The fall day is cloudless, calm and temperate. I've just finished a great meal on the patio of a popular café not far from the Plaza. An espresso is en route, and now, there's only one thing left to do to complete the perfection of my dining experience: scratch a decades-old nicotine itch.
I take a familiar puff, a deep inhale, and there's a warm collision at the back of my throat. I exhale: a dense but quickly dissipating cloud. It gets better as I repeat the ritual and pair it with the just-delivered caffeine concentrate.
But suddenly I'm aware that this whole thing might not be as satisfying for my waiter and the restaurant's other patrons as it is for me. No one says a word. The looks I'm catching, though, as I billow out another nebula, range from disgust to curiosity.
That's not smoke coming out of my mouth; it's water-vapor. Nothing's on fire. There's been no combustion. Still, confusion reigns. So I find a quiet patch of shaded grass beyond the confines of the patio to enjoy what's left of the afternoon–and my electronic cigarette.
The diners and staff at the restaurant are far from alone in their befuddlement, curiosity and inherent distrust about "e-cigarettes." They have been around a decade but are only recently becoming ubiquitous in urban society. Studies and surveys show that millions of people are using e-cigarettes, and the number is steadily climbing. Financial analysts predict that, by year's end, e-cigarettes will comprise an industry that has doubled in size since 2012 to become worth more than a billion dollars. Some even say the rise of the e-cig has contributed to a slight decline in cigarette sales.
The market's explosive growth, its lack of regulation, an increase in use among children, pressing medical questions about health effects and the products' association with one of America's true social pariahs has placed e-cigarettes at the center of a vigorous national public health debate. That debate has found footholds at the state and local levels, too.
Essentially, e-cigarettes are battery-powered devices that heat a solution of vegetable glycerin, propylene glycol and artificial flavoring, converting the mixture into vapor the user inhales. The act has birthed a new verb into the parlance: vaping. The overwhelming majority of vapers, me included, buy e-cig juice that's infused with the highly addictive drug nicotine at a level chosen by the purchaser.
A 2010 federal court decision gave the U.S. Food and Drug Administration the authority to regulate the e-cigarette industry and to treat the devices the same as other tobacco products. That means the FDA, which will arrive at its fourth self-imposed deadline to issue proposed rules at the end of this month, could levy heavy taxes on the industry, ban sales to youths and restrict the celebrity-driven commercials pitching Big Tobacco's versions of e-cigarettes. Those ads have been published online and are airing on television, a venue that has been off limits to the likes of Reynolds American and Lorillard, Inc. since 1971.
The marketing strategy concerns critics of e-cigarettes, who say it has taken decades of education and a near-advertising blackout to get the cool out of smoking. Another concern is the wide array of e-cigarette juice flavors such as chocolate, Gummy Bear, black-cherry pomegranate, and Starburst. Some, including a Santa Fe public health expert who works for the local school district, say those flavors are an appeal from manufacturers to kids. Small business owners and consumer groups counter that adults want a product that tastes better than an ashtray, favoring flavors like grape Jolly Rancher and Jamaican Rum.
The FDA is under increasing pressure from anti-smoking groups, medical associations and—as of last month, a group of 40 state attorneys general that includes Gary King of New Mexico—to step in and regulate e-cigarettes. The World Health Organization has come out hard in favor of strict regulations on e-cigarettes, citing a lack of consistency in the products and unknown health risks. Last week, the European Parliament rejected a proposed set of regulations from health officials that would have treated e-cigarettes as medical devices and could potentially have hamstrung the industry with exorbitant certification costs reserved for drugs. However, the governing body did adopt a ban on legal sales to anyone under 18 and restrictions on e-cigarette advertising.
So far, at least 25 states prohibit sales to youths. Three others–New Jersey, Utah and North Dakota–have indoor-use bans on e-cigarettes. So do a number of cities, including Boston, Seattle and Indianapolis.
At least 15 Santa Fe Public Schools students have been caught with an e-cigarette on campus during the first six weeks of the academic year.
New Mexico has neither. The cities of Santa Fe and Albuquerque haven't touched the issue. In fact, no e-cigarette-related law has ever been proposed in either city or in the Legislature. The closest New Mexico lawmakers have come to taking up the conversation was when state Rep. Mimi Stewart, D-Albuquerque, specifically exempted e-cigarettes from a bill to increase taxes on tobacco products earlier this year. The exemption came after Stewart received calls and emails from vapers and e-cigarette store owners, and with no objection from a representative of the American Cancer Society. The bill failed in committee.
