘Alabama’ and ‘redneck’ and you’ll get a lot of hits.

But despite Zant bringing the sunny skies of Alabama to the world’s attention 50 years ago, most first-time visitors to this corner of the States, known as Gulf Shores and Orange Beach, are likely to come away pleasantly surprised.

I, for one, didn’t even know that the 22nd state had a coastline.

And it’s a lovely one. As I arrive, Alabama’s pristine shores are sparkling, pelicans glide overhead in neat V formations and the empty golden beaches stretch into the distance. It feels remote and tranquil – yet to the east lie Florida’s crowded sands, while 600 miles south across the Gulf of Mexico, Cancun throbs with all-night parties.

Here, it could not be more different. The narrow coast juts out beneath Mobile Bay, a shallow inlet from the sea, and stretches from the Civil War bulwark Fort Morgan in the west to the serene Orange Beach in the east, with so many quiet bays you’ll often find you have the beach all to yourself.

My billet is The Lodge At Gulf State Park, a Hilton hotel. Despite its 350 rooms, the neutral colour palette, laid-back atmosphere and host of wooden screens and panelling make it seem more like an opulent beach shack.

Directly behind lies Gulf State Park, a world of meandering trails, quiet lakes and a key part of one of the most biodiverse regions in the United States: 450 of America’s 1,000 bird species either live or pass through Alabama.

This I learn from my guide, Kelly, during a morning park stroll. She excitedly points out flame-red cardinals and high-hanging turkey vultures. The distant staccato yelps, she says, are those of a cooper’s hawk.

A small crowd gathers around us when Kelly picks up a passing ribbon snake with bulbous eyes. ‘Venomous snakes have thin black eyes, while non-venomous snakes have more rounded pupils,’ she explains. ‘So don’t worry!’

If avoiding serpents appeals then both traditional and e-bikes are available to hire at the park, while the nearby Waterville USA waterpark is ideal for families when the mid-afternoon heat picks up.

Back on the shore at Gulf State Park Pier, the hazy coastal views are magnificent and fishing is a fine way to pass languid mornings. Rods are available to hire for £16 for four hours.

My awkward attempts at casting are almost as risible as the fish’s luck in gobbling on to the shrimp at the end of the hook. I return empty-handed.

For a more successful taste of the deep, some of the Gulf’s finest seafood is found further east, at Orange Beach.

Coastal restaurant is the place to go: its dreamy patio is bathed in the milky orange glow of a Gulf sunset just about every evening and its creamy grouper fish sandwich is deliriously succulent. Don’t miss the magnificently delicate Murder Point oysters, too.

This being America, though, I also spot a trend for grilled oysters doused in melted cheese and fiery hot sauce, something I feel is akin to pouring Irn-Bru into a glass of single malt whisky.

Ready for a change of scene, I drive an hour north towards Five Rivers Delta for a Wild Native kayak tour. Here, the landscape evolves into an evocative scenery of lazy river bayous, often referred to as ‘America’s Amazon’.

As I paddle slowly downstream in my kayak, I notice the dead eyes and dark green snout of an alligator poking through the water near some reeds. It lies there, motionless, like a scaly submerged statue.

‘There’s been only one recorded alligator attack in 48 years in Alabama,’ my chirpy guide, Chris, announces. ‘In Florida they’ve had over 300.’

This fact keeps everyone at ease, alongside his relentless stream of chatter, wildlife facts and jokes.

Speaking of Florida, back at Orange Beach there’s a bar straddling the Florida/Alabama state line, imaginatively titled Flora-Bama. Heading for a drink there, I come to a ramshackle maze of wooden corridors with five stages and live music every night.

On the two-storey main stage, the Justin Johnson Trio belts out Tom Petty covers as a huge stars-and-stripes flag unfurls from the ceiling.

The swinging jazz rhythms of New Orleans are just a three-hour drive away and make for an alluring diversion, but I’m content here with empty beaches, seductive southern rock, otherworldly nature and an endless sun.

