E-cigarettes have been touted as a familiar way to deliver the nicotine that smokers crave and help them shake their addiction to traditional cigarettes – but how safe are they, really?
Walk down Woodward and you’ll see lines of tourists, college students and residents puffing on electronic cigarettes and vaporizers, one after the other – “like people trains,” as my nephew described. The blanket declaration that “vaping is better than smoking” led to an e-cigarette boom that’s sweeping the nation at a rate that’s alarming some, despite the fact that electronic cigarettes began as a method to wean smokers off the cancer sticks.
They might be effective – some evidence shows short-term success when used in smoking cessation programs – but experts have not had time to thoroughly examine this new, rapidly accelerating trend. Reports of injuries related to vaping and vaping paraphernalia are on the rise, alongside troubling information about a nicotine addiction crisis that sweeping the teenaged population – low-income teenagers notwithstanding.
Two Steps Forward, One Step Back?
You may ask, “Isn’t this a white people issue?” or, “Why should I care?” Problems related to cigarette use affect nearly all people – black and white, young and old. For now, we’ll focus on that favorite auntie who tries to quit Marlboros every year.
The Centers for Disease Control and Prevention estimates that 14% of adults in the United States are smokers. That’s down significantly from previous numbers, but it still means that 34.3 million people smoke cigarettes, a habit that kills one out of every two long-term users. And 16% of smokers are black and more likely to die of a smoking-related disease than their white counterparts. Smoking can even fast-track conditions like diabetes.
E-cigarettes have been touted as a safer alternative to smoking. They deliver the nicotine that smokers are addicted to without the deadly stuff like carbon monoxide and tar. The way it works is a rechargeable battery heats up a metal coil which vaporizes a nicotine liquid – available in replaceable cartridges – turning it into a mist, which users then inhale. The first prototype was made by Hon Lik, a Chinese pharmacist spurred by his own smoking addiction and his father’s lung cancer diagnosis.
So, how beneficial are e-cigarettes in helping to curb our addiction to the real thing? According to a report published by the U.S. National Library of Medicine, black smokers were more likely to report plans to continue using e-cigs compared to whites and Hispanics. The same report said that black participants were more likely to use e-cigarettes as a cessation aid and “may be particularly vulnerable to maintaining their use.”
Lynn Sutfin, spokesperson for the Michigan Department of Health and Human Services, says, “We’ve seen 59 cases of injuries and illnesses relating to vaping in the state of Michigan, and two deaths so far.” The MDHHS released a public health advisory in response to severe lung injuries relating to vaping. At the time of advisory, there had been 2,290 cases identified in 49 states overall. Patients who have used vaporizers or electronic cigarette devices have suffered pneumonia, ruptured alveoli – the air sacs in the lungs – and other potentially fatal pulmonary problems.
“I don’t think we’d say vaping is safer than smoking,” Sutfin says. “The causes of a lot of these issues are hard to determine because the problem is so new. It could be additives in the liquid, certainly, but it could also be the hardware or just the practice itself.”
Dr. Geneva Tatum, pulmonary critical care medicine specialist at Henry Ford Hospital, says the best way to stop smoking would be to use conventional methods until more data is gathered. “We know that vaping does produce low levels of harmful chemicals. I’d recommend using lozenges, patches or gum, because we just don’t know,” Tatum says. “We do know of one chemical that’s been linked to vapable marijuana cartridges, vitamin E acetate, but that’s almost an entirely different issue.
A Whole New Market
In 2020, e-cigs and vaporizers are a long way from the prototype Lik built back in 2003. Vaping has its own culture and an industry that includes devices with more customization than a new iPhone and expos where vape aficionados perform smoke tricks.
All that nearly stopped when, last October, Gov. Gretchen Whitmer attempted to enact a vape ban in the state of Michigan. Judge Cynthia Stephens blocked it to prevent vape businesses from having to suddenly close, leaving those who shop there in a collective shrugged shoulder.
Nathan Esquivel, owner of Corktown Smoke Shop in Detroit, says that he’s mostly concerned about providing for his customers who want to quit cigarettes. “A lot of my customers just want an alternative to smoking tobacco. We can’t prove that it’s safer, but they feel that it is and they’re happy they made the switch. We’re happy we can provide for them,” Esquivel says.
Responsible adults choosing to consume nicotine is fine. But I’m not sure whether the cloud coming from the group of teenagers next to me at the bus stop is coming from their breath meeting the winter air or the vapes hidden up their sleeves. Parents, teachers and concerned experts have noticed that nicotine addiction is spreading like wildfire among teenagers who’ve never smoked a traditional cigarette.
E-cigarette use among teens has been called an epidemic. Though big vape brands like Juul and Blu have said that their products are only meant for adults, their marketing campaigns saturated social media in an explosion of bright colors, exciting venues and smiling, attractive, teenaged-looking smokers. To its credit, following criticism, Juul did voluntarily decide to halt social media marketing and eliminate its fruity-flavored cartridges.
The U.S. Department of Health and Human Services says that nicotine can have “long-lasting effects on teen brain development, making it harder to concentrate, learn and control impulses.” Teenagers addicted to nicotine also have a higher chance of addiction to harder drugs.
“I would definitely say it’s a public health crisis for youth. Kids are going to try things and take risks, so it isn’t surprising. I think the speed at which this happened is the most surprising thing,” says Jeff Griffith, director of communications for The Youth Connection in Detroit. “Part of it definitely is the marketing. It’s designed for young people. When you have flavors like chocolate milk and strawberry bubblegum, it’s inevitable.”
If you’ve never seen a Juul, it looks almost exactly like a USB stick – it even plugs into the computer to charge. Chrystal Wilson, assistant superintendent of communications and marketing for Detroit Public Schools Community District, says that parents shouldn’t be vilified too harshly if their kids are caught with a vape device.
“These things are discreet. They can fit in the palm of your hand! So many parents just aren’t aware that their kids are stopping at the gas station on the way home and buying them,” Wilson says. Pair delicious flavors and doses of nicotine with sleek, tiny devices that are easily concealed in a hoodie pocket, and it’s a recipe for widespread teen addiction. For me, someone with a 16-year-old sister, that’s a scary thought – and I’m not alone.
Wilson says that DPSCD is dedicated to getting at the root of the vaping issue when it comes to the city’s teens. They’ve partnered with TYC on panels and apps to educate students in light of cases like the 16-year-old boy who underwent a double lung transplant at Detroit’s Henry Ford Hospital after being admitted for vaping injuries.
“It takes a village. Some of them vape because they’re stressed at home or out of peer pressure. Some might just think it’s cool or not understand what they’re really doing to themselves,” Wilson says. Griffith doesn’t think that the crisis is targeting young black teens in particular; however, there might be something to be said for low-income areas. “I don’t think it’s race-related. But we do work on the east side among some lower-income communities, and advertising for tobacco products like Juul is heavy there,” he says.
Regardless of what you think of e-cigarettes and the apparent “crisis,” the black community needs to stay vigilant, because big tobacco is certainly paying attention. In December 2018, Altria, the leading U.S. cigarette manufacturer, invested $12.8 billion into Juul, giving it a 35% stake in the e-cig maker. And if history is any indication, we can expect them to continue to aggressively market their products to young people and African Americans, especially in urban communities.