Is nicotine all bad?

Since he ditched Marlboro Lights five years ago, Daniel's fix is fruit-flavored nicotine gum that comes in neat, pop-out strips. He gets through 12 to 15 pieces a day and says he has "packets of the stuff" stashed all over. But he doesn’t see himself as a nicotine addict.

Like many people, Daniel believes nicotine gum is far less harmful for him than smoking. Doctors worldwide agree. By giving up cigarettes, they say, Daniel has removed at least 90 percent of the health risks of his habit.

Even so, the possibility that people can be addicted to nicotine, but not die from it, is at the heart of a growing debate in the scientific community. Scientists don’t doubt nicotine is addictive, but some wonder if a daily dose could be as benign as the caffeine many of us get from a morning coffee.

It’s a debate that has been aggravated by the rising popularity of electronic cigarettes - tobacco-free gadgets people use to inhale nicotine-laced vapor, which have helped some people quit smoking. The idea of nicotine as relatively benign goes against the negative image of the drug that built up over the decades when smoking rose to become an undisputed health threat.

Psychologists and tobacco-addiction specialists, including some in world-leading laboratories in Britain, think it's now time to distinguish clearly between nicotine and smoking. The evidence shows smoking is the killer, not nicotine, they say.

"We need to de-demonize nicotine," said Ann McNeill, a professor of tobacco addiction and the Institute of Psychiatry, Psychology & Neuroscience at King's College London, who has spent her career researching ways to help people quit smoking.

She wants people to understand the risks are nuanced – that potential harms lie on a curve with smoking at one end, and nicotine at the other. People who don't see that may hesitate to seek help stopping smoking, or try to restrain their intake of nicotine replacement therapy (NRT). That can make it harder to quit.

Some studies show nicotine, like caffeine, can even have positive effects. It's a stimulant, which raises the heart rate and increases the speed of sensory information processing, easing tension and sharpening the mind.

All this raises other questions: Could nicotine prime the brains of young people to seek harder stuff? Or, in an aging society, could its stimulant properties benefit people whose brains are slowing, warding off cognitive decline into Alzheimer’s and delaying the progression of Parkinson’s disease?

So far the answers aren’t clear. And the divide is as political and emotional as it is scientific.


McNeill says her work is, in part, to honor the legacy of her former mentor at King's, British psychiatrist Mike Russell. About 40 years ago, Russell was one of the first scientists to suggest that people "smoke for the nicotine, but die from the tar" – an idea that helped lay the ground for the NRT business of gums, patches, vaporizers and now e-cigarettes.

Some scientists note Russell’s insight has been misused by the tobacco industry. For decades, companies’ false promises of “light” cigarettes helped lure more smokers, says Mike Daube, professor of health policy at Curtin University in Australia. “We have seen more than six decades of tobacco industry distraction products, promotions and deceptions,” he says. “They reveled in advertising that implied both reduced risks and even health benefits.”

Smoking kills half of all those who do it - plus 600,000 people a year who don't, via second-hand smoke - making it the world's biggest preventable killer, with a predicted death toll of a billion by the end of the century, according to the World Health Organization.

Few doubt that nicotine is addictive. How quickly it hooks people is closely linked to the speed at which it is delivered to the brain, says McNeill. The patch is very slow; gum is slightly quicker. But there is no evidence as yet that significant numbers of people are addicted to either. Daniel, who works long hours in London's financial district, says he chews less on weekends when he's relaxing, doing sport and hanging out with his kids.

One reason smoking is so addictive is that it's a highly efficient nicotine delivery system, McNeill says. “Smoking a tobacco cigarette is one of the best ways of getting nicotine to the brain - it's faster even than intravenous injection." Also, tobacco companies used various chemicals to make the nicotine in cigarettes even more potent.

Pure nicotine can be lethal in sufficient quantities. There is some evidence it may lead to changes in adolescent brain development, especially to the part responsible for intelligence, language and memory.