Alabama’s a sweet home, indeed.

Donald Trump raised more than $2 million from donors who attended a ‘candlelight dinner’ with him at Bedminster Tuesday night – after his day in federal court and defiant speech delivered outside the clubhouse.

CNBC reported Wednesday that supporters who donated or raised more than $100,000 toward his 2024 White House bid were invited to the intimate affair.

They were fed Trump favorites including burgers and crab cakes, and were served wine and cocktails. 

The initial invitation had teased special Congressional guests, but only Alabama Sen. Tommy Tuberville made it to New Jersey, as there were ongoing votes Tuesday night. 

Tuberville stayed for the donor dinner. ‘I was invited a couple weeks ago, this had been planned,’ he told DailyMail.com Wednesday about the scheduling.

Prior to the more exclusive dinner, a crowd of several hundred gathered in front of the clubhouse at Trump’s Bedminster, New Jersey, golf resort to hear him deliver blistering remarks about the Mar-a-Lago documents case. 

That event attracted some Trumpworld favorites including My Pillow CEO Mike Lindell, Sebastian Gorka, Andrew Giuliani and Bernie Kerik. 

Eric Trump attended the event, as did Kimberly Guilfoyle, the fiancee of Donald Trump Jr.

Aides who had traveled with the president to Miami, including Boris Epshteyn and Margo Martin, were also on hand for the speech. 

Walt Nauta, who is also facing federal charges over the Mar-a-Lago documents case, returned to New Jersey with the president, Trump’s spokesman said, but DailyMail.com did not spot him in the audience for the speech. 

One large group in the audience was Vietmanese Americans for America First, who were easy to spot as all the women were sporting the same red MAGA dress.

Trump told the audience that the prosecution was ‘the most evil and heinous abuse of power in the history of our country.’

‘I did everything right and they indicted me,’ he complained.

The former president suggested that other political figures had gotten away with much worse. 

‘He lost the nuclear codes,’ Trump claimed of Bill Clinton, who he called a ‘nice guy.’

‘They should have used him a little bit more as an adviser in the 2016 election,’ Trump also joked, alluding to how he beat Clinton’s wife Hillary in the presidential election that year.

Trump also charged that George W. Bush’s White House ‘lost 22 million emails.’

‘A document shredding truck was spotted on the way to Dick Cheney’s house. Can you imagine?’ the former president added. 

He spoke at length about the Bill Clinton ‘socks’ case, which fact-checkers have already said isn’t a valid comparison to what Trump is accused of doing. 

When Trump paused to take a swig out of a bottle of water a member of the crowd shouted ‘Happy Birthday!’ at him. 

He turned 77 Wednesday. 

‘Nice birthday isn’t it?’ the ex-president commented. 

Trump grinned as a crowd of supporters then sang ‘Happy Birthday’ to him. 

‘Nice birthday. Wonderful birthday,’ he said. 

‘I was with Eric and Lara and the kids – “Happy Birthday grandpa!” – I said oh great, I just got charged with, they want 400 years approximately, if you add them all up. A fake 400 years. So thank you darling, that’s so nice. It’s a wonderful birthday,’ the former president continued. ‘We’re going to make it into the greatest birthday of all.’  

America’s postcode lottery for the price of giving birth has been revealed in DailyMail.com interactive maps.

Based on data from healthcare insurance claims analyst FAIR Health, they show how the national average stands at $12,900 for a vaginal delivery and $15,500 for a C-section.

The costs ranged by as much as $13,000 for a vaginal delivery depending on where someone lives, with Alaska and New Jersey charging up to $21,000 for birth, while in Alabama and Louisiana, the price for the same procedure could be below $8,000.

The situation was worst for uninsured patients, who could face costs upwards of $50,000 for giving birth in the country.

Some states were more expensive because of their high cost of living and the fact that they had nationally renowned healthcare providers. 

On the other hand, states with a lower cost of living tended to have lower price tags for giving birth. The map comes as the number of births per year continues to trend downwards in the US, with many now waiting until later in life to have children.

