E-cigarettes: A pathway from addiction or another health hazard?

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Three years ago Paul Evans believed his addiction to the nicotine in tobacco-based cigarettes would kill him.

Now the Salt Lake City resident believes the new-age e-cigarettes literally saved his life.

“I smoked for 12 years,” Evans said. “I realized I was no longer a ‘smoker’ when someone offered me a cigarette at a party and I didn’t just say no, I actually didn’t want it. Vaping had literally saved my life.”

Evans is among a growing number of e-cigarette users in the U.S. Many have quit smoking through what they term as “vaping,” which is widely considered to be a safer alternative to real cigarettes. E-cigarettes give smokers the nicotine they crave but withhold the more deadly chemicals found in real cigarettes.

Opponents argue that though it’s safer than smoking, there’s not enough data to support it as a healthy alternative in the long run. Some worry it’s another unhealthy product in a new package. The sweet flavorings also concern many that children will take up the habit.

The question is, is it simply a way to remove tobacco from a smoker’s life, is it a pathway from addiction, or is it another unhealthy drug many are passing off as a safe alternative?

Regardless of the controversy, vaping is a growing trend in the United States. Since its introduction into the U.S. market in 2007, sales have increased by an average of $120 million per year. Two and a half million people are reported to use e-cigarettes regularly, and the number is growing.

The science

E-cigarettes cut out tobacco and tar but use water vapor to get nicotine to ex-smokers. Nicotine is highly addictive, but it is not considered to be nearly as harmful as other substances in regular cigarettes. Riley Farr, a former huka and tobacco user who quit after three years, said nicotine is similar to caffeine. He said he worries that many think nicotine is unhealthier than it is because it often comes packaged with tobacco.

“Nicotine isn’t really that bad,” he said. “[It] really has just been given a bad light by tobacco because they’re almost always combined together. But if you look at nicotine and caffeine side by side, I don’t see a difference.”

E-cigarettes use a battery-heated coil to turn a nicotine-based water solution into vapor that a user inhales. They contain four main substances, nicotine, propylene glycol, vegetable glycerin and flavorings like strawberry or cotton candy. All of the products are currently approved by the FDA as safe for human consumption.

Vape pens are absent many of the poisons found in regular cigarettes, including tobacco and tar. Because they heat into vapor and don’t burn into smoke, vape pens don’t leave third-degree smoke on clothing or furniture, which means a vapor’s house won’t have a bad odor.

Most scientists and doctors agree that more research needs to be done before vaping can be considered completely safe. But Jeff Stier, risk analysis director with the National Center for Public Policy Research, said he recommends e-cigarettes to anyone who wants to quit smoking.

“Have all the vapor you want; the nicotine in there is what’s keeping you from burning and inhaling the tobacco that kills you,” he said. “This is not about getting off nicotine … just quit smoking.”

What this means for smokers

Several products offer satisfaction for smokers’ nicotine cravings. In fact, many states offer nicotine gum, pills and patches for free to anyone hoping to quit smoking.

These are all valid options. According to a recent study by the Lancet, 5.8 percent of people quit smoking using one of the traditional methods. That’s a high percentage relative to trying to stop without any help and for many, these are the right choice.

Other smokers have issues with the gum and patches. One problem is that the nicotine comes at a constant rate. When people smoke a cigarette, they self-titrate, which means they have control over how often they get the nicotine by how frequently they take a puff. With the patches smokers have no such control.

“Smokers self-titrate; some people are constantly puffing, and some take a puff here or there,” Stier said. “It’s no surprise that patches don’t work for most people, it’s a constant stream of nicotine. It doesn’t replicate the smoking experience.”

Another issue many mention is the lack of throat hit. When smokers suck on the end of a cigarette, part of their satisfaction is feeling the smoke hit the back of the throat. Neither gum nor patches can replicate that sensation, but vape pens give smokers the throat impact they’re looking for. Aaron Fraizer, president of Utah Vapers, confirmed vaping satisfies cravings better than other methods.

“If you get a device that has a lot of power and vapes really hot, it will feel very similar to a real cigarette,” he said. “You’ll hear vapers say it has good throat hit when you inhale it; it hits your throat and hits your lungs.”

Fraizer quit smoking after 35 years by using e-cigarettes, and he’s not alone. In a recent study performed by the Lancet, 7.3 percent of people were able to quit smoking using nicotine e-cigarettes, 1.5 percent more than patch users. All things considered, vape pens have become effective aids in helping people quit smoking.

The future of e-cigarettes

Vape shops, or stores that specialize in e-cigarettes, are becoming more and more popular. Currently there are 26 certified vape shops in Utah.

Though evidence exists that vaping is safer than smoking, many are concerned there’s not enough data to guarantee its safety long term. Others worry that the candy and bubble gum flavors may be enticing to children. To negate these concerns, state governments around the nation are pushing new reforms that tax e-cigarettes and restrict their use to places usually designated to smokers.

Many applaud the reform, hoping making vaping less visible will keep children away from even trying it. Because nicotine is highly addictive, vaping presents a new challenge to parents. According to a congressional staff investigation out of California, more than 20 percent of middle school students who have used e-cigarettes said they had never tried traditional cigarettes. This is alarming, because although vaping is safer than smoking, children under the age of 18 need to understand there’s still risk involved in inhaling nicotine.

“I support a ban on youth, for anyone under 18,” Stier said. “All responsible vape shops that I know of refuse voluntarily to serve to minors.”

The reform has helped keep e-cigarettes out of the mainstream, but some worry it will stop smokers from using it as a tool to get away from real smoking. Farr said he worries government regulations will make vaping just as expensive as smoking.

“Right now it’s cheaper even than chewing tobacco,” he said. “Hopefully that doesn’t change, because it’s really helping people quit.”

The push and shove between the government and vape shops has been going on for some time. Both sides want to protect children, but many worry this push will hurt those using vape pens to find a healthier lifestyle.

“I just wish the government would support our efforts rather than fight them,” Fraizer said.

Many are satisfied, however, that the government is making efforts to protect its citizens from the new product until more research is done concerning its long-term health effects.

Evans said as he looks around his life, he has much to be thankful for.

“Vaping not only helped me quit, but helped many of my friends as well,” he said. “I’m proud that vaping has saved so many lives.”

Whether e-cigarettes are a healthy alternative to cigarettes or just a pathway to quitting is yet to be seen. But for people like Evans, it was a pathway off tobacco, which, most agree, is a step in the right direction.

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