Stanton Glantz, a professor of tobacco at the University of California, San Francisco, says the younger kids are when they start using nicotine, the more heavily addicted they get. "This is likely because their brains are still developing," he said.

Countering that, others say studies have focused on animals and that in any case, nicotine should not be available to under-18s. Michael Siegel, a tobacco control expert and professor at Boston University, says that in the few studies so far, such effects have been seen only in smokers, not smoke-free nicotine users.

Elsewhere, studies have looked at nicotine's potential to prevent Alzheimer's disease, and to delay the onset of Parkinson's.

A study in the journal Brain and Cognition in 2000 found that “nicotinic stimulation may have promise for improving both cognitive and motor aspects of Parkinson's disease.” Another, in Behavioral Brain Research, suggested “there is considerable potential for therapeutic applications in the near future.” Other work has looked at the stimulant's potential for easing symptoms of attention deficit hyperactivity disorder (ADHD).

In Sweden, many people get their nicotine from sucking smoke-free tobacco called "snus." Research there has put rates of lung cancer, heart disease and other smoking-related illness among the lowest in Europe.


Even so, the idea of "safe nicotine" has not caught on.

Marcus Munafo, a biological psychologist at Britain's Bristol University, says public health campaigns of the 1970s and 1980s bound nicotine, addiction and cigarettes tightly together to hammer home smoking's harms. Those associations may blur the potential for cleaner nicotine to lure smokers away from cigarettes.

Munafo is questioning the notion that a nicotine addiction is, in itself, bad. At a "smoking laboratory" in Munafo’s department, people who are still hooked on cigarettes smoke under controlled conditions. At the moment, researchers are studying genetic differences in how deeply people inhale, as part of a project analyzing people’s needs and responses to nicotine.

"Should we really be that bothered about addiction in and of itself, if it doesn't come with any other substantial harms?” said Munafo. “It's at least a discussion we need to have."


Lawmakers push to ban indoor use of e-cigarettes

ALBANY—As the session in Albany nears its end, lawmakers are pushing to enact a sweeping change to the way e-cigarettes are regulated, pushing legislation that would bring electronic cigarettes under the provisions of New York State’s Clean Indoor Air Act, which prohibits cigarette smoking in most public and private work areas, as well as in bars and restaurants.

The statewide push comes just months before the federal Food and Drug Administration is expected to issue regulations governing e-cigarettes, and as localities around the state have passed a hodgepodge of different laws governing their use.

The e-cigarette industry has seen explosive growth in recent years, and a Centers for Disease Control and F.D.A. report issued in April showed use of the products among middle- and high-school-aged teenagers tripled between 2013 and 2014.

New York City implemented its own ban on electronic cigarette use in bars, restaurants, offices and parks in 2014, as an amendment to the city's 2002 Smoke-Free Air Act. Earlier this week, a Manhattan Supreme Court judge upheld the constitutionality of that ban, which had been challenged by smokers' rights advocates, according to the New York Law Journal.

Late last year, Governor Andrew Cuomo signed a law that would ban the sale of liquid nicotine to people under age 21 in New York City and under age 18 elsewhere in the state, and which requires that liquid nicotine, the smokeable ingredient in e-cigarettes, be packaged in childproof containers. Liquid nicotine is toxic if ingested, and a one-year-old in upstate New York died in December 2014 after accidentally ingesting the substance.

But lawmakers say the umbrella legislation is needed, to tie together the different local laws and create a uniform policy for handling e-cigarettes.

At a lobbying event in the Capitol on Wednesday, a 13-member coalition, including representatives from the American Cancer Society, Roswell Park Cancer Institute and Medical Society of the State of New York, expressed their support for the legislation to bring e-cigarettes under the Clean Air Act.

E-cigarette industry officials have touted the products as helping traditional cigarette smokers transition to a safer product, but Dr. Mark Travers, Assistant Professor of Oncology and Director of the Air pollution Exposure Research Laboratory at Roswell Park Cancer Institute, said research reveals that e-cigarettes are not “100 percent safe.”

