Research on vaping starts to clear smoke on possible health effects
Chelsey Bowles said she doesn't stink anymore.
"Not smelling like an ashtray is nice, definitely," the Hanover resident said.
Bowles said she no longer coughs in the mornings, her taste buds are back, she can smell again, and walking up stairs is no big deal.
That's the difference, she said, between smoking cigarettes and vaping.
At SS Vape in Manchester Township, 19-year-old Bowles said she was smoking about a pack a day before completely making the switch in December.
Bowles is part of the exploding popularity of vaping, or using a smokeless "cigarette" that, when inhaled, electronically delivers flavored liquid with varying levels of nicotine. She started with 24 mg, and now she's down to 3 mg per bottle of vaping liquid.
Success: Officials are pushing for more regulation as the debate rages on over vaping's possible health effects and role as a smoking-cessation tool. Gov. Tom Wolf has proposed a 40 percent wholesale tax on vaping devices.
"I have an issue with that, because he's trying to lump us in with tobacco," Bobby Allen said. "This isn't tobacco."
A smoker since he was 11 years old, Allen said that in September he went from more than two packs a day to nonsmoker in just two days of vaping.
Allen, 38, of York City said he uses only 0 to 3 mg of nicotine but "jumped into the hobby aspect" — he makes his own coils, allowing him to get a bigger hit with more flavor and a bigger cloud.
Drew Klinedinst, 30, of York City said he was a smoker for 15 years before vaping for the first time last October.
"I did this for three days, and I couldn't stand cigarettes," he said, noting that he uses 3 to 6 mg of nicotine.
Education: Marie Drawbaugh, a tobacco cessation specialist for York Hospital, said she doesn't recommend vaping as a method of quitting cigarettes; she suggests evidence-based methods for her clients.
If smokers do want to quit with vaping, they should "do their homework and understand what they're getting," she said.
"We don't even know what's gonna happen in the long term," Drawbaugh said of the possible health effects. "Twenty years from now, we'll see."
Drawbaugh said maybe 20 percent of her clientele has tried vaping, but younger clients are more likely to make the switch — older smokers say it doesn't feel the same.
"They'll try them, but many of them say, 'No, that's not what I want,'" she said.
If a smoker wants to switch, it's important to avoid using combustible cigarettes and a vaping device simultaneously, Drawbaugh said.
"My concern is the people who go back and forth all day long, because who knows how much nicotine they're getting then?" she said.
For Karen Rizzo, president of the Pennsylvania Medical Society, successful bridging from smoking to vaping is a welcomed, positive outcome.
"This concept is an option to talk about with patients that are trying, are motivated to quit," she said. "That's where the usefulness of this product, in my mind, is."
Unregulated: Nicotine is "a very serious addiction that's not given credit for how binding it is," said Pam Miller, a tobacco cessation specialist for Memorial Hospital.
And with thousands of liquids and more than 400 unregulated brands of vaping devices on the market, "we don't know exactly how much people are getting," she said.
Miller said she focuses on intent when her clients take up vaping: If they want to try it for harm reduction, "I think there could be value in that person making a behavior change."
She said she's seeing a lot of people making the switch with the thought that vaping is smokeless and free of carbon monoxide — but transitions from vaping to smoking nothing are rare.
"I have talked to people who have completely switched from combustible products to e-cigarettes, but I haven't talked to people who've gone from there," Miller said.
Using both products "sort of perpetuates the habit and addiction," she said. Some clients, for example, will go from smoking two packs a day to one — but vape for the rest of the day, she said.
Miller said she's hoping the FDA puts some final regulations on vaping products soon.
"The bottom line is, I want people to be able to make an informed decision for themselves," Miller said.
Safer than cigs?: Vaping has a "different risk profile" than cigarettes, so it's inappropriate to compare the products apples-to-apples, said Stanton Glantz, a professor of medicine at the University of California, San Francisco.
Because vaping doesn't burn anything, it exposes people to a lower risk profile in terms of cancer-causing chemicals, he said.
But cigarettes are probably the most toxic consumer product ever developed, so for vaping to be safer is meeting a "low bar," said Glantz, director of UCSF's Center for Tobacco Control Research and Education.
The cloud emitted from vaping is not just water vapor, though — it's an aerosol with nicotine, propylene glycol, flavors and fine particles that are one-50th the size of a human hair, he said.
One way vaping enthusiasts can increase a hit is to raise the temperature of coils in a device — and as they get hotter and hotter, Glantz said, more formaldehyde is created.
"Some can produce more (formaldehyde) than conventional cigarettes," he said, noting that some users hold competitions to see who can produce the biggest cloud.
Health effects: As far as health impacts of vaping, "we know a little bit," but there's more science to be done, Glantz said during a March research briefing on an RTI International study of the secondhand effects of vaping.
"We don't know anything about the long-term health impacts of e-cigarette use because you have to wait a long time to find out," he said.
But it's well-established that exposure to ultra-fine particles has adverse effects on blood vessels, as they prevent the vessels from getting large when they need to, Glantz said.
The particles are small enough to go from the lungs to the bloodstream and trigger an inflammatory process, he said.
When vapers exhale the aerosol, it's put out into an environment where bystanders are exposed to those particles — "a very strong justification for integrating e-cigarettes into clean-air laws and policies," Glantz said.
Glantz said his guess is that, "in the end, what we're gonna find is health risks related to heart attacks and noncancer lung disease."
Ready to quit?: York County's hospitals have tobacco cessation programs that can help smokers quit for good:
York Hospital: (717) 851-5857
Memorial Hospital: (717) 849-5463
Hanover Hospital: (717) 316-7894
— Reach Mollie Durkin at firstname.lastname@example.org.