Shelley Mann-Lev, drug prevention coordinator for Santa Fe Public Schools, says at least 15 students ranging from seventh graders to high school seniors have been caught either bringing an e-cigarette to school or using one on campus during the first six weeks of the academic year.
"We have seen a very alarming increase among our schoolchildren," Mann-Lev says, adding that she could only recall one or two e-cigarette seizures on SFPS campuses during the entire last school year. "There has been, from my experience, an explosion of use in Santa Fe, and we are very, very concerned … From a public health perspective, I would hope everybody would be concerned about children having access to e-cigarettes and the potential for addicting a new generation to nicotine."
The school board, she says, has not yet formally adopted a policy that would ban the possession, use, distribution or sale of e-cigarettes on SFPS campuses. However, the district already treats them like contraband.
National consumer and merchant groups, along with several Santa Fe e-cigarette shop owners, recognize that regulation of the industry is inevitable. There's no such thing as a party that never ends. They agree that a youth sales ban is appropriate and that quality standards ought to be set for the juice and for the devices themselves. But the groups and business owners are asking for modest, if any, taxes–not the prohibitive tariffs slapped on cigarettes as a way to punish Big Tobacco for its past lies and other misdeeds. They point to thousands of people who have traded smoking for vaping to a resoundingly positive effect and a growing body of scientific evidence that suggests their products are far less harmful than cigarettes.
Gregory Conley is a New Jersey-based attorney who, in his spare time, works as legislative director for Consumer Advocates for Smokefree Alternatives Association (CASAA).
"In their quest to punish Big Tobacco, states, cities and the FDA could squash these emerging small businesses that have no interest in people smoking," Conley tells SFR in a telephone interview. "Sixty to 80 percent of the U.S. market for e-cigarettes is not controlled by Big Tobacco. These are ethical people who, as part of their business plan, want to get people off cigarettes. The primary role of e-cigarettes in society is to reduce disease and death and to give consumers choices. If you get pleasure or satisfaction from using nicotine, you should know that there's another option besides quit or die."
A sampling of restaurants, bars and other businesses in Santa Fe reveals a mixed bag of reactions to vaping. E-cigs are off-limits at The Cowgirl; likewise at Café Pasqual's. The Santa Fe Bar and Grill and Del Charro Saloon allow vapers to puff at will. Harry's Roadhouse considers vaping on a case-by-case basis. E-cigarette use is prohibited inside and within 25 feet of any Starbucks, although that's a national policy, and one that doesn't appear to be strictly enforced here. The city itself has no law on the books that singles out e-cigarettes, and no plans to implement one, according to a city spokeswoman.
But the City Attorney's Office believes that Santa Fe's indoor smoking ban already prohibits the use of e-cigarettes inside city limits.
Like much of America, Santa Fe appears unsure about what to make of e-cigarettes. And that includes more than just the group of people who were tossing quizzical looks at me after I finished that recent meal.
I was born and raised in Kentucky. So it's hardly a newsflash that I started indulging in my home state's No. 1 (legal) cash crop at the age of about 10. For most of the next 30 years, I smoked cigarettes – a lot of cigarettes. There were two cold-turkey kicks, one of which resulted in about a year of abstinence when I was in my mid-20s, and countless unsuccessful attempts at quitting with gum, lozenges, patches, Willy Wonka-style-dream-inducing pills and sundry combinations thereof that no doctor ever would've advised.
A growing number of my friends have picked up e-cigarettes in recent years, with varying degrees of success in terms of sustained smoking cessation. I was dismissive and judgmental for a long time. But in the back of my mind, I knew trouble and mortality were lurking. Pushing 40, I was having trouble breathing. My energy level was low. My morning cough was no longer seasonal. And I struggled to see a way out, thinking myself too old a dog for any new tricks.
But on an illogical whim in early June, I dropped a little more than a hundred bucks for a fancy e-cig and decided to give it a try. I haven't smoked since, and I can breathe, taste, smell. My suspicion is that this has worked where so much else failed because e-cigarettes simulate so closely the experience of smoking. The tactile and oral fixations are sated. The act of puffing, inhaling, then exhaling a big, thick cloud is alarmingly realistic. Even the nicotine-junkie ritual now has a substitute: instead of tearing the plastic and foil off my pack of smokes, I refill the tank on my e-cigarette when the juice runs out.
I interviewed 14 local vapers for this story. Overwhelmingly, their experience mirrors mine. They point to e-cigarettes' success in getting them off the old paper-and-tobacco death sentences where things like nicotine gum and patches failed. They ranged in age from 25 to 53. All but one had heavy smoking habits that have now vanished for periods of months or longer in a wispy cloud of flavored vapor.