“There are a variety of harmful compounds in the vapor from electronic cigarettes," Travers said. "Second-hand smoke is what we are exposed to in the air when a traditional tobacco product or electronic cigarette is smoked. Third-hand smoke is the residual tobacco contamination left behind on surfaces in a room where a product is used. This third-hand smoke is readmitted over time into the air so nicotine is a great example of something that very readily sticks or absorbs, in scientific terms, to surfaces in a room and gets readmitted over time, exposing you to that in the air again."

Senator Kemp Hannon, a co-sponsor of the bill along with Assemblywoman Linda Rosenthal, said the state also needs to pass measures to address earlier legislation that banned the sale of e-cigarettes to people under the age of 18. The problem, Hannon said, was that it is difficult to enforce an under-18 rule when many of the vendors who sell e-cigarettes aren’t required to register with the state the way that they would if they were selling traditional tobacco products.

Hannon said he hopes the legislation could pass before the scheduled end of session on June 17, but said he can't count on the bill’s passage, despite broad support in both chambers of the Legislature.

“I don't know” if it will pass, Hannon told Capital. “The great part about policymaking in a legislative body is you can’t assume. I want it to happen, but I can't assume.”


E-Liquid in E-Cigarettes: Is It Safe?

E-liquid -- the "smoke juice" that goes into an electronic cigarette, sits in the crosshairs of proposed federal regulation. Photo: Johnson Creek Smoke Juice.

Reducing the harm associated with tobacco use is a legitimate aim. ... What is needed to determine how best to achieve this is good-quality science...
-- Jeff Stier, senior fellow at the National Center for Public Policy Research.

To obtain this "good quality science," the U.S. Food and Drug Administration next month will announce a new regulation "deeming" electronic cigarettes (e-cigarettes) and the nicotine-laced e-liquid that fuels them to be products subject to the Food, Drug, and Cosmetic Act. Products that, like tobacco, need government regulation.

"Once the proposed rule becomes final," according to the FDA, the agency "will be able to use powerful regulatory tools, such as age restrictions and rigorous scientific review of new tobacco products and claims to reduce tobacco-related disease and death."

But is that necessarily a good thing? Is it a bad thing?

Tobacco is big business. "Vaping" is more often a store-front affair. Photo: Flickr.

The kids are all right (but are they right?)
According to data from the Centers for Disease Control and Prevention, the percentage of Americans who smoke cigarettes is at an all-time low today. Only 17.8% of adults in the United States smoke, down more than 50% in the last 50 years.

Importantly, the rate of teen cigarette use has recently plummeted to just 9.2%, defying historical trends by falling below the rate of adult smoking. There has been an especially steep drop-off since the 2003 introduction of "vaping" e-liquid as an alternative to smoking tobacco.

Today, some 8% of adults say they have tried e-cigarettes -- half the smoking rate. Recent CDC findings, though, indicate that teens (the ultimate "early adopters") actually prefer vaping over smoking. E-cigarette use among high school students nearly tripled from 4.5% in 2013 to 13.4% in 2014, even as smoking rates plummeted.

If, as their defenders claim, e-cigarettes are less dangerous to use than analog cigarettes, then teens appear to be moving toward a safer vice of choice.

What does the FDA want to know?
Which brings us to the FDA and its proposed regulation of e-cigs. This week, the Smoke-Free Alternatives Trade Association, or SFATA, held its annual conference in Chicago, featuring speakers such as Stier (quoted above) discussing the "significant challenges" posed by FDA regulation.

On its official website, the FDA highlights four questions it wants to answer once e-liquid has been "deemed" essentially the same as a tobacco product:

  • the "potential risks of e-cigarettes";
  • how much "nicotine or other potentially harmful chemicals" e-liquid contains;
  • whether there are any benefits to the use of e-cigarettes; and
  • whether e-cigarettes are a gateway leading teens to try "conventional cigarettes."

