Vaping Revisited

When we published an article about "Vaping" (the use of electronic cigarettes) on Scarsdale10583 less than a year ago, no one knew if inhaling the vaporized liquid posed a health risk. And even though that question has not yet been answered, the CDC has found that teenagers are vaping more than they were a year ago. In fact, the Oxford Dictionaries' word of the year in 2014 was "vape."

What is vaping and why is it becoming trendy? (A quick review)
Vaping is using an electronic device (called a vape pen, e-hookah, hookah stick, hookah pipe, or e-pen) to heat a tobacco-free liquid (usually called e-liquid) for the purpose of inhaling and exhaling the vapor in a way that looks and feels similar to traditional smoking. The liquid is made up of water, glycerin, propylene glycol, and flavors, some with and some without nicotine. There are more than 7,000 flavors of the e-liquid on the market, including cotton candy, sensual vanilla, Cuban mojito, root beer float, and toffee latte. On one website, you can even purchase custom blended flavors.

Vaping proponents claim the liquid must be safe because these same ingredients are in other products we have all been using for years, such as salad dressing, asthma inhalers, and shampoo. Opponents claim that we have not determined whether the liquid ingredients are safe for inhalation even if they are deemed to be safe in food or shampoo. Teens are interested in vaping because it is odorless, it tastes good, the flavors are fun and varied, and they can play around with exhalation of the vapor. It is marketed as a healthy, safe, and an all-natural alternative to smoking.  

Are Scarsdale teens vaping?
The short answer is "yes," although it is not known to what extent.
The National Youth Tobacco Survey (NYTS) is a self-administered questionnaire given annually to middle and high school students in public and private schools around the country. In 2014, data from 22,000 students was evaluated and revealed a three-fold increase in the use of electronic cigarettes between 2013-2014 (from 4.5% to 13.4%) among both middle school and high school students.

There were several comments on the previous vaping article we published (including some posted months after its original publication) from people claiming to be 15 and 16 year olds discussing the safety of vaping. (These comments are posted anonymously and may not be from Scarsdale readers.) JD wrote, "I'm only 15...is it bad that I want a vape stick? I'm not into the nicotine just the vape [vapor] itself. I've seen people do tricks and I think they are really cool. It's practically sugar water right?" JD, then wondered, "...would it be safe for me to own one?" Similarly, Jasper R commented that, "...it can only cause sickness if you have a lot of nic [nicotine]. I'm a user...and I am only 16 and I see no bad side to them if they can keep me away from smoking Mary Jane or cigs. So what is the real bad side?"

Vaping advocates and vendors contend that vaping is a safe, tobacco-free way to quit smoking traditional cigarettes rather than as a newly adopted habit of non-smoking teenagers. 'Your mom' commented that (s)he is working on getting another disposable hookah pen, and that "...they are the perfect way to keep yourself away from a drug more harming," again, indicating that teens aren't using vape pens as an alternative to smoking cigarettes. The comments also lead one to believe that teens may be misinformed about vaping. "Mother of two" wrote, "...all it is, is flavored water vapor. It can also hydrate you. And since it's water vapor there's nothing harmful to your lungs."

How do teens gain access to vape accessories and liquids?
The laws around vaping and selling vape supplies vary not just by state, but by county and even city and town. For example, whereas Westchester County requires that a person be a minimum of 18 years old to buy vaping products at a store, in New York City buyers must be at least 21. Both the devices and liquids are available at convenience stores as well.

Is vaping safe? Is it dangerous?
The jury is out on this one. Studies are currently being done to determine the safety profile of e-cigarettes. In a recent op-ed in the New York Times, Joe Nocera discussed the debate on vaping, specifically the safety or detrimental effects of nicotine. He quotes Mitch Zeller, head of the FDA's Center for Tobacco Products, who said, "When nicotine is attached to smoke particles, it will eventually kill. But the same drug in a patch...is such a safe medication that it doesn't even require a doctor's prescription." The Center for Tobacco Products, a division of the FDA is now conducting more than 50 studies on e-cigarettes and will soon have regulatory authority over their sale and use.

Opponents of vaping say that the use of "teen/kid marketed flavors" are encouraging young people to vape before side effects are known. They also claim it's relatively unregulated so quality control is virtually non-existent. Proponents say the ingredients and the lack of second hand smoke make it innocuous and claim that vaping helps people quit smoking cigarettes or helps them avoid starting to smoke at all. The New England Journal of Medicine recently published a study showing that a significant amount of formaldehyde is inhaled when vaping at 5.0 volts. However, this study was widely criticized because it is unlikely that anyone would vape at this voltage as it burns the coils and gives the nicotine a bad taste. Many experts haven't gone as far as to say that vaping is harmful to teens, but do say that it is still an unknown potential hazard to developing brains and bodies.

Another concern about vaping is that smokers can put whatever they want into electronic cigarettes and sometimes add controlled substances. E-pens can be used to covertly smoke illegal substances, and since it can be quite easy to purchase the cigarettes for long-term use, whether online or with the help of an 18 year old friend, it makes using illegal substances that much easier.

I tried vaping.
In between preschool drop off and pick up, I went to White Plains Vapor on Mamaroneck Avenue in White Plains to learn more about vaping. Entering the store, I was engulfed by a haze in the atmosphere and found two people vaping. Michael, the owner, checked my ID with an app on his phone as he does with all people who look under 35 (I was flattered). To ensure the integrity of his business, Mike doesn't sell anything online. However, he told me that if kids want to vape, they'll use untraceable Amazon or other gift cards to purchase vaping devices and liquids online. Mike's angle is to sell vaping as a smoking alternative. "There's no tar, no smell, no ashes, no tobacco, it doesn't stain your teeth, there's no second hand smoke," he reported. "I smoked for 20 years and tried everything to quit; the patch, the gum, Wellbutrin...nothing worked until I tried vaping. I use liquid with the mid-range level of the nicotine," he added. Mike said he feels healthier and can climb stairs without becoming breathless. He has a wall of cigarette boxes with people's names on them and the date they replaced smoking with vaping. Mike thinks vaping is relatively benign, especially when compared to smoking traditional cigarettes. I asked him if he knows of any side effects and he mentioned that some people report dry mouth. He's safety conscious. "I always tell people that if they have kids, they need to keep the liquid and device high up." He was referring to an incident in upstate New York where a child drank the sweet e-liquid and died of nicotine poisoning.

At the tasting bar, I was served "pink bunny" e-liquid, which is marketed as "strawberry milk" to inhale while watching Saturday morning cartoons. All tasting samples are nicotine-free. I pressed the button on the device and inhaled the sweet vapor. I didn't cough and the vapor wasn't harsh to inhale or exhale. I could see immediately why teens would be vaping even if they weren't smokers. Mike assured me that whereas cigarettes have numerous cancer-causing ingredients, the atomized liquid of the vape-pen produces a simple and harmless vapor. Although Mike said his typical client is 35-50 years old, I can't imagine that "pink bunny" appeals to that age group.

As Mike's buddy who worked at the store blew a huge fog of vapor out of his mouth, I exited the store, happy to catch a breath of fresh air. I was not convinced that vaping is safe. A dull headache came on but I had no idea whether this was from vaping, breathing in the second-hand vapor or if I was dehydrated from an early morning run. Until the data proves that vaping is safe, teens should be made aware that inhaling unregulated ingredients isn't natural, and that vaping could become addictive.