"I was a 30-year smoker, I've been vaping a month, and now I'm not smoking," says Ken Woodard, 47. Sporting a bandana, a black leather jacket and a graying goatee, Woodard reclines on a couch inside The Vapor Store in Santa Fe on a recent weekday afternoon, takes a long puff off his e-cigarette and continues: "My lungs are clearer, and I feel good … I don't know what the plan is (in terms of eventually getting off the e-cigarette.) It may be something I want to enjoy for a while. It's way healthier than smoking, I know that."
Does he? Do I? I know I feel better. So does Woodard. So do a lot of other people. But beyond the anecdotal benefits of halting the inhalation of thousands of chemicals that have been proven time and again to kill people, what might vaping be doing to me, Woodard and the others? Are we going to grow mushrooms on our lungs in 20 years?
The short answer is no one knows because e-cigarettes haven't been around long enough for an effective study of the long-term health effects.
"Is something going to come up in 50 years?" says Lee Pack, a longtime Santa Fe businessman who owns The Vapor Store, which has three locations in town and another in Denver. "We won't know till 50 years."
There is some science, though. Much of it is encouraging for vapers. Some of it isn't. Nearly all of it says more research is needed.
One study, conducted at the Roswell Park Cancer Institute in New York and partially funded by the National Institutes of Health, found that e-cigarette vapor contained "potentially carcinogenic and toxic compounds" when a machine engaged the device for about 30 seconds–far beyond the capacity of a human lung.
"The levels of the toxicants were 9-450 times lower than in cigarette smoke," according to the study's abstract. "Our findings are consistent with the idea that substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants. E-cigarettes as a harm reduction strategy among smokers unwilling to quit warrants further study."
"E-cigarettes are probably better than cigarettes–the kind you burn–but it's still a drug."
Another study, conducted at Drexel University in Pennsylvania and paid for by CASAA, the consumer group, found that second-hand exposure to e-cigarette vapor does not warrant concern.
Matthew Campen is an associate professor at the University of New Mexico College of Pharmacy in Albuquerque. A student and a resident in his department conducted a study on mice last year using a subcutaneous pump to administer nicotine to the animals.
"We have been interested in nicotine as the active ingredient in e-cigarettes," Campen tells SFR. "Our concern is that people are going to see this as a safe alternative to smoking and continue to use nicotine … As shown in our short study, nicotine alone puts the heart and the blood vessels at risk. However, using a cautionary principle approach, e-cigarettes are probably better than cigarettes – the kind you burn–but it's still a drug."
Campen says that, anecdotally, he didn't think there would be any risk of cardiovascular disease from second-hand vapor. But he wondered aloud whether people exposed to the vapor could be at risk for nicotine addiction.
Overall, Campen likens e-cigarettes to harm reduction, a public-health approach that includes things like methadone and needle exchanges for heroin addicts and condoms for teens determined to have sex.
"Common sense needs to be employed," he says. "If you're going to use this to stop smoking, it's more like getting on methadone. It's not a nutrient. And if physicians are going to recommend this and embrace it as a way to stop (smoking) they need to appreciate that there needs to be a plan in place to get off the e-cigarettes, because the risks associated with nicotine continue."
Harm reduction is a phrase heard over and over from Santa Fe's e-cigarette shop owners. Three of them tell SFR that's exactly why they're in the business.
"This is my greatest public work," says Pack. A serious man of 45 with a penetrating blue-eyed stare, and who has clearly done his homework on e-cigarettes, Pack speaks mostly in business and scientific terms. His tone shifts, though, when he talks about some of his customers. "It's good business, too, and I didn't necessarily set out to have it be this way. But the Christmas cards we get, the people who come in here … with tears in their eyes after realizing: 'I hadn't gone a day without a cigarette in 30 years. I just did it yesterday.' They feel better. They look better. Some of these people have been smoking for six or seven decades. That's turned out to be sort of a good-feeling thing: to say that my business has gotten thousands of people off cigarettes."
That's not enough for some officials.
Here at home, Attorney General King signed a letter on Sept. 24 with 39 other state attorneys general asking the FDA to make good on its now two-year-old promise to issue proposed regulations on e-cigarettes. The regulations, the letter says, should "address the advertising, ingredients, and sale to minors of electronic cigarettes."
I was smoking about a pack of American Spirit cigarettes a day, at a cost of about $8 a pop. (A pack of Marlboros costs, on average in New Mexico, about $7.)