Regulating e-liquid: The risks...
Congress's hometown newspaper, The Hill, quoted Consumer Advocates for Smoke-free Alternatives Association President Julie Woessner as warning that FDA regulation could "wipe out" the e-cigarettes industry. That would doom the hundreds of millions of dollars that tobacco companies Reynolds American  (NYSE: RAI  ) and Altria (NYSE: MO  ) have sunk into their Vuse and Green Smoke e-cigarette businesses.

What's really inside an e-cigarette? Inquiring federal regulators want to know. Source: Flickr.

The bigger threat, though, isn't to the makers of the e-cigarettes themselves -- which are generally fairly generic devices, incorporating a battery-powered heating element that warms e-liquid into a vapor for inhalation. The real worry is that the FDA will crack down on small businesses manufacturing the e-liquid itself.

According to the FDA, regulation of e-liquid would include requiring manufacturers to "report product and ingredient listings" and "only market [e-liquid] after FDA review." The New York Times reported that applying for FDA approval of a new e-liquid formula could easily consume "more than 5,000 hours and cost more than $300,000." These are costs that the hundreds of storefront "vape shops" would have real difficulty absorbing. Large, multinational companies, in contrast -- the kinds that investors focus on -- could easily absorb the costs.

... and benefits
A more optimistic way to look at FDA regulation, however, is its potential benefit. Taken at its word, the agency's primary concern in "deeming" e-liquid to be similar to a tobacco product is gaining the authority to conduct scientific analyses of the chemicals that "vapers" are putting in their lungs. In short: to confirm, once and for all, whether vaping is safer than smoking -- and if so, whether it's effective as a means of getting people to quit smoking.

If these tests prove vaping's defenders are correct -- that's great! More than a decade after e-cigarettes came on the market, all sides of the debate should welcome having some real scientific evidence of this fact. It would surely help to grow the market for e-liquids.

But if these tests prove that vaping advocates' claims are bunk -- well, we should all probably want to know that, too.


E-cigarettes: Doctors' View: E-cigarette, tobacco smoke enough alike to warrant regulation

What are e-cigarettes? Have you ever seen one? Do you know how they work? Are they as bad for your health as traditional cigarettes?

It is fair to say that three or four years ago these were new questions and we did not know the answers. But now we do, and it is certainly time for you to know — and for our St. Louis County Board of Commissioners to know as they consider a vote to help protect citizens of our county from the “invisible” harm caused by these gadgets if being used indoors.
Details about e-cigarettes and their health effects are well-described in a recent report from the California Department of Health, and even more recent good information on e-cigarettes can be found in the News Tribune’s “Our View” editorial on Friday, headlined, “County up next in quest for clear air.”

E-cigarettes is a good news/bad news story. Are they less toxic than traditional cigarettes? Likely. Are they really safe to use? Not likely.

First, how do they work? With no tobacco or cigarette paper to burn, there’s no smoke. They really are electronic gadgets with several sections, one with a small battery, one with a small amount of fluid usually containing some nicotine as well as flavoring and other chemicals, and a high-temperature chamber that converts the liquid into an aerosol or fog to be inhaled by the user (an action called vaping) and then exhaled where it is readily inhaled by those around the user.

What is in this aerosol emitted by the e-cigarette? At least 10 chemicals known to cause cancer, birth defects or other reproductive harm, including nicotine, formaldehyde, heavy metals and volatile organic compounds, according to the report. It’s not what you or your favorite teenager should be exposed to.

Nicotine, a key ingredient in the aerosol, is highly addictive. Of course, that is why so many users of traditional cigarettes said for years that they could quit whenever they wanted but usually never could.

We should all wonder why the three major tobacco companies purchased start-up e-cigarette companies. What do they know that we do not? One thing is this: Kids who start using purportedly safer e-cigarettes often switch and become traditional smokers or, even worse, dual smokers who use both e-cigs and traditional tobacco cigarettes. They are then addicted to nicotine for decades. Is that what the big tobacco companies are banking on?

Our elected county leaders soon will vote on this simple question: Should e-cigarette use indoors be regulated as a public health hazard just like traditional tobacco smoke? That is, no smoking in indoor places such as worksites, bars, restaurants, stores, arenas, etc.

