Many Questions Surround Spike In E-Cig, Vape Usage

Many Questions Surround Spike In E-Cig, Vape Usage
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BERLIN – Jon Caudle has been smoking for 60 years.

She started in the 1950s — the era when you were just as likely to see a housewife smoking at the dinner table as a couple lighting up at a bar. Cigarette ads featured all your favorite figures, from Mickey Mantle to Santa Claus.

“Everybody smoked,” Caudle recalls. “It was more unusual to see somebody who didn’t.”

Knowing now how unhealthy it is, Caudle has tried to quit. She once went nearly four months without a cigarette. That lasted until she thought she would have just one smoke.

“I went right back to a pack a day,” she said.

At 76, Caudle, who lives in Newark, believes she may have finally found a way to kick the habit. She’s one of a growing number of Americans who are now “vaping” — using electronic cigarettes and vaporizers to breathe in nicotine. Manufacturers promote the products as a way for users to inhale nicotine without the harmful effects of tobacco smoke.

“After three days of using it, you feel better,” said Jason Budler, owner of Damokee Vapor in Ocean Pines. “You don’t hack up every morning. People have stopped wheezing.”

Budler’s shop, which opened eight weeks ago, is one of several area shops that are now catering to e-cigarette users. The store sells the devices, their batteries, their tanks and the liquid that fills them. The liquid, often referred to as “juice,” comes in hundreds of flavors, ranging from vanilla custard to “unicorn blood.” Nicotine levels in the liquid vary — from none to 18 milligrams a bottle. The idea is for users to start with a nicotine level comparable to that they are accustomed to from traditional cigarettes and to decrease it gradually.

“It helps people quit,” Budler said.

He says that with confidence. Budler only decided to open the shop after becoming an e-cigarette user himself. After smoking for more than a decade, Budler’s attempts to quit using nicotine gum and the patch failed. He laughed when he saw a co-worker using an e-cigarette two years ago.

“I thought it looked funny but I tried it and I was hooked,” he said.

Budler hasn’t smoked tobacco in nearly two years. These days you will find him vaping behind the counter in his shop.

While he is still inhaling nicotine, he’s not breathing in the more than 5,000 chemicals — 50 of which are known carcinogens — identified in tobacco smoke.

“You’re not burning tobacco and inhaling it,” he said. “This is just giving you controlled levels of nicotine.”

Products Unregulated

While the owners of vape shops are quick to tout what they see as the benefits of e-cigarettes, health officials urge users to be cautious. Linda Green, community health nurse at the Worcester County Health Department, says the devices are simply too new to completely understand. At this point, the products are not regulated and aren’t even within the Food and Drug Administration’s jurisdiction because they don’t contain tobacco.

“We hope that will change,” Green said.

Because the products aren’t regulated, any company that has the resources can jump into the vaping business. Green says that means there’s no guarantee the products are what they are advertised to be. She says it’s too soon to say how e-cigarettes affect a person’s health and claims that they help smokers quit haven’t been evaluated.

“Research is just starting to evolve,” she said.

There has not been any scientific evidence that suggests e-cigarettes should or should not be used to help a person quit smoking, according to a report put together by Donald Shell of the Maryland Department of Health and Mental Hygiene and Dawn Berkowitz of the Center for Tobacco Prevention and Control. That same report says there have not been enough studies completed to determine whether they are even safe to use.

According to the Centers for Disease Control, the number of adults who had used e-cigarettes jumped 10 percent between 2010 and 2011. The agency reported that e-cigarettes do appear to have fewer toxins than traditional cigarettes but need to be studied before their long-term effects on health can be determined.

“As stated in the CDC press release …,” the report from Maryland’s Department of Health and Mental Hygiene reads, “on the surface and with what we know at this point, without long-term studies, it appears that e-cigarettes have a lot less toxins versus conventional cigarettes, but the long-term effect of using these products is not known.”

Health officials also worry that the electronic devices and the flavored liquids associated with them will appeal to children. Although many states have banned the sale of the devices to minors, that doesn’t mean children don’t get their hands on them. Green says there have been students found with e-cigarettes in Worcester County’s public schools. Though the devices don’t emit the smoke cigarettes do, she says the extremely addictive nicotine is still a cause for concern.

“Nicotine constricts blood vessels,” she explained, “so the heart has to work harder to pump blood to the brain and to the body’s organs.”

Because the liquid used for vaping contains a concentrated amount of nicotine, she said it could also prove dangerous in the hands of children. Nationwide, the number of poison control center calls regarding nicotine increased from one per month in September of 2010 to 215 per month in February 2014, according to Maryland health officials.

