e-cigs and “vaping”


A friend of mine has struggled to stop smoking and appears to have had his longest stretch of avoiding tobacco by moving to e-cigarettes.  I have been around him a few times when he uses the product. It looks pretty much like a cigarette, but emits a wispy bit of vapor which rapidly dissipates.  It is a nicotine delivery system, but absent the tar and other components of cigarette smoke. I don’t mind standing close by when he uses it. I prefer to be one county away from anyone smoking a cigarette.

An e-cigarette is a battery-powered vaporizer which simulates tobacco smoking by producing a  relatively inconspicuous vapor. The device uses a heating element to vaporize a liquid that typically contains a mixture of propylene glycol, glycerin, nicotine, and flavorings. The use of e-cigarettes to deliver nicotine and other substances is referred to as “vaping.” The device itself is called a “vape” or “e-cig” and the various liquids it vaporizes “e-juice.” But, in classic form, the e-cigarette is a nicotine delivery system.

This is probably a good time to remind ourselves that tobacco kills about 6 million people per year and contributes to 1 out of 10 deaths worldwide. But, it is the other stuff in tobacco smoke, not present in nicotine vapor, that makes smoking so lethal.  Nicotine provides the addiction and tar produces the cancer, heart disease, respiratory illnesses, and the whole deadly menu of deadly effects. Nicotine gets you hooked and tar gets you sick or dead.

There is a bitter debate going on in the public health community about whether the advent of e-cigarettes is a good or bad thing. Here is my best, short version of the debate, covered  this year in a series of articles in the New York Times.

Pro:  While nicotine addiction remains an undesirable thing, getting nicotine in relatively unadulterated form, without the more toxic tar and other components of tobacco smoke, is relatively harmless and may be a way for people to give up tobacco smoking.

Con: Because of the perceived relative safety of e-cigarettes people, and especially young people, are more likely to start using e-cigarettes, perhaps leading to nicotine addiction and, worse, transitioning at some point to tobacco. In addition, some on this side argue that there is substantial reason to believe that there are other byproducts in e-cigarette vapor (traces of carcinogens, and toxic metals such as cadmium, nickel and lead) which could cause serious health problems, especially with long, consistent use.

There is not much data yet to answer the questions at the heart of the debate. So far, the data on the lasting effectiveness of e-cigs as a way of kicking tobacco are, at best, mixed. There are some early surveys to suggest that some of the young people who report having tried e-cigarettes deny any history of smoking tobacco. This suggests the possibility of e-cigs as a kind of gateway to tobacco use.

There are many varieties of e-juice, by the way, I suggest you Google “vapes” and explore one of the major online sellers to get an idea. There are non-nicotine e-juices which appear to be just about the flavor.  With or without nicotine, there is a range of available flavors (coffee, spicy, fruity, etc.)

Of course, it didn’t take long for e-cigarettes to become a favored way to smoke pot or, more accurately, inhale THC-laced vapor. This often happens via the use of hash oil via vaping, which offers a higher concentration of THC, the psychoactive ingredient in marijuana. For an excellent story on this trend, hear and read this NPR report. I recently watched a couple of YouTube videos featuring a young man who refers to himself as a “vapologist.” (It was unclear where he earned his vapology degree or whether he was duly licensed in his home state.) One of the things this man does is to perform “mods” and “hacks” on the vaporizers. These modifications increase the burn rate and supplies more vapor faster. (It probably does other things, but lacking formal training in vapology, I’m not competent to say.)

Also of concern for parents and school officials–who would like their kids to avoid e-cigarette–is the ease with which a single e-cig can be concealed and used. Without the telltale strong smell, ash, and butts left by cigarette smoking, vaping may be highly inconspicuous. It is not hard to imagine the use of these products going undetected in schools.

In fairness, when one is aware of the massive damage done to human beings by tobacco, I find myself reluctant to categorically demonize e-cigs as a method to stop smoking tobacco, at least until more research comes. In the interim, we have to be aware of  yet another source and another mechanism of substance abuse. I suspect we will be hearing more about other and more dangerous illicit substances being consumed via vaporizers, in addition to the potential toxic effects of using the devices themselves.

These devices are being encountered in schools. It is a problem because of the range of e-juices available, from some that are simply flavorings, to hash oil, an alternate method of using getting cannabis into one’s system.

The use of these devices can be very easy to conceal and very hard to detect. To understand this better, I asked my e-cig-using friend to take a big pull from his e-cig and blow the vapor into my face. When he did, I felt no acrid irritation in my eyes or nose. I did pick up a scent, but it was a vague, pleasant scent that, for some reason, reminded me of baby powder. I never would have believed it was the vapor from an e-cig.

Mountain Brook Schools’ Board of Education, recently revised it’s tobacco policy to include e-cigarettes. E-cigarettes are banned on any of our campuses and students caught with them will have disciplinary consequences. The consequence will depend, though, on what the student also has on hand to use in the e-cig. At the least, the consequence will be similar to what a student would get if he or she was caught with a tobacco cigarette. If the student has an illegal, controlled substance at school they are using via e-cigs, the consequence would be based on what that substance is. In those cases, criminal charges associated with having a controlled substance at school would be possible..

Dale Wisely