Life in KC

A cloud of questions linger over electronic cigarettes and vaping

Vapor World

Candi McCann explains the growing trend of vaping. Video by Rich Sugg/
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Candi McCann explains the growing trend of vaping. Video by Rich Sugg/

Logically, both sides can’t be right about vaping. Yet ever since electronic cigarettes became popular a few years ago, a hotly contested conversation has lived somewhere between the vaccine debate and the people who can’t agree whether red wine is healthy or killing us.

Even as it moves through the misty ghost of the vape’s expulsion — what users identify as a “cloud” — the debate is noisy.

How safe is vaping? And should the age at which it’s accessible be raised from 18 to 21?

Holly Crane takes a pull from her vape, releasing a lazy cloud that seems disproportionate to the contact time and size of the device.

“I was a smoker for 19 years,” Crane says, speaking and vaping behind the curtained-off VIP area inside the Mid-Con Vape-Con. An Ozarks vape vendor, she organized the convention held last month in Joplin.

“And I’m a really smart person,” she continues, a statement gently alluding to the school-friendly rhyme about smoking: “Tobacco is wacko.”

A growing industry is marketing vape products with a range of bells and whistles, but the root mechanics are the same across all of them. Heat from the vaping device atomizes nicotine liquid. In goes a controlled dose of nicotine and, after a drag of the vape, out comes a thick, almost misty exhaust.

Manufacturers have met customers with product diversity on par with the customization offered by an Android phone. For example, there are devices that can deliver a range of smoke and flavor volumes, and others that carry a digital interface for precise heat control.

Candi McCann explains the growing trend of vaping. Video by Rich Sugg/

The first generation of vaping devices were battery-operated, but newer machines have internal batteries that plug in to recharge like a cellphone.

The product branding’s heavy emphasis on fun coupled with a nicotine-addicted consumer base has created exceptional growth within the industry. According to an analysis by Wells Fargo Securities, vaping and electronic cigarettes are forecast to become a $3.5 billion industry in 2015, nearly triple its size three years ago.

Much of the revenue comes from former tobacco users like Crane. She says vaping is safer and more culturally palatable than tobacco.

“One thing I’ll tell my customers, people who say, ‘Well, I just love smoking,’ and I say, ‘Well, smoking doesn’t love you back,’ ” she says.

It’s a lexical distinction. The vapor that Crane produces isn’t “smoking,” which is legally defined as involving tobacco.

Careful wording permeates the whole vaping discussion: The electronic cigarette and vape cannot be called a “smoking cessation” tool because that would make it subject to a number of unwanted regulations.

A.J. Moll is an unpaid spokesman for St. Louis-based Bistate Regional Advocates for Vaping Education, or BRAVE, a group active in legislative initiatives pertaining to vaping in Missouri and Illinois. Responding to a query about the alleged safety of vaping relative to tobacco, he says in a statement, “No one in the industry or advocacy side of vapor products says that vaping is a ‘safe’ alternative to smoking.”

But, “We do say that it is 98 to 99 percent safer than smoking and have a growing body of evidence to back that claim,” he says.

In other words, there’s no evidence to suggest that vaping is as good as not smoking at all.

The words are facing increased scrutiny as the electronic cigarette market — a regulatory free-for-all with vendors self-governing and being policed by a tight-knit customer base quick to identify and sound the alarm about impure product — reaches a critical point.

The Food and Drug Administration is expected to announce vaping regulations soon. Meanwhile, local group Tobacco 21|KC is pushing to raise the minimum age to purchase tobacco and vapes to match the legal age of buying alcohol. Since the group formally launched in late October, its work has prompted discussions and advancing proposals in Independence, Kansas City and the Unified Government of Wyandotte County.

If they succeed, vaping will be confined to adults 21 and over.

The broad audience of folks who vape includes classmates of Park Hill High School senior Jordan Elder. She says it’s not easy to police e-cigs in schools. If a student brings one into a classroom, “it’s not like your teacher’s going to be able to spot that when they have 20 other kids to worry about.”

Elder helps lead high school anti-drug collective Youth With Vision, a cross-district student organization partnered with Tobacco 21|KC.

She’s particularly concerned that some of the more palatable vape liquids are courting users outside of the legal target audiences.

“The thing that bothers me is that they’re being marketed toward kids and children. What they do is they take flavors like root beer and cotton candy. Like, what 45-year-old man is gonna say, ‘I want a cotton candy vape today’?” she asked.

Tobacco 21|KC’s coterie — which also includes Blue Cross and Blue Shield of Kansas City, the Healthcare Foundation of Greater Kansas City and the Greater Kansas City Chamber of Commerce — sees the lingering doubts about safety as a reason to restrict young adults’ access to the devices until they have the capacity to understand the potential risks of vaping.

Elder acknowledges the lack of evidence demonstrating a clear danger, but “we know it’s probably not just water vapor,” she says.

“The only people who are saying that ‘it’s not just water vapor’ are the anti e-cigarette people,” Moll asserts. “There have been rigorous studies,” he says, name-dropping Drexel University researcher and Ph.D Igor Burstyn and his work, which is collected in a study titled “Peering Through the Mist.”