An Aid To Quit Cigarettes

As far as using e-cigarettes as a way to quit smoking, Green says that she has seen just one person in her smoking cessation classes use the devices to end a dependence on tobacco products. She has seen awareness of the products increase dramatically though. Two years ago, very few of the people she worked with had even heard of an e-cigarette. Today, everyone in her class knows what they are. Nevertheless, she does not recommend them as a way to quit smoking. She says area residents interested in ending their smoking habit should use the Maryland Quitline (1-800-QUIT-NOW) or contact the Worcester County Health Department to find out about programs offered locally.

While Green doesn’t encourage their use, she says if someone really thought e-cigarettes would help them quit smoking she wouldn’t deter them.

“If someone thinks it’s absolutely necessary, I’m not going to say no you can’t be in our class,” she said. “I’m a firm believer in the policy that you have to do it your own way. Different things work for different folks.”

After trying and failing to quit smoking numerous times, Budler knows that he wouldn’t have been able to kick the habit without e-cigarettes.

“The hard part for me was the act of smoking,” he said. “I would have never quit if I didn’t have something to occupy my hands.”

Budler reports the products give former tobacco smokers an option for those times when they are really craving a cigarette. Budler once quit smoking for eight months only to have a stressful day prompt him to light a cigarette.

“With these, with stressful situations you can use them when you get that urge,” he said.

Caudle, too, believes her addiction to smoking is more about having something to do with her hands than inhaling nicotine. Although she was a pack-a-day smoker, she’s been using e-cigarettes with liquid containing the lowest level of nicotine. Because she doesn’t have to smoke an entire cigarette but instead can just take a puff here and there whenever she feels the urge, she says the first bottle of e-cigarette liquid she purchased lasted her three weeks.

That bottle cost her $12. She had been spending nearly $200 a month on cigarettes.

“That’s a lot of money that could go someplace else,” she said.

Caudle never expected to find herself using the latest electronic gadget to curb her smoking habit but has nothing but good things to say about the product now that she’s started. With the growing number of people using the devices, she doesn’t even feel out of place vaping in public, something she’s able to do just about anywhere.

“I pull it out, take a drag and put it back,” she said. “No one pays any attention. You don’t have a burning cigarette.”

Impact On Smoking Bans?

Although most smoking bans do not currently include e-cigarettes, that’s something that appears to be changing. Several major cities, including Boston and New York City, have expanded their smoking bans to include e-cigarettes. The Baltimore City Council is currently considering the same change. Here on the shore, just this week Rehoboth Beach officials began discussing the issue. Rehoboth Beach Commissioner Stan Mills said he was drafting an ordinance to add e-cigarettes to the smoking ban that was enacted earlier this year in Rehoboth.

“There are other major cities that have recognized that for whatever reason e-cigarettes should be included in the ban on tobacco products,” he said.

Mills said the issue came up in Rehoboth as commissioners were looking at the effectiveness of the smoking ban. He said throughout the summer, police officers received complaints that there were people smoking in areas it wasn’t allowed. They’d go to investigate only to find out that the individuals were using e-cigarettes, which were not prohibited under the town ordinance.

In Ocean City, where officials are expected to consider a smoking ban later this month, the restrictions as drafted would not include e-cigarettes, according to city planner Bob Nelson.

“Although e-cigarettes would be excluded under our proposal,” Nelson said, “there is the possibility that this new council might want that changed to include them, which we would.”

As vaping has increased in popularity locally, it’s not uncommon now to see a person using an e-cigarette at a bar or on the beach. Health department officials say that although the devices aren’t covered under the Clean Air Act, their use can be restricted by individual business owners. Green says the health department advises concerned business owners to set their own policy. If they don’t want the devices used in their establishments, they should post a sign.

That’s just what owner Jen Dawicki did at The Globe in Berlin. She said that because the FDA had not yet determined the impact vaping had on health, she didn’t want e-cigarettes in her restaurant. She recalled being alarmed the first time she saw what she thought was smoke emanating from a table where a diner was using one of the devices.

“If I’m feeling that way, are the other guests feeling that way?” she said.

Budler says he has no problem with e-cigarette use being relegated to areas where tobacco smoking is allowed. He’s also hoping to see the FDA get involved in the industry. Like Green, he wants to make sure the products he’s selling are made safely and meet certain standards. What he doesn’t want to see is the e-cigarette industry taken over by major tobacco companies.

“People who are vaping don’t like what Big Tobacco’s selling,” he said. “It needs regulation but it needs to be its own subcategory and not lumped in with tobacco.”