Amid the media and political sensationalism cluttering up the public information stream, here are 11 things you need to know about vaping.
1. Vaping is a process not a product. It is the process of using a device to heat a liquid and inhaling the vapor that results. Vaping tools are known as “electronic cigarettes,” and come in several styles including a pen-style, a cig-a-like, or a tank system.
2. Some e-cigarette systems are a closed system and use a pre-filled cartridge, “cart,” or “pod” that contain a liquid called “e-juice.” The most popular closed e-cig system is the Juul device. Depending on the closed-system brand, users can choose their level of nicotine and the flavor of their juice. Closed systems use a type of nicotine for their juice called “nic salts” which is very concentrated and allows the e-cig device to have a small, sleek profile by using a small amount of liquid and a small battery to power the device.
3. An open, refillable system involves a tank and battery, often sold separately. Users can select juice flavors, nicotine levels including zero nicotine, and in some cases, at what temperature they want to heat their juice. The temperature affects the flavor and the nicotine levels delivered to the user. Most tanks systems use a form of nicotine known as “freebase nicotine” and because it is not concentrated requires a larger reservoir to hold the juice and larger batter to power the device.
4. There are four ingredients in legitimate nicotine e-juice: vegetable glycerin (VG), propylene glycol (PG), nicotine and flavoring. The flavoring in e-juice is food flavoring used in many food products sitting on the shelves of your grocery store or 7-11.
5. Cannabis-based byproducts, legal in some places and illegal in others, can also be delivered through a vaping system. Many of the deaths and illnesses in the news headlines involve illicit, counterfeit THC cartridges cut with an oil to make the product appear more genuine. The New England Journal of Medicine, which studied 53 patients within 90 days of their symptoms, found:
“Among the 41 patients who were “extensively interviewed,” 80 percent reported using THC products, 7 percent mentioned CBD products, and 17 percent said they had vaped nicotine only. The authors note that “information on product use is based on reports by the patients, and patients may be reluctant to report illicit drug use.“
Inhaling oil brings the risk of lipoid pneumonia, a deadly condition arising when the inside of the lungs are coated with inhaled oil. There are no oils in legitimate nicotine based e-cigarette juice. None of the illnesses of deaths have been linked to flavored nicotine juice but the CDC has explicitly linked contaminated THC carts to the outbreak of vaping-related illnesses.
6. E-cigarettes, as we use them today, were invented in 2003. They have been used for over a decade without a crisis of hospitalizations and deaths, and are used all over the world. Other countries are not reporting deaths associated with “vaping” as reported here in the U.S. which would be expected if the recent illnesses were caused by nicotine or flavored nicotine e-cigarettes.
7. E-cigarettes are used for harm reduction among smokers who want to quit and among former smokers who want to continue their break with tobacco. The Royal College of Physicians in London released a study concluding “the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.” E-cigarettes and vaping carry 95% less risk that combustible tobacco and the British health system actively encourages smokers to use e-cigarettes to quit tobacco.
8. Underage smoking is at its lowest level in history. There is a strong negative correlation between vaping and smoking: as vaping among teens rises, smoking among them declines. If vaping were a gateway to smoking, we would have seen the levels of smoking among teens rise along with the levels of vaping. That’s not to say it’s acceptable for teens to addict themselves to nicotine, but to say that e-cigarette use is not tied to the far dangerous addiction of smoking.
9. Many groups fighting against vaping are funded by the pharmaceutical industry which manufacturers competing albeit less effective smoking cessation products. One such group is The American Lung Association. Dr. Scott Gottlieb landed on the board of Pfizer pharmaceuticals after leaving his position as head of the FDA, which regulates e-cigarettes. Gottlieb’s FDA generated reports about the teen vaping epidemic strongly suggesting the need for a ban on flavored e-juice despite a successful track record of getting adults to quit deadly tobacco. Pfizer manufactures a product called Nicotrol, which is a nicotine inhaler.
10. Politicians and elected officials are especially hostile to vaping and e-cigs because every smoker that stops using tobacco and starts using electronic cigarettes is taking money out of their greedy pockets. Tobacco is highly taxed while e-cigarettes are not.
11. Flavored e-juice is almost exclusively the choice of adults who have kicked the smoking habit and are not marketed to lure children into a life of nicotine addiction. Banning flavored e-juice will have serious consequences for the people who have quit tobacco but now find themselves unable to obtain their preferred juice flavor that keeps them away from cigarettes. It also brings the risk that people will turn to newly illegal flavored juice that is not regulated and contains unknown ingredients, just like the illegal and deadly contaminated THC products.