The city of Duluth and many other communities in Minnesota already have answered this question in the affirmative: Yes, e-cigarette aerosol and tobacco smoke have enough in common to warrant being regulated in the same way under the Minnesota Clean Air Act.

In short, keep them outside.


E-cig Uncertainty


Pro/Con: Should the FDA regulate e-cigarettes?

On Jan. 11, 1964, the Surgeon General’s Advisory Committee on Smoking and Health released its very first report on tobacco smoking.

Based on scientific evidence consisting of over 7,000 articles relating to smoking and disease, the report cited tobacco smoking as a major cause of lung and laryngeal cancer and chronic bronchitis.

The report launched a “war on smoking” that soon required health warnings on cigarette packages and bans on broadcast cigarette commercials, and by recent years had led to bans on smoking in certain areas, with numerous laws and regulations in between.

During this half-century of cigarette regulation, two facts have been impressed upon the nation: 1) smoking tobacco kills people; 2) once a person is addicted to smoking cigarettes, or, rather, to the nicotine one ingests by smoking cigarettes, it is very hard for a person to quit.

So when an invention came along — e-cigarettes — that supply nicotine in much the same way as a tobacco cigarette, but without any apparent link to cancer or lung disease, there were many cheers.

Finally there was a product that could help those who were addicted and for whom the available anti-smoking aids had not been of sufficient help.

Lives could be saved. People could replace their tobacco cigarettes with e-cigarettes; switch out smoke and carcinogens with water vapor and the horrible smell with no smell at all — or the light scent of a chosen flavor, such as mint or strawberry.

One would expect the response of the public health community to be a near-universal “hurrah.”

But for those who appear to be addicted to regulation, and not to public health, e-cigarettes provide an unwelcome challenge.

How do they go about banning access to a product that saves lives? And what do they say when people, quite reasonably, ask, “why do you want to”?

For many of these regulators, the answer is as “what if.” “What if” vaping — inhaling water vapor through an e-cigarette — turns out to be harmful? “What if” people who vape decide to start smoking, because they first vaped?

It is on the basis of these “The director of the FDA’s Center for Tobacco Products, Mitch Zeller, J.D., made the key point clear in an interview with the Robert Wood Johnson Foundation’s New Public Health: “People are smoking for the nicotine, but dying from the tar.”

He says e-cigarette regulation should take into account the “continuum of risk: that there are different nicotine-containing and nicotine-delivering products that pose different levels of risk to the individual,” and regulate accordingly.

Which means America should not treat e-cigarettes and vaping just like tobacco smoking and smoking, because smoking is far more dangerous than vaping.

Smoking kills. Vaping is a safer alternative, and our nation’s regulatory policy will save lives if it reflects this fact.


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Secondhand E-Cig Vapor Can Penetrate Paint. What Does That Mean For Your Lungs?

The aerosol particles emitted from vaping are so tiny they can actually seep through paint on walls — the pores in the paint would look like Swiss cheese in comparison to the particle size.

The emissions from e-cigarettes are just water vapor, right? Wrong.

The “vapor” emitted from an e-cig is actually not water vapor, but more like an aerosol gas, as the emissions consist of tiny particles that contain nicotine, glycerin/glycols, artificial flavorings and preservatives, among other chemicals, according to a new study from RTI International.

And the warm, humid conditions of the lungs seem to prevent these aerosol particles from evaporating — which is cause for concern. This is just one of the learnings gleaned from an expert panel that convened on Thursday to discuss the latest research in vaping.

The takeaway: E-cigarette emissions — whether you yourself are vaping or if you’re standing next to someone who is — have an immediate effect on your acute lung function.

A big concern is the size of the particles, according toJonathan Thornburg, Ph.D., author of the study and a senior research engineer and director of Exposure and Aerosol Technology at RTI International. “They are smaller than 1,000 nanometers, 50 times smaller than the width of a human hair,” he says. “They can stay airborne for a long time, and penetrate into the deepest part of our lungs.”

