ST. GEORGE — E-cigarettes have been in the news quite a bit lately, with reports from multiple sources claiming both positive and negative aspects. The popular nicotine delivery systems, long touted as a safer alternative to conventional cigarettes, have become a polarizing subject, with proponents and opponents alike pointing to studies in favor of — or against — the product.
A study on e-cigarettes was released in early December in the journal “Environment Health Perspectives” by the National Institute of Environmental Health Sciences. In the report, the scientists studied the contents of 51 varieties of e-cigarette flavors and discovered 47 of the 51 samples contained at least one chemical flavoring, and 39 of the 51 flavors contained diacetyl, a product known to cause bronchiolitis, aka popcorn lung. Furthermore, the scientists also found multiple flavors also contained the chemicals 2,3-pentanedione and acetoin.
“I’ve heard about the popcorn lung,” local resident and e-cigarette user Tailer Holt said. “I recently tried to quit vaping because it freaked me out. That’s scary.”
Holt said that she used e-cigarettes to quit smoking tobacco, but she would also like to quit vaping, in large part because she worries about a different set of health risks.
“It just doesn’t make sense,” Holt said. “You can use vaping to quit smoking, but then you’re just at risk for something else other than lung cancer. I’m going to get popcorn lung instead.”
A study released in the Journal of Nicotine and Tobacco Research (part of Oxford University Press) showed diacetyl levels in flavored liquids were substantially lower than in tobacco products, although it acknowledged a need to eliminate the chemical from flavored vapor products.
In January 2015, a report published in the New England Journal of Medicine stated its finding of high levels of “hidden formaldehyde” (a known carcinogen) in e-cigarettes — between 5-15 times the amounts found in conventional cigarettes. Critics of this paper (including the American Council on Science and Health) point out the high voltage settings used by the researchers were unrealistic.
Researchers at Johns Hopkins Bloomberg School of Public Health released a study showing exposure to e-cigarette vapor can compromise the immune health of lungs. Additionally, the research showed vapor can also give rise to free radicals, the particles responsible for accelerated DNA damage and cancer growth. The scientists on this study acknowledged that while the levels of free radicals in e-cigarette vapor is significantly lower than in conventional cigarettes, the levels were still high enough to cause damage.
Adding to the negative outlook on e-cigarettes, an environmental group in California this year filed a complaint against the manufacturers of the liquid component, citing high levels of carcinogens found in its independent tests of the products. The Center for Environmental Health filed a lawsuit against 15 different manufacturers, including R.J. Reynolds, saying the defendants violated California’s Proposition 15, which specifies companies are required to warn users if their products expose them to cancer or birth-defect-causing chemicals. A class action lawsuit by three e-cigarette users against the manufacturers of the liquid component has been filed as well.
The Center for Environmental Health filed a lawsuit against 15 different manufacturers, including R.J. Reynolds, saying the defendants violated California’s Proposition 15, which specifies companies are required to warn users if their products expose them to cancer or birth-defect-causing chemicals. A class action lawsuit by three e-cigarette users against the manufacturers of the liquid component has been filed as well.
Brendon Gunn, co-owner of Cloud 9 Vapor, said the positives of vaping far outweigh the negatives and there is a concerted effort on the part of tobacco lobbyists to sway legislators to craft rules limiting e-cigarettes and their distribution.
“There’s a federal law that says that we cannot claim that this product will help you quit smoking,” Gunn said, “regardless of the staggering evidence that goes to show that hundreds upon thousands of people have actually quit smoking using these products.”
Some prominent reports appear to bolster Gunn’s position. A study published in August 2015 by Public Health England, an executive branch of the United Kingdom Department of Health, showed e-cigarettes are approximately 95 percent safer than conventional cigarettes. The report stated smokers who were trying to quit should utilize e-cigarettes and be encouraged by stop-smoking services to use vapor nicotine delivery devices. The report also states smokers who do not want to quit should also be encouraged to use e-cigarettes to help reduce smoking-related disease and negative health outcomes. Contrary to popular opinion, the report states, vaping is not undermining the decline in smoking but may in fact be helping perpetuate that long-term reduction of tobacco use.
