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Health: Hazy future
Story by Heidi Kyser and
Photography by Brent Holmes
What’s not to like about inhaling nicotine vapor instead of smoke? Plenty. But as some states move to regulate the vape craze, Nevada is a bit slow on the uptake
“I used to smoke about a pack a day,” says Laura Stephens. She started smoking when she was 16; during her deployment to Iraq as an Army medic, she’d burn through as many as three packs a day. Now she’s a vaper. She got into vaping five months ago, after her 6-year-old daughter asked her to quit smoking. Stephens hasn’t touched a cigarette since.
She prefers zero-nicotine juice and a variable-voltage unit, because it allows her to control the thickness of the vapor. “It gives you that mental thing,” she says, “helping with your pacifier effect — the sensation that you’re still smoking.”
In case you haven’t been to a bar, nightclub or college campus lately and witnessed the phenomenon for yourself, a vape is a vaporized nicotine inhaler. A user puts one of a variety of devices to his lips and draws on it, pulling flavored, nicotine-infused liquid (“juice”) over an element (“coil”), heated by a battery pack, which turns the liquid to vapor. The user inhales the vapor and then exhales what isn’t absorbed by his body.
Vaping devices range from small plastic cylinders that resemble toy cigarettes to larger plastic cylinders that look like sex toys to metal contraptions that resemble shop tools. You could spend hours at a vape shop learning the intricacies of the practice; less fussy types can pick up a pack of disposable e-cigarettes at a gas station and start vaping right away. Or, you can order a starter kit online. Since it’s an as-yet unstandardized practice, there is an array of approaches and supplies.
But a lack of standards hasn’t stopped vaping from picking up a head of steam. An analyst for Wells Fargo Security estimated that the e-cigarette market would reach $2 billion in 2014, top $10 billion by 2017 and surpass the conventional tobacco market by 2021. Localvapers.com estimates there are 48 vape shops in Clark County — and that’s not counting all the hookah stores and regular smoke shops that sell e-cigs. Major Las Vegas thoroughfares are dotted with billboards advertising them.
Much of the hype reflects Laura Stephens’ experience with e-cigarettes as a smoking alternative. The ad aired during this year’s Super Bowl by NJOY, an e-cigarette manufacturer, had the tagline, “Friends don’t let friends smoke. Give them the only electronic cigarette worth switching to.”
[HEAR MORE: Nevada leads the nation in secondhand-smoke exposure. Learn more on "KNPR’s State of Nevada."]
Up in the air
The U.S. Food and Drug Administration hasn’t approved e-cigarettes as cessation tools. Still, why shouldn’t smokers be encouraged to switch to vaping? If someone’s going to inhale nicotine anyway, he may as well choose the option that doesn’t come with tar and the other noxious elements of tobacco smoke. Right?
Maybe. The vaping industry makes plenty of claims but provides few verifiable answers: Is it really a safe alternative to smoking? Is the vapor just harmless steam? Will the playfully named juice flavors and toylike vapes lure kids?
The authorities intend to clear the smoke. Following a legal battle that held up sweeping regulation, the FDA recently announced its intention to propose a rule allowing it to regulate e-cigarettes as “tobacco products” (nicotine is extracted from tobacco leaves). The resulting regulations could cover marketing, ingredients listings and testing. The FDA won’t give a timeline, but insiders expect it to happen this year.
Some states aren’t waiting. New York has banned the sale of e-cigarettes to minors; California’s and Oregon’s attorney generals have pursued e-cigarette makers in court, resulting in settlements that have banned certain sales and marketing practices. Nevada, perhaps true to its libertarian nature, has declined to take such action. The 2013 legislature determined that local regulation is not permitted, that e-cigarettes are not covered under the Nevada Clean Indoor Air Act, and that there are no restrictions on advertising them. Left with no ammunition, Nevada Attorney General Catherine Cortez Masto could do nothing but join 39 other states in urging the FDA to make its move. (There is some local movement, however: UNLV recently banned vaping in its Student Union facility or within 20 feet of any entrance. And the Southern Nevada Health District, which banned vaping on its property three years ago, has integrated e-cigarettes into its $850,000 public awareness campaign.)
Judging by the steady decline in youth smoking over the past decade, projects like the Health District’s anti-smoking campaign Xpoz seem to have worked. Maria Azzarelli, head of the district’s Tobacco Prevention and Control Program, believes e-cigarettes could undo her team’s work by giving Big Tobacco a new entrée with adolescents. Indeed, Lorillard, the third biggest of the Big Three in U.S. tobacco, now owns blu, a top-selling brand of e-cigarette. The other two are entering the market as well.
The 2012 National Youth Tobacco Survey indicated that 1.8 million middle and high-school students nationwide had tried e-cigarettes. And Azzarelli points out that e-cigarette marketing bears a striking resemblance to Big Tobacco’s old bag of tricks: celebrity endorsements, the glamorization of the practice and, perhaps most troublesome, flavoring. Additionally, health experts are concerned that the candy and fruit flavors of vape juice will entice young users. Vendors of vaping products, by and large, avoid selling to minors, but current regulation doesn’t actually prevent it. And while existing law stops tobacco companies from putting flavoring in cigarettes, Azzarelli can show you a storage box full of flavored tobacco products — now including e-hookah and e-cigarettes — demonstrating the numerous ways manufacturers get around this restriction.
It’s yet another reflection of the Wild West phase in which vaping finds itself. There is a lot we don’t know — starting with, what’s in the vapor? Juice comes in two broad categories: with and without nicotine. Ask an e-cigarette merchant how the nicotine content is measured, and you’ll get interesting answers. Consider this conversation I had with Alan Phu of Yosi Vapor Boutique:
Phu: It comes in 12 and 18 mostly. We have 24, but we discourage people from using that.
Me: Is that 12 or 18 milligrams, or percent?
Phu: Either one.
Me: But …
Juice labels may also be confusing. In a 2009 study, FDA product testing found that some juices labeled as “0 nicotine” did actually contain the drug, and that percentages indicated on labels weren’t always accurate. To avoid this, Phu says, Yosi only buys from well-established, reputable juice vendors; staff does not mix the juice themselves, as many vape merchants do. One such merchant is Dale Rohrbaugh, co-owner of Las Vegas Vapor Lounge, who says both that he mixes his juice to be 12 percent nicotine and that a 10 milliliter bottle of it contains 3 milligrams of nicotine.
Measures aside, the nicotine itself is problematic — a highly addictive vasoconstrictor. But the biggest mystery about vape juice isn’t the nicotine; it’s whatever else is in it. Proponents of vaping are frequently heard to say the flavoring is made of plant extracts or food-grade chemicals. “There’s nothing harmful in that,” Rohrbaugh says. “It’s what we eat every day.” But even he doesn’t know for sure. As of now, the solid science is scarce, and manufacturers aren’t required to list ingredients on labels. That could change if the proposed FDA regulations pass and the Health District succeeds in spreading its message.
Where would that leave the dozens of vape shop owners in the valley? Rohrbaugh doesn’t sell to minors, he labels his products to be kept out of the reach of children, and he points out that his business is making a contribution to the economy. He’s suspicious of regulation.
“Believe me, this would have been stopped a long time ago if it was dangerous,” he says. “The only restrictions politicians would put on e-cigarettes would be because of lobbying from big tobacco companies. They’re buying up all these little companies to run them into the ground.”
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Also available at Clark County and Henderson libraries.