The extremely minute size of the particles actually ups their penetrative powers, which is causing experts to wonder what the impacts will be for tissues inside the body. Stanton Glantz, Ph.D., professor of medicine at University of California, San Francisco and director of the UCSF Center for Tobacco Control Research and Education, says the aerosol particles emitted are so tiny they can actually seep through the paint on painted walls. If you scaled that representation to size, the pores in the paint would look something like Swiss cheese in comparison to the particle size — which might cause imminent problems.

We may see vastly different health effects result from of e-cigarette use than we do from conventional cigarettes. Because they don’t burn anything and there’s a lack of combustion, fewer cancer-causing chemicals are emitted. However, e-cig emissions are still composed of ultra-fine particles with nicotine and numerous other potentially damaging additives. “Even some of the flavorings are dangerous — like cinnamon, if you inhale it, can be quite toxic,” Glantz says. “It’s a different risk profile. Some toxicologists think it’s inappropriate to even compare e-cigarettes to tobacco cigarettes.”

Glantz thinks we may eventually discover more heart-related consequences associated with vaping. “Exposure to the ultra-fine particles inhibits blood vessels to get larger when they need to, and makes platelets sticky, which leads to more heart attacks,” he says. “The particle effects are a big factor. The oxidizing agents also oxidize cholesterol, which leads to heart disease and heart attacks.”

And that doesn’t just go for e-cig emissions. Similar health issues also might result in areas of high air pollution, too. “It’s important to understand that heart attacks are triggered,”Glantz continues. “The ultra-fine particles lead to inflammation, which can actually trigger a heart attack.”

Ultimately, when asked flat-out about safety, the panel concluded that e-cigarettes are probably not as harmful as standard cigarettes. “We know that the level of carcinogens and toxins are lower,”says Thornburg.

That said, there was no endorsement for unending use.

“They’re not as dangerous as cigarettes, but they’re not safe,”Glantz says. “You are better off not using them. The question is how much safer are they than regular cigarettes?”

To put it in better perspective, Glantz also offers this: “They are less toxic than a cigarette, but the cigarette is probably the most toxic consumer product ever designed. It’s a low bar.”

And although many ingredients are regarded as generally safe by the FDA upon ingestion, the effects upon inhalationaren’t well understood or studied, leaving a need for better clarity — especially with the prevalence of e-cigarettes taking off in recent years. Since 2007, e-cig sales have doubled each year, finally reaching the $1 billion mark in 2013.

Roughly 13 percent of adults have tried vaping, one-third of whom had never before smoked conventional cigarettes, according to Annice Kim, Ph.D., a senior social scientist in the Public Health Policy Research Program at RTI. “Eight percent of current tobacco smokers also use e-cigarettes,” says Kim, who is currently tracking vaping trends on social media and among key demographics, like kids and teens.

“The trends are alarming,” she says. “Seventeen percent of 12th graders have used e-cigarettes in the past month. To date, 40 states have prohibited e-cigarette sales to minors, but as of January 1, 2015, only four states have banned e-cigarette use in schools statewide.”


‘Vaping’ is an ‘unknown’ risk

Layne Forden smoked for 17 years until he discovered “vaping.”

He is now smoke-free and has been for two years — but he does “vape” and owns Go Vapors in Cedar City.

Vapers, or e-cigarettes, are not sold as a means to quit smoking, but Forden said most of his customers are smokers or ex-smokers.

“It’s amazing the transition they go through,” he said. “Especially the elderly. They have more energy, can breathe and become active again.”

Forden said his customer-base has grown leaps and bounds since he opened a year and a half ago, but most of them — at least 80-90 percent — are not young adults, which is a stereotype hitting the media.

Vaping has taken the country by storm, taking the idea of the e-cigarette and turning it, for some, into a way of tapering off cigarettes, though companies shy away from marketing e-cigarettes as smoking cessation alternatives.

