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Health risks of e-cigarettes hazy

From left, e-cigarette enthusiasts Jay Philbrook, 36, of Palm Harbor, Judd Docherty, 29, of Palm Harbor, and Adam LaRoche, 38, of Oldsmar vape Tuesday at Magic Dragon Vapes in Clearwater. The FDA has indicated interest in regulating e-cigarettes, which have had little study for health impact and little oversight.
Published Oct. 17, 2013

Jay Philbrook hated everything about smoking. The wheezing, the aching throat, the way it made his clothes smell, the awful taste in his mouth, getting out of breath climbing stairs.

But most of all, "I didn't like my son watching me smoke."

Philbrook, 36, tried repeatedly to quit, but his craving for nicotine—fueled by an 18-year, pack-a-day habit—was greater than any patch or lozenge could satisfy.

Then, about two years ago he heard about electronic cigarettes. The battery-operated devices produce a vapor laced with varying amounts of nicotine, but without the smell, taste and many of the regulations associated with tobacco. "Now I don't wake up wheezing, my sense of taste and smell have improved, I'm not as breathless as before and I feel better, I have more energy," said the Palm Harbor man.

"Is it worse than smoking? I don't know. I like to believe they are safer, but there are chemicals in it. I'd like to know more."

Philbrook recently signed up for a Moffitt Cancer Center research looking at e-cigarette users, what attracts them to the devices and whether they help people quit tobacco. "E-cigarettes are very controversial," said Thomas Brandon, director of the Tobacco Research and Intervention Program at Moffitt. "On the plus side, they may be less dangerous than cigarettes and they may help people quit or reduce smoking," which kills 5 million people worldwide annually.

"But we don't know the long-term effects of inhaling that nicotine solution, all day, every day, for years," he said. "So we don't know if they're safer than tobacco. The research hasn't been done."

• • •

E-cigarettes have grown in popularity in the past decade. Celebrities endorse them; race cars carry logos of the most popular brands. U.S. sales are expected to approach $2 billion this year, according to industry analysts. A reusable e-cigarette kit ranges from $40 or $50 to about $150 or more.

Ronnie Zurcher, 43, of Palm Harbor said his kit cost $90 and he spends about $30 a month on liquid, versus $200 to $300 a month on cigarettes.

The devices have their own vocabulary. Users call it vaping, not smoking. The nicotine solution — which often comes in candy flavors — is called e-liquid or juice. Most of the devices have a small battery that heats a coil and turns the juice into vapor. There's no flame, no ashes. Some e-cigarettes look like regular cigarettes, others look like a small, fat tube with a ¾-inch tank or chamber for the juice and a mouthpiece.

Some are disposable after an hour or so of puffing (they cost around $9 each), others can be recharged and used for months.

Most juice is a mix of propylene glycol, vegetable glycerin and liquid nicotine, plus optional flavorings. Kyle Guffey, owner of Magic Dragon Vapes in Clearwater, mixes solutions on the premises with flavorings such as chocolate, cherry, waffle — even tobacco-flavored juice that mimics particular cigarette brands.

Business is so strong at the 5-week-old shop that "I made my rent in the first three days," said Guffey, 36, who used e-cigarettes to quit a 15-year, two-pack-a-day smoking habit.

A popular feature there is a tasting bar to try different flavors. A bystander might notice a faint candy smell, or a slightly chemical odor. If there are a lot people in a tight space, a vapor cloud can form. But you don't leave smelling like an ash tray.

• • •

The Food and Drug Administration, which regulates tobacco products, is observing e-cigarettes but doesn't monitor them. So there's no way to know exactly what's in the juice or how it was manufactured, shipped or stored, particularly if purchased from a foreign source.

Another concern is that e-cigarettes still are delivering highly addictive nicotine. As smokers know, nicotine can be both a stimulant and a relaxant. But it also has a variety of negative health effects, and may even promote the growth of some cancers, according to Brandon.

An FDA analysis of some e-cigarette products found low levels of nitrosamines, ethylene glycol and diethylene glycol — all associated with cancer and other health risks — but far less than what you'd get in a conventional cigarette.

Because the vapor isn't as objectionable as tobacco smoke, users find their families don't mind if they vape at home and some can vape at work. (Public agencies such as schools, however, treat them like any other cigarette).

Still, the fact that e-cigarettes seem more acceptable worries anti-smoking advocates like Shannon Hughes, bureau chief of Tobacco Free Florida.

"What kind of message do we send to a kid who sees someone puffing on one of these things? Just the fact that it normalizes smoking behavior and will erode all our progress on that front, that's a real problem," she said.

Bolstering her point: E-cigarette use has doubled in the past two years among Florida high school students, data show.

Last week, Countryside High School senior John Shauer, 18, stopped by Guffey's shop, which won't sell to younger teens. He says vaping helped him quit a two-pack-a-day smoking habit that started when he was 11.

"This is better for me," he said.

Brandon hopes he's right.

"It's hard to make a strong recommendation at this point, but I'm not telling people not to use them," he said. "My message is, all the data aren't in yet. I'm keeping an open mind and I'm hopeful."

Contact Irene Maher at imaher@tampabay.com

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