Electronic Cigarette Use is Exploding – But is it for Good?
by Linda L. Esterson

It seems we can’t go anywhere these days without seeing someone light up, but often we don’t see the smoke. Instead of tobacco, we smell something sweeter, almost inviting.

Electronic cigarette use, or “vaping,” is exploding, and the aromas are filling the air all over the county.

An e-cigarette is a battery-powered device that heats a liquid that produces an inhalable vapor. The liquids are flavored and are usually infused with varying amounts of nicotine.

According to Vic Vega, owner of three Vapor Villa locations, including one in Eldersburg that opened in October, e-cigarettes can be helpful for smokers who are trying to quit tobacco.

“They get the sense that they are still smoking, but without the chemicals of the cigarette,” he said.

Others aren’t using e-cigarettes as a replacement — they just like vaping.

Hundreds of flavors are available. Vega sees the most demand for Starburst and Skittles flavors, although blueberry cheesecake and caramel apple also quite popular. SS Vape in Westminster’s TownMall offers flavors that mimic cigarettes, such as menthol, and others that are more unusual. Manager Dawn Danehy said the store offers “Tiger’s Blood,” which is a dragon fruit flavor; “fruit juicy gum” that tastes like Juicy Fruit; and “Spoonful O’Berries,” which resembles a sugared breakfast cereal. In fact, Danehy says, most candy and cookie tastes can be found in a vape flavor.

Cost Savings

One factor driving e-cigarette use is cost.

A pack of cigarettes costs an average of $7 to $8 in Maryland. Vaping is significantly cheaper. According to Vega, an e-cigarette user vaping the equivalent of 20 cigarettes — one pack — a day, would spend about a dollar.

Initial costs for e-cigarette users vary. A simple starter pack at SS Vape retails for $14.95 and includes a battery, atomizer tank and a USB charger. Flavorings are purchased separately. A step up is the $19.99 CEO starter kit, which features two chambers, allowing for double-strength vaping and the mixing of flavors. Pricier kits have adjustable voltage levels, larger tanks and more powerful batteries. Such kits can cost more than $100.

Health Benefits
Paul Thompson, who had been a pack-a-day smoker since he was 16, unsuccessfully tried to quit using nicotine patches and medications.

“It was like telling an alcoholic to stop drinking, and only giving you a beer,” says the 52-year-old Westminster resident. A few years ago, he learned about e-cigarettes on the Internet, and went to SS Vape to investigate.

Thompson now smokes a few cigarettes each morning, then switches to electronic cigarettes, with 24 mg of nicotine in the vapor. He plans to gradually reduce the amount of nicotine in the flavoring and ultimately eliminate it altogether.

Smoking has harmed his health. He suffers from frequent lung infections and has been diagnosed with chronic obstructive pulmonary disease. But, after switching to e-cigarettes, Thompson says he can breathe easier, especially during exercise. His blood pressure has dropped, and his periodontist is “tickled pink” with the improvement in his gums.

“This was the best purchase I’ve ever made,” he says. “And I don’t say that lightly.”

Sharon Dustin smoked a pack of cigarettes daily for more than 30 years. In the summer of 2013, she visited SS Vape. She started with a small starter kit and 18 months later is still vaping.

The changes are clear. She’s less susceptible to colds in the winter, her coughing and wheezing have diminished, her sense of smell returned and she can breathe easier. Eliminating the smell of smoke from her clothing was a plus.

Today, Dustin, 55, can outpace her friend when they go walking.

After beginning at 18 mg of nicotine, she’s now using between 3 and 6 mg. In late January, she bought a smaller bottle of flavoring with the intent of stretching it longer than its usual three weeks.

“I would like to be done with the habit altogether and say I don’t smoke anymore,” Dustin proclaims. “I have smoked and quit before. This has made it way easier.”

Vega has a customer in Catonsville who brought in X-rays of her lungs before and after one month of e-cigarette use. He could see significant clearing in the image.

“Vaping is the most successful form of smoking cessation ever around,” he says.

Medical concerns
Despite the accolades from users, e-cigarettes are not without critics. The Food and Drug Administration has yet to release an official ruling regulating the industry. Current regulations on smoking were created long before the introduction of e-cigarettes.

Last April, the FDA announced its intention to extend its tobacco authority outlined in the Family Smoking Prevention and Tobacco Control Act of 2009 to e-cigarettes and other currently unregulated products, including cigars, pipe tobacco, nicotine gels, water pipes, and dissolvables. The proposed rule would require products to register with the FDA and report product and ingredient listings, market only new products reviewed by the FDA, and limit claims of reduced risk to only products confirmed by the FDA following a review of scientific evidence. There would also be a minimum age for sales, required health warnings on packaging and a prohibition of sales in vending machines accessible to youth.

While the FDA continues its evaluation, area health professionals remain skeptical.

“It’s no different than a new delivery system for nicotine,” says Dr. Amit Narula, director of pulmonary medicine at Carroll Hospital Center. “The use of nicotine has consequences and addiction potential. It’s likely not safe and has no health benefits.”

Narula added that even if users vape with liquids that don’t contain nicotine, there is still a concern about the chemicals inhaled. He refrained, however, from making a statement about the toxicity of the e-cigarette until the FDA releases its findings.

“In general, I don’t think at this time anyone can say with certainty that electronic cigarettes should be used as there is no scientific data backing whether it is a good method for smoking cessation,” he notes. “[They] clearly offers health risks, but do they offer health benefits?”

Barbara White, director of the Cigarette Restitution Fund Program at the Carroll County Health Department, listed a variety of concerns, including secondhand vapor — like secondhand smoke — and safety concerns with the equipment, such as a battery exploding while being charged.

The potency of the nicotine and chemicals, however, are the primary concern to White.

“Nicotine is a very powerful poison,” she says. “It can be absorbed through the skin and inhaled [when handling the liquid]. A teaspoonful of highly diluted e-liquid can kill a small child.”

Calls to poison control centers increased by 40 percent from September 2010 to February 2014 following exposure of children to e-cigarettes, White says. Pets are also at risk, she added.

Currently, White notes, there are 468 brands of e-cigarettes on the market. According to the Centers for Disease Control, e-cigarette use has doubled from 2011 to 2012 among middle and high school students and adults ages 18 to 34. Sales are expected to surpass $10 billion by 2017 and spending on advertising also has risen sharply from $5.6 million in 2010 to $82.1 million in 2013 across all media channels.

White is also concerned that, in addition to nicotine and solvents, vapors also contain chemical flavorings and preservatives. Although they may be “generally recognized as safe” by the FDA, the designation is based on tests of the compounds when they are heated and inhaled, not ingested. White also cites recent diagnoses of lipoid pneumonia — a chronic inflammation caused by fatty substances (lipids) in the lungs — due to e-cigarette use. The specific cause is repeated exposure to glycerin-based oils found in e-cigarette vapor.

In an effort to protect employees and customers, restaurants and employers have added e-cigarettes to policies excluding indoor smoking.
But while health professionals express concern, millions continue to vape.