E-cigarettes are called “cig-alikes.” They have an end that glows as the user inhales and only emits steam, or vapor. What’s in e-cigarettes changes from one company to the next.

A spin-off of the e-cigarette is the “vaper.”

A “vaper,” or personal vaporizer, is cylindrical and has a tank to hold liquid. Some vapers are small, others large. Some are charged with an USB charger, others have a battery one can remove and charge. The liquid, or juice, has four ingredients — United States Pharmacopeia approved vegetable glycerin, propylene glycol and flavoring and, for those who want it, nicotine, Forden said.

The vapers heat up the liquid, turning it into vapor that is inhaled.

Vegetable glycerine is made up of plant oils, which are natural triglycerides. It’s used in things including food, herbal tinctures and cosmetics, according to several websites.

USP approved propylene glycol is used in everyday items such as ice cream, cake and frosting, candies, salad dressings, sodas, cosmetics and pharmaceuticals — oral, injected and topical, according to several health and science websites.

The flavorings are often those used in making candy — strawberry, peppermint, root beer, melon, etc.

However, the flavorings are where one should worry, said Brendon Gunn, co-owner of Cloud 9 Vapor in St. George.

“Our company has chosen to deal with flavoring companies that have done extensive research,” he said.

Many flavorings are made with dyes, alcohol as well as other chemicals already known to cause problems, so it’s wise for consumers to investigate the products they buy and what’s in them, he said.

It doesn’t help, Gunn said, that there are so many different companies, brands of e-cigarettes and vapers and recipes for juice out there, and there is no set ingredients.

Gunn said vaping is a phenomenon which threatens to out-pace tobacco in sales in the next decade but worries Americans because it’s unknown.

Many are also worried youth will begin trying it making it the next “gateway drug.”

Theodore Moon, a pulmonary specialist at Intermountain Health Care in St. George, said because vaping is so new, it will be a while before any studies can accurately determine its harmful effects.

The fact that it’s growing exponentially in popularity worries Moon because effects are currently unknown. He said he fears there will be another health crisis similar to that related to cigarettes down the line, and he doesn’t offer it to his patients as an alternative, either.

Moon said he has “yet to meet anyone who has quit by using e-cigarettes.”

Those who walk in his shop wanting to use vaping as a way to quit are strongly advised to ween themselves off of nicotine, Gunn said.

Forden agrees customizing a plan lessening the additive is the best option.

Gunn said nicotine is a dangerous, deadly additive.

Forden doesn’t suggest anyone making their own juice at home use nicotine.

“If it were up to me, it would be illegal for the (public) to buy nicotine,” he said. “It’s that dangerous.”

Studies are slowly emerging in this new fad and its possible effects.

One study conducted by Thomas Eissenberg of Virginia Commonwealth University discovered that five minutes after smoking cigarettes, smokers had elevated levels of nicotine and carbon monoxide in their systems — vapers didn’t.

Cigarette users also had an increased heart rate, whereas vapers didn’t, according to the study.

Before deciding vapor is safe because of the one study, though, one must consider the findings of another – the University of Athens examined the effects of vapor on the lungs, and the findings weren’t positive.

The researchers found increases in airway resistance, similar to that suffered by smokers, the study indicated.

Gunn agrees with Moon that it’ll be years before any solid evidence shows the true effects of vaping.

But Gunn and Forden also go out of their way to create juice with as little chemicals as possible, they said.

The thing to remember, though, is not everyone who makes and sells juice considers safety, Gunn said.




California is the newest case study in the e-cigarette information wars. On Sunday, California's public health department went live with an awareness campaign about e-cigarettes on a new website, Still Blowing Smoke. By the time of their official launch on Monday, vaping advocates were already on the offensive with a nearly identical site: Not Blowing Smoke.

The websites are easy to confuse. Backed by three vaping-advocacy groups, Not Blowing Smoke borrows font, design elements, and imagery from the state's website — except where California’s is filled with public-health warnings about e-cigarettes, the copycat site downplays the health concerns and says the science proving these devices are healthy is unequivocal.


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