The State of Utah does not have an official stand for or against e-cigarettes, but according to Brittany Karzen, media liaison for the tobacco prevention program at the Utah Department of Health, there are rules in place to protect minors and the general public.
“We don’t have any longitudinal studies, we don’t know what the long-term effect of their use is, but we do know that for teens and kids, they’re bad because the nicotine affects the developing brain,” Karzen said. “They’re regulated in some ways like a tobacco product, they’re not allowed to be sold to anybody under the age of 19. They are covered in the Indoor Clean Air Act as well.”
The Indoor Clean Air Act specifies neither tobacco products nor e-cigarettes can be used in any enclosed indoor areas accessible to the public or within 25 feet of any door, window, opening or air intake where smoking or vaping is already prohibited.
Karzen said the Utah Legislature has directed the Department of Health to create a rule regulating e-cigarettes. This rule would establish specific policies on labeling, nicotine content and bottling standards.
“We have drafted that rule. The administrative rules committee is looking into it,” Karzen said.
Gunn said he has no problem with the new regulations.
“They’re doing a whole new restructure … but we’re compliant with what they’re doing,” he said.
While the new state-level rules are not a worry, Gunn said, it is federal regulations that would drive many vaping companies out of business. He also said he believes large tobacco companies are conspiring with the federal government to drive smaller e-cigarette companies — such as his — out of business.
“Those who weather that storm are going to be in business for a long time and do well for themselves. The other 99.9 percent … is going to get burnt by big tobacco’s magnifying glass,” Gunn said. “Some companies may be big and strong enough and (if they) have a good attorney, they may survive long enough to be part of a buyout. The sad truth about it is, big tobacco will not stop and they have the resources to completely take this industry over.”
Despite some negative publicity, Gunn said Cloud 9 Vapor has only seen its sales increase.
“It has done nothing but help us,” Gunn said.
Gunn was also adamant in his belief that part of what gives vaping and e-cigarettes a negative reputation is irresponsible users who either keep the devices in reach of children or who give the product to teenagers. Gunn said he shares those concerns of e-cigarette opponents.
“People need to treat this product seriously and not allow their children to play with the devices, don’t give them to their 16-year-old kids to go puff on, and to be responsible adults with the product and treat as it needs to be treated: as an adult product. Keep it away from children.”
The most important point, Gunn said, is more people are switching from tobacco to electronic cigarettes. He said it is up to society to keep it out of the hands of children in order for it to be available to those who use it responsibly.
“It’s a great product; I think it’s a really good thing for our society to have to replace tobacco with. However, if we don’t as a society get responsible and treat it as an adult product, then it’s going to give firepower to state and (federal) government legislation to slowly reduce its availability.”
Kye Nordfelt, director of health promotion at the Southwest Utah Public Health Department agreed that the product needs to be kept out of children’s hands. The manner in which the product is advertised, he said, and marketed — fruity flavors, colorful packaging and high technology — is clearly an attempt to get kids to use e-cigarettes.
“In a lot of ways, it’s a real public health challenge,” Nordfelt said. “It causes significant problems for teenagers moving into the future. Most tobacco users start using cigarettes or tobacco products in their teenage years. Over the last few years, we’ve seen a significant (increase) in teen e-cigarette use.”
Nordfelt said that the health department conducted its own survey from 2013-2015 of 12th-grade students and found an increase of approximately 300 percent in that age group using e-cigarettes. He said that when the survey began, approximately 4 percent were using vapor products but by 2015, that percentage had jumped to 12 percent.
“That’s a very unusual increase,” he said.
Nordfelt said that nicotine is a powerful drug that has a negative impact on teenage development.
“It does impact the brain,” he said. “It manipulates different parts of the brain. It affects memory, it affects learning and it also wires the brain for addiction.”
Holt said that while using an e-cigarette helped her reduce her addiction to conventional cigarettes, she knows it is an unhealthy habit that she hopes to break in the near future.
“I really do want to quit vaping,” she said. “I go to the gym and I just think it would benefit me to not vape.”
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