To Vape or Not to Vape

The last decade has seen a significant rise in the use of electronic cigarettes, also known as e-cigarettes or “vapes,” but there are still many questions relating to what they are and what the difference in practical effect is between them and traditional cigarettes. Vaping shops have popped up all over the country, and Knoxville itself has seen many new businesses develop both in the city and surrounding areas. The influx of these shops causes us to wonder about the health advantages or disadvantages of electronic cigarettes, which are often advertised as smokeless and advantageous to those trying to quit smoking tobacco. The absence of smoke, or at least the re-naming of smoke to “vapor,” creates something of a gray area in terms of what the legal and social rules are for electronic cigarettes. Conversely, there are strict regulations on traditional cigarettes in regards to where and when you can smoke them. Regardless of the assertions of the vaping industry, the health benefits of vapor over tobacco are still murky at best. Additionally, there have been alarming stories circulating in the news about exploding vapes, which gives rise to questions regarding the fundamental safety of these devices. So, with a culture of vaping on the rise, what exactly is all of this stuff, and what is the difference for the consumer between lighting up a Marlboro and turning on an e-cig?

Health

Vaping is inhaling and exhaling the vapor produced by any electronic cigarette, with heated and vaporized fluid substituting for the smoke that results from burning tobacco. Electronic cigarettes came into the picture in 2003—not much is known about the long-term effects of using them. This lack of information has led many consumers to make their own assumptions about the supposed health benefits of vaping, since users are not inhaling the same carcinogenic and dangerous chemicals found in conventional cigarettes. Numerous smokers have been making the leap from cigarettes to electronic cigarettes in the last fourteen years in hopes of getting at least a partial benefit from quitting smoking. With many different types of vaping products available to the public, each could have potentially different health effects.

Dr. William P. Powers, a pulmonologist at UT Medical Center, stresses that “although vaping is a small victory in terms of quitting tobacco, there is still much that is unknown about it.” These unknowns raise many concerns for Powers, and he “would much rather see people using conventional nicotine replacements” such as nicotine patches or gums. His biggest issue is the lack of long-term data to support the idea that vaping is in any way healthier than smoking cigarettes, especially considering that not that long ago cigarettes were thought to be healthy themselves. “Vaporizers use the combustion of heavy metals, which can be carcinogenic in itself,” and “the juices vary from box to box, making it difficult to know what you’re inhaling.”

The material consumed in a vaporizer, known in the industry as vape juice, is made up of four main ingredients: Propylene Glycol (PG), Vegetable Glycerin (VG), flavoring distilled in water, and nicotine (though the addictive chemical may be omitted in certain juices). PG and VG turn to vapor when heated; they provide both flavor and mouth/throat sensations, depending on the amounts of each used in a particular juice. For example, PG provides a harsher feeling in the throat comparable to that of regular cigarettes; it also carries flavor in a more effective manner than VG. PG also gives off less smoke and thus produces a smaller cloud of vapor when combusted; therefore, juices with higher concentrations of PG are suggested for use in public places. VG gives a smoother throat-feel, concentrating sensation in the mouth, but does not transmit flavor as well. Juices with higher concentrations of VG produce denser clouds of vapor when combusted. A style of vaping called “cloud chasing,” where the user tries to create the densest smoke cloud possible, has been popularized by smokers who prefer VG. Cloud chasing competitions are growing in popularity in vape culture.

Since PG and VG are the two most significant components of vape juice, it is important to know what they are and if they are harmful. A study by the British Industrial Biological Research Association gave 60 lab rats daily doses of Propylene Glycol for two years, with research finding no effect on mortality or carcinogenic potential. It should be noted, however, that these tests were done by feeding rather than forcing the inhalation of smoke from the superheated material, as occurs in the process of vaping. Similar tests have been done on rats using Vegetable Glycerin yielding the same results, but again without testing the effects of inhalation. For ingestion, the FDA has deemed both ingredients as generally safe, an assertion that can be misleading to the consumer of e-cigarettes. It does not necessarily mean that inhaling the vapor from combusted PG and VG is without long-term effects. Therefore, it is unknown whether vaping is significantly safer than smoking cigarettes. And, while the FDA has said that PG and VG are at least somewhat safe, it should be noted that e-cigs are not currently regulated by the FDA. Most evidence of their safety is anecdotal, as electronic cigarettes have not been around long enough for the scientific community and public to ascertain what potential dangers these devices can introduce with lifelong use. The harmfulness of secondhand vapor is unknown, and, because vapes are currently unregulated, the labeling of actual nicotine concentration in the vapors could be much higher than what is printed.

Law

Since the use of vapes is a relatively new phenomenon, the legality of certain practices remains a little foggy: because they are not regulated as tobacco products, their use does not generally follow the same rules as cigarettes. As recently as 2015, some states did not have laws banning their sale to minors, and there is no current legislation to subject the sale of vape products to taxation, a practice which has been proven in the past to hinder tobacco use in both adults and minors. Whereas the legal regulation of indoor smoking has long been established, the legality of indoor vaping is also something of an unknown quantity. Many states do have regulations on whether or not you can vape indoors, but Tennessee (along with Nebraska, Rhode Island, and Nevada) is one of only four states that have no guidelines whatsoever on the topic.

Much of the legal attention to vaping in the state has been focused on deterring use among minors, one of Dr. Powers’ other concerns. “Using flavors that are fruity or like candy can appeal to children, which can lead them towards smoking tobacco,” he says. A study done by the Centers for Disease Control and Prevention concluded that 29 percent of high school students have used e-cigarette products, and also reported that vaping doubles the chances of users smoking cigarettes. Underage smoking is something the Knox County Health Department has been specifically trying to address. Their 2014-2015 Community Health Assessment centered on lowering the rate of every type of smoking within the region, especially for pregnant women and children. A great deal of concern has generated about minors using electronic cigarettes due to the fact that the rate of use among middle and high schoolers tripled from 2013 to 2014.

The Variety of Products and the Future of Vaping

The vaping experience can be a varied on, depending on what style of vaporizer you use and the type of juice you burn. Consumer choice is based on several different factors including flavor, mouth and throat-feel, and concentration or presence of nicotine. Vape pens are the most common device, and usually resemble traditional cigarettes in shape, though they may more closely mimic the look of an actual writing instrument. They use concentrates, which are waxes and oils, and cater to a wide variety of tastes with candy, soft drink, and tobacco flavors available. Concentrates are known for clogging up vape pens, however, which requires significant maintenance. Vape pens can also use e-liquid, though it comes in canisters proprietary to the maker of the pen.

Another type of vaporizer is the portable vape. These are slightly larger than vape pens and are not as easily concealed, but they also have a significant advantage. They are highly customizable in terms construction of the vaporizing device, type of juice, and size of the canister containing the liquid. One can order custom vaping “rigs,” but this gives the product a significantly higher price tag. Many experienced users, however, consider it worth it to pay more for greater functionality. As one might expect, there are significant style and aesthetic choices to be made when putting together a custom vape rig.

Neither type of e-cigarette offers unique health benefits, and their overall value as substitutes for tobacco cigarettes remains to be seen. It would appear that people are able to stop smoking cigarettes when vaping, though to what degree and how long a term is unknown. Knowing whether or not switching from the inhalation of combusted tobacco to the inhalation of combusted liquid makes a difference to one’s health will depend on future research on long term effects. For now, it does not seem safe to say there is a definitive difference or tangible benefit. Indeed, it would seem prudent to note that regardless of the specifics or the sexy language, vaping is still the practice of inhaling smoke.