For the analysis, FAIR Health looked at its database of 41billion claims — the largest in the US — and included those linked to giving birth in 2022.

These were claims for the actual birth — such as renting the labor room — and for tests afterward — like fetal stress and any scans.

The analysis calculated figures for people with health insurance, comprising 92 percent of the population and those without.

Patients will likely only need to pay a fraction of the total costs out-of-pocket — typically $2,500 to $3,000, with insurance companies footing the rest.

Major insurance groups like Cigna and Aetna negotiate the price of a birth or C-section with insurance companies, with patients later required to pay only a percentage of the total.

However, those who come to healthcare systems without insurance face much higher costs.

The costs were calculated for people who did not face complications, with those that do likely to face a larger bill. 

Broken down by state, the most expensive for vaginal delivery was Alaska ($21,525) and New York ($19,990).

Rounding out the top five were New Jersey ($18,688), Connecticut ($17,387) and Massachusetts ($16,731).

At the other end of the scale, there was Alabama ($7,840), Louisiana ($7,981) and Maryland ($9,183).

Alaska was also the most expensive state for C-sections, with the procedure priced at more than $25,000.  

The state was followed by New Jersey, also at $25,000, New York ($22,353) and Connecticut ($29,956) regarding C-section costs.

The cheapest state was Alabama, priced at $8,913, with Louisiana second at $8,995 and Maryland third at $9,856.

Alaska is one of the most expensive places for healthcare in the United States, including giving birth, partly because of its geographical isolation.

This leads to higher costs for getting vital medical supplies to the state, while the limited competition — due to fewer providers — allows those there to charge more.

The costs of giving birth in Alaska are also forced by its high cost of living, with people needing to earn more to live comfortably in the state.

The cost of giving birth is also higher in the New York metropolitan area — New York, New Jersey and Connecticut.

This may be linked to it having a higher quality healthcare system, with hospitals there often ranking among the best in the country, alongside the higher cost of living in the area.

Women giving birth in these areas may also face higher insurance premiums and deductibles due to the higher cost of living, also inflating prices.

At the other end of the scale were the southern states — particularly Alabama — for both vaginal deliveries and C-sections.

This is likely driven by the state having a lower cost of living and, as a result, being able to charge less for healthcare than in other areas.

It also has a low population density, which can result in less demand for healthcare — which would also help to push down prices. 

Robin Gelburd, the president of FAIR Health, said that Alaska’s high prices were due to its ‘remote geography and practice settings, cost of travel and potential lack of access to practitioners and relevant facilities.’

On Alabama, he said this was a state with ‘a relatively low cost of living that translates generally into lower cost of healthcare’.

He added: ‘The lower prices may also be a reflection of the reimbursement rates negotiated between plans and providers in the South and the relative negotiating power of the parties.’ 

It comes after it was revealed that a record number of women are now waiting until they hit their 40s to have children. 

Data from the Centers for Disease Control and Prevention (CDC) showed that the birth rate for women aged 40 to 44 rose four percent 2022 from the previous year to a record high.

There was also a 12 percent uptick among women aged 45 to 49, the first change in this rate since 2015, and to another record level.

Experts say that more people are putting off starting a family until later in life, instead focusing on their career, travel and social life in their younger years. The cost of giving birth and becoming a mother is also a factor.

The rise of technologies such as invitro-fertilization (IVF) and egg freezing have also played a role.

The uptick among older women comes as America’s fertility rate hovers at just below 1.7 births per woman. It hit a record low in 2020 at 1.6 when the pandemic led many couples to put off having children.

The data was released as a ‘Cost of Giving Birth’ tracker on the FAIR Health website.

Its president Robin Gelburd said: ‘FAIR Health is pleased to shine a light onto the costs of giving birth from state to state and nationally.

‘With the Cost of Giving Birth tracker, we once again use our vast data repository to inform healthcare stakeholders — including patients, policy-makers, payors and providers — on issues that matter to them.’