E-cigarettes a cloudy issue
As alarms sound, users say they aid against cigarettes
Even as doctors and health agencies have issued warnings on vaping, some users in Northwest Indiana say it has been one of the only things that helped them ease off cigarettes.
About 90% of her sales come from vaping products, said Endia Lardydell, 42, part owner of Vapor & More, near U.S. 30 and Broadway in Merrillville. So far, sales haven’t taken a hit, as most of the store’s customers are regulars, she said.
Even so, she is worried about the effect it could have on the business. Like others, she said she believed THC cartridges, not nicotine, were linked to the outbreak.
At 16, she started smoking cigarettes, going up to a pack or two per day. Five years ago, she switched to vaping. Her taste and sense of smell, and appetite improved, Lardydell said.
“The benefit for us is great,” she said of ex-cigarette smokers.
Her customers are asking what they would do if a flavor ban went through, Lardydell said. Since tobacco or menthol flavors would stay, would it push them back to cigarettes?
“The main thing to stop smoking, you don’t want to get a menthol flavor or a tobacco flavor,” she said. “I wouldn’t want to do a menthol flavor. That would make me want to smoke cigarettes.”
Bobbye, 68, a customer who asked that her last name not be used, said she transitioned to vaping last fall after smoking cigarettes for more than 50 years.
Too long, she said.
Her plan is to stop vaping as well, concerned about the alleged harm caused by vaping liquid going inside her lungs.
Her children have called and told her to quit, especially after deaths showed up in the news.
“I’ll get there,” she said. “I’m dependent about it. I can’t go nowhere without my vape.”
She said she was skeptical of news linking vaping to recent deaths, saying cigarette companies have an interest in pushing the risks of vaping.
In December, Altria, a tobacco conglomerate that owns Phillip Morris, bought 35% of Juul, a popular e-cigarette brand. Its starter pack costs about $50.
At Vaporz Vault in Hobart, store manager Jason Wisniewski said it’s too soon to tell if sales will be affected.
Right now, his customers have two concerns: Can vaping kill you? If flavored e-cigarettes go away, will they go back to cigarettes?
Wisniewski said he believes the harm is coming from cartridges containing THC or Vitamin E acetate, coming off the black market or gas stations.
His store strictly cards customers and doesn’t sell to anyone under 18, he said.
If flavored e-cigarettes were banned, it would shift more sales onto the black market, he said.
Wisniewski said there should be better regulation to stop underage vaping, rather than putting smaller vaping shops out of business.
His first cigarette at 17 was at a party after he broke up with a girl, he said.Six years later, he was mountain biking in Colorado with friends when he couldn’t keep up. He switched to vaping.
“I was scared at first, but I wasn’t scared for my health,” he said. “I’ve been vaping for six years. Nothing has been wrong. My health has improved since then.”
Doctors and health advocates sound alarm
Doctors and health advocates have long since warned of vaping risks, especially for teens.
Indiana’s 2018 Youth Tobacco Survey concluded e-cigarette use jumped 387% in high schools and 358% in middle schoolers from 2012. Around 35,000 kids started using e-cigarettes from 2016 to 2018, according to the report.
“We do not hit peak lung function until our 20s,” said Dr. MeiLan Han, a pulmonologist and University of Michigan Professor of Medicine. “Anything that you are putting into your body has the potential to (harm) your growth and development of the lungs.”
A lack of FDA regulations has given the public a false sense of security, she said.
E-cigarettes have been on the U.S. market for more than a decade. FDA officials have repeatedly delayed enforcing regulations on them, responding to industry complaints that it would wipe out thousands of small vaping companies.
Most experts agree the aerosol from e-cigarettes is less harmful than cigarette smoke since it doesn’t contain most of the cancer-causing byproducts of burning tobacco. E-cigarettes generally heat liquid containing nicotine.
But there is virtually no research on the long-term effects of vaping.
“Even before this crisis, most lung organizations had concerns,” Han said. “You simply can’t say it’s a safer alternative. It’s not worth the risk.”
The federal government will act to ban thousands of flavors used in e-cigarettes, President Donald Trump said Wednesday, responding to a recent surge in underage vaping that has alarmed parents, politicians and health authorities nationwide.
The surprise White House announcement could remake the multibillion-dollar vaping industry, which has been driven by sales of flavored nicotine formulas such as “grape slushie” and “strawberry cotton candy.”