Here’s the brief: Burstyn contends that there’s no evidence to suggest vapes and liquids expose users to dangerous concentrations of any contaminant.

With regards to Tobacco 21|KC, Moll says that whatever young vape users are out there, that’s not a consequence of commercial messages targeting minors.

“First, there is no marketing to children,” Moll says. “If you go to a toy store, you’re not going to find an e-cig.”

Regarding criticism of youthful flavoring of some of the vape liquids, “My wife actually came to me with that same argument,” Moll says.

“I went to the freezer … and I pulled out a bottle of vodka. It’s called ‘Fruit Loops’ vodka, and I said, ‘Who is this flavor for?’ 

Moll adds that nicotine gum comes in fun iterations, too. Like “fruit chill” and “berry blast.”

Moll’s argument against Tobacco 21|KC’s actions targeting vaping goes into more novel and controversial territory: electronic cigarettes are proven to be a less harmful alternative to smoking, and minors have been proven to be effective at consuming substances they shouldn’t be.

Tobacco 21|KC’s inclusion of vaping devices and electronic cigarettes would remove a smoking alternative from a group that could really use it, those turning 18 and arriving at voting age with a fresh cigarette habit. Tobacco 21|KC treats the world as if smoking is confined to just the people legally entitled to purchase the products. It doesn’t account for underaged smokers.

So, Moll says, “We find it irresponsible to ban a safer cessation method.”

Edward Ellerbeck, a doctor and researcher at the University of Kansas Medical Center who works with smokers trying to quit, is skeptical of efforts to keep vaping available to young users. “Man, they’re really adamantly trying to hold on to their 18 to 21’s. I don’t even want to get into those arguments.”

As a smoking replacement and a smoking cessation tool, vaping could be of use, Ellerbeck concedes: “Theoretically, they can work.”

But for now, he’s waiting for the vaping industry to produce a consistent product that a regulatory body has proven to be the same each time. “We need the quality control,” he says.

Ellerbeck references studies that, in rare instances, turned up trace amounts of lead and cadmium in vaping devices. Rigorous regulation, disclosures and stiff penalties for inconsistent or dangerous products would eliminate some of those unnecessary risks, he says.

He also cites work from Nikki Nollen, a colleague and University of Kansas assistant professor who co-authored a soon-to-be published paper asserting that the usefulness of vaping as a smoking replacement is being oversold.

The research studied smokers who used electronic cigarettes. Forty percent stopped using tobacco completely within two weeks. But after four weeks, the group of quitters was down to 15 percent.

A United Kingdom study on the relationship between the electronic cigarette and tobacco abstention roughly matches Nollen’s findings.

Nollen cautions against drawing strong inferences from her study, which involved only 40 participants. Still, given the recidivism rates, Nollen says the claim of vaping as a smoking cessation tool deserves more scrutiny.

And the study Moll mentioned? The one claiming there’s no evidence that vapes and liquids expose users to dangerous contaminants? That researcher notes, “The aerosol generated during vaping as a whole … creates personal exposures that would justify surveillance of health among exposed persons in conjunction with investigation of means to keep any adverse health effects as low as reasonably achievable.”

The short answer about vaping is that there’s no short answer. The one thing vape proponents and health advocates can agree on is that the science is inconclusive. And usually it’s that the opponent’s science is inconclusive.

Back at the Mid-Con Vape-Con, much of the excitement is centered on the visuals. Vaping gives off generous weather systems of thick, lazy, wet smoke, heavier than the wisps of miniature cirrus clouds coming off a lit cigarette. The event features a “cloud chasing” contest, a competition to see who can form the biggest, most elegant emission.

Among the convention attendees, there’s little controversy about vaping. The users appear to have moved on from the scientific discussion about the health effects of electronic nicotine delivery, a debate that in their view has been roundly settled.

What they do want to talk about is an emerging culture rallying around the activity.

“You can switch to something that doesn’t harm you and love it and be part of the hobby and part of the community,” Crane says.

For former smokers, this is a space to indulge the nicotine habit without the baggage of the vaping device’s ancestor.

Vaping has created a wave of excitement in a way tobacco — because of health issues and social taboos — probably won’t see again.

“At this point in my life, vape is life,” says Tim Byerly, a conventioneer from Bowling Green, Ky.

“It’s a community of people that used to be outsiders because we used to have to go outside to smoke, and we used to have to hide ourselves because we didn’t want to offend anyone with our cigarette smoke,” he says.

“But we’ve created this huge community of people that have come together for nothing else than helping other people quit smoking.”

But for a smoker, vaping is like agreeing to go out for drinks with an ex you haven’t gotten over. It’s a potentially risky pleasure.

Nollen thinks it’s very simple: the questions around vaping are worth asking, and they have yet to be answered in a scientifically sound way.

Hard-won victories are at stake.

“We’ve made such great strides in smoking rates nationally since the ’60s, and e-cigs are threatening that,” she says. “One product is again normalizing the use of nicotine.”