— After 20 years of cigarettes, things started adding up for
Abhi Nath: The smoke burn. Future health concerns.
whole ick factor."
employer added a $50 health insurance surcharge. "And I
was dating a girl and she hated cigarettes. So I started
months on, Nath, 38, of Philadelphia, gets looks of curiosity,
not disgust. He feels and smells better. He plans to gradually
reduce the nicotine level (there’s no tar or ash) — and to
enjoy doing it.
only thing about e-cigarettes is there is no regulation of the
content. How do you measure the claim that it is 5 percent
nicotine?" Nath said. "That is the one very, very
scary part about it."
a few years, "vaping" — e-cigarettes produce
vapor, not smoke — has upended the market.
stigmatized habit is suddenly cool again. A burning stick has
become a high-tech gadget (one product vibrates when it senses
another nearby, a sure conversation-starter). Falling
cigarette sales are balanced by big growth in electronics.
deadly behavior in the United States might morph into a
lifesaver. Or a product with an unknown safety profile might
lure more smokers. The e-cig has divided a public health
community whose reliance on carefully collected scientific
evidence is no match for a fast-moving new technology backed
by some of the world’s slickest marketers.
why so much is riding on a Food and Drug Administration
decision expected soon on whether and how to regulate
states have stepped in. New Jersey bans sales to people 19 and
under, and the use of e-cigs in indoor work and public spaces.
In Pennsylvania, anyone of any age can buy and use them
don’t burn and don’t produce tobacco smoke, which contains
dozens of known carcinogens. Instead, electric current from a
battery heats a liquid containing nicotine. The resulting
vapor is inhaled, mimicking the feel (and look) of tobacco
smoke with what more closely resembles steam. Nicotine — the
ingredient that causes addiction but that is not necessarily
harmful — provides the kick.
research is ongoing, it seems likely that vaping will prove
safer than smoking, which the Centers for Disease Control and
Prevention estimates leads to more than 440,000 deaths per
alone supports a public health point of view — embraced by
the industry and cited by every vaper in this article —
known in the field as harm reduction. It’s the philosophy
behind methadone maintenance for people addicted to heroin. It
prevents deaths by accepting the lesser of two evils.
McGoldrick takes the other view.
need to look beyond that very narrow question of ‘Are they
less harmful than cigarettes?’" said McGoldrick, vice
president of research for the Campaign for Tobacco-Free Kids.
Former smokers might be brought back, he said. Sponsoring
sporting events and marketing flavors like bubble gum — both
prohibited for regular cigarettes — might lure youngsters
who would not have smoked.
all comes down to, are these going to be used to decrease
smoking or to increase smoking?"
who has tried to quit would be hard-pressed to recognize that
experience at Ecigs International, a new e-cigarette store and
vapor lounge on in Philadelphia. A handful of customers sit
around blowing "clouds" and talking about the merits
of different products.
people there started with more basic disposables, the products
that look like an oversize cigarette, battery included,
provide puffs equal to about a half-dozen regular cigarettes,
and cost $7 to $12 in convenience stores. Now they favor
rechargeables, which come with external chargers and which can
be customized with a range of atomizers — the heating
element that turns nicotine liquid into vapor — and
varieties of the "e-juice" that feeds them; the
store mixes 150 to 200 flavors with a range of nicotine
had open-heart surgery 13 years ago and a heart attack three
years ago," said Robin Patterson, 48, who drives from her
home in Allentown, N.J., east of Trenton, for supplies. She
was unable to quit smoking until July, she said, when her
brother suggested an e-cigarette.
the same "throat hit" as with regular cigarettes,
and the electronic varieties offer the same "oral
showed off her new black chrome Vamo V3, a complete $110 kit
that she supplemented with a $22 Kangertech Protank II
atomizer that holds more e-juice, of which she bought two
bottles, guava and spearmint, each with 24mg of nicotine.
Total cost: $149. The e-juice will last a month and a half;
the rest, in theory, could work for years. Yet the total cost
equals two weeks of her old 1½-pack-a-day Virginia Slims
set a personal goal of reaching zero nicotine level within a
year by buying liquids with lower content every four months.
Meanwhile, she vapes wherever she wants — home, the car, at
work as a corporate relocation manager, even once flying from
Newark to Chicago.
don’t cough anymore," Patterson said. "The
blessing is that I don’t smell like an ashtray
make up just one percent to two percent of $90 billion in
tobacco sales. But an August report by Goldman Sachs predicted
a rise to 20 percent by the end of the decade. Another top
analyst projected last month that e-cigarette revenue would
exceed that from cigarettes by 2021 for Reynolds American
Inc., which sells both.
three big tobacco companies recently created or bought
e-cigarette brands, among them Lorillard Inc.’s blu eCigs,
the market leader, along with privately held NJOY.
original e-cigarettes were bulky rechargeables. NJOY, founded
in 2006, introduced the first disposable two years ago,
instantly changing the market. NJOY set the stage for the
current regulatory vacuum when it successfully sued to stop
the FDA’s plan to classify e-cigarettes as drug-delivery
now plans to regulate e-cigarettes under the 2009 law that
authorized it to oversee tobacco. It cannot ban them, as
Japan, Brazil, and Mexico have. It can regulate e-cigarettes
marketed as cessation tools, requiring evidence from clinical
trials. And it could approve messages that they are less
harmful than cigarettes, but only if manufacturers submit
evidence of a net benefit to public health.
expect some version of tobacco rules, which allow the FDA to
test safety, restrict sales to minors — and, in the case of
regular cigarettes, limit self-service displays and the sports
and entertainment sponsorships known to increase sales.
limits would be too much for Craig Weiss, CEO of NJOY, who
said he supports "reasonable regulation." But given
the death toll from tobacco — "basically a 9/11 every
three days," he said — "I don’t want them to
restrict our ability to advertise our product."
longtime tobacco researchers are pressing for restrictions,
hoping to prevent a new generation from getting hooked before
evidence proves e-cigarettes are safe.
have found harmful ingredients. Perceptions that e-cigarettes
can help smokers quit far outstrip the evidence, they say.
knows how they will be used in the long term.
may be people who use this exclusively for their entire life
and we need to know how it will affect them," said Andrew
Strasser, an associate professor of psychiatry at the
University of Pennsylvania who is enrolling cigarette smokers
in a study to see how they respond to e-cigarettes.
"Others may use it for a short time," he said. Still
others may add e-cigarettes to an existing cigarette habit.
conclusion: "More evaluation needs to be done before you
make a decision either way."