Handful of deaths linked
An Indiana adult died of a respiratory illness linked to vaping, state officials concluded Aug. 5.
So far, six deaths have been linked to e-cigarette use in the U.S., with others in Illinois, Minnesota, Kansas, California and Oregon. More than 450 cases in 33 states and U.S. Virgin Islands are under investigation, according to the U.S. Centers for Disease Control and Prevention.
Indiana is examining 30 cases, with eight directly linked, officials said. Ages mostly ranged from 16 to 29.
“The tragic loss of a Hoosier and rising number of vaping-related injuries are warnings that we cannot ignore,” Indiana Health Commissioner Kristina Box said in a release. Box and Indiana Gov. Eric Holcomb announced a $2 million plan to create a youth-focused text-to-quit program and anti-vaping publicity campaign last month.
On Aug. 30, the CDC issued a nationwide medical advisory linking cases of severe pulmonary disease to vaping. Infectious diseases were ruled out as a cause, officials said.
No single device, ingredient or additive has been identified. Most of the patients say they vaped products containing THC, the high-producing ingredient in marijuana. Others say they vaped only nicotine and others say they vaped both THC and nicotine.
New York state has focused its investigation on Vitamin E acetate, an ingredient that has been used to thicken marijuana vape juice but is considered dangerous if heated and inhaled.
The CDC is also investigating Vitamin E acetate, but officials said they’re looking at several other ingredients as well. The CDC recently warned against buying vaping products off the street because the substances in them may be unknown. The agency also warned against modifying vaping products or adding any substances not intended by the manufacturer.
Experts warn: ‘stop immediately’
For that reason, doctors and health officials are continuing to suggest people stay away from all vaping products until the investigation establishes exactly what’s at the root of the illnesses.
“While it is unclear what substances are causing injury, when you use these products with other chemicals, you may not know everything that you’re inhaling and the harm it can cause,” Box said.
Anyone using e-cigarettes within 90 days who has developed respiratory symptoms should stop vaping immediately and see a doctor, Box said. Symptoms can include coughing, shortness of breath, chest pains, nausea, vomiting, diarrhea, fatigue, fever or weight loss.
The FDA has had the authority to ban vaping flavors since 2016, but has previously resisted calls to take that step. Agency officials instead said they were studying if flavors could help smokers quit traditional cigarettes.
“The e-cigarette-related lung illnesses currently sweeping across the country reaffirm our belief that the use of ecigarettes and vaping is an urgent public health epidemic that must be addressed,” American Medical Association President Patrice A. Harris said in a release.
“We must not stand by while e-cigarettes continue to go unregulated. We urge the U.S. Food and Drug Administration (FDA) to speed up the regulation of e-cigarettes and remove all unregulated products from the market,” he said. “We also call on the FDA to immediately ban flavors, as well as marketing practices, that enhance the appeal of e-cigarette products to youth.”
“Increasing the awareness of the harmful nature of these products and their addictive power is the only way to prevent another generation of Americans from developing nicotine dependence,” Harris added.
‘Lungs are not meant to inhale anything but clean air’
Studies to show if vaping could help people trying to quit smoking are “conflicting,” said IU Simon Cancer Center Tobacco Treatment Program Director Deborah Buckles.
“The manufacturers and vape shop owners are marketing these products as safer than cigarettes and as a way to “switch” or “kick the cigarette habit” however, these are NOT an FDA approved smoking cessation aid,” she said via email. “In fact, the manufacturers fought against being regulated by the FDA as a smoking cessation aid. Also, many people (especially teens) feel these are safer, don’t contain nicotine, aren’t addictive and aren’t tobacco products.
All are false, Buckles said.
“Even the vials of e-liquid that say 0 mg of nicotine do often in fact contain nicotine,” she said. “In addition, many of the 69 known or suspected cancer causing agents found in cigarette smoke are also found in vaping devices/liquids. My comment is that the lungs are not meant to inhale anything but clean air. Anything else that is inhaled has the strong potential to be harmful.”
Even so, the number of deaths should be put into perspective, she said.
“Nationally we have seen 6 deaths (as of today but climbing daily) due to vaping,” she said. “Each year there are 11,000 Hoosier adults and nationally 480,000 adult deaths due to smoking cigarettes.”