My e-cigarette—the actual device—cost me $112. It's considered a medium- to high-end rig. The nicotine-infused juice I vape costs $12 for a 15 mL bottle, which usually lasts me about 10 days.
|So, after a significant expense up front, I am saving a crapload (scientific term) of money by vaping instead of smoking.|
In a news release, King cited a concern for children getting hooked on nicotine through e-cigarettes, which he wrote "may still contain carcinogens," despite claims from manufacturers to the contrary.
In a subsequent interview, King says the statement about carcinogens was based on his background in and knowledge of organic chemistry–not on any scientific data he had reviewed. He reiterated his desire for a ban on youth sales but conceded that e-cigarettes may wind up being "another tool in the fight against smoking." The AG says he will explore ways to support a study of the devices in New Mexico.
Mann-Lev of Santa Fe Public Schools says there could be a place for e-cigarettes in a harm reduction approach. She picks up on the methadone analogy mentioned by UNM's Dr. Campen.
"If this was just for harm reduction for people who couldn't quit other ways, there may be a place for e-cigs in our tool kit," she says. "But we certainly wouldn't give methadone to children."
Two of the three shop owners who spoke to SFR have "18 and older" signs in their business. All three say they don't sell to kids.
Regardless, kids are getting e-cigarettes, and King's concerns about more children using them have some strong grounding in reality. In early September, the Centers for Disease Control and Prevention issued the results of an annual survey that showed the number of kids in grades 6 through 12 who had tried e-cigarettes more than doubled from 3.3 percent of those surveyed in 2011 to 6.8 percent in 2012. The number of kids who had used e-cigarettes at least once in the 30 days before they were surveyed also jumped, from 1.1 percent in 2011 to 2.1 percent in 2012. The CDC data show that among kids who had ever tried e-cigarettes, 9.3 percent had never smoked a cigarette. In all, the CDC estimates that 1.78 million kids have at least experimented with e-cigarettes.
"This is a serious concern because the overall impact of e-cigarette use on public health remains uncertain," CDC analysts wrote. "In youths, concerns include the potential negative impact of nicotine on adolescent brain development, as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products."
The city of Santa Fe banned indoor cigarette smoking in 1999. And the City Attorney's Office appears to believe that the Santa Fe Smoke Free Ordinance already covers e-cigarettes, according to a Sept. 30 email provided to SFR by city spokeswoman Jodi McGinnis Porter.
"I checked with (assistant city attorney) Alfred Walker and he is confident that our smoking ban covers the electronic/vapor cigarettes and such are prohibited in public places," city legislative liaison Melissa D. Byers wrote in the email.
Byers included the city's definition of smoking in the email. It prohibits any "lighted tobacco products," however, and does not appear to include what actually takes place when a vaper takes a hit off an e-cigarette.
Like Pack, Leland Titus, owner of the newly opened Vapor Werks on Airport Road in Santa Fe, sells high-end e-cigarettes and mixes all his liquids in-house. Titus carries the same fancy model I'm using–it looks like the handle of a light saber–and a whole host of others, some even fancier, some more akin to starter models. They range in price from about $40 to about $140. Tanks that hold the liquid also come in degrees of ostentatiousness.
Titus talks about the upfront cost of a nice model e-cigarette being a hurdle on the front end. But the juice is relatively inexpensive–a $15 bottle lasts me about 10 days–so vaping is, in the long run, a damn sight cheaper than smoking, he says.
His advertising is limited to newspaper ads, Facebook, a few YouTube videos and a Cat in the Hat-clad dude he employs to dance around in front of his store holding a sign. He also doesn't sell the disposable e-cigarette models now being produced by all three of the world's largest tobacco companies–the Mark Ten from Altria (makers of Marlboro,) the Vuse from Reynolds American (which makes Camels) and Lorillard's (Newport) Blu e-cigarette.
Big Tobacco, on the other hand, is advertising plenty in the age of no regulations.
"Finally with Blu, I took back my freedom," Jenny McCarthy says in a television ad, then throws a sultry smile at the camera from her seat in 'da club. The Blu e-cigarette, like its other Big Tobacco brethren, looks like a cigarette and even lights up on the tip when the user takes a puff.
Conley, of the consumer group CASAA, says there's a distinction in user-friendliness and motivation between Big Tobacco's e-cigarette interests and the mom-and-pop operations like Vapor Werks and The Vapor Store. The high-end products can be varied for nicotine strength and intensity of vapor; Vuse e-cigarettes, et. al. can't. Small vapor shop owners couldn't care less whether people smoke cigarettes; Big Tobacco has a glaring CDC fact staring it in the face: More than 45 million Americans smoke cigarettes, and about half of smokers try to quit each year.
Representatives from Lorillard and Reynolds American did not respond to requests for comment for this story. A spokesman from Altria says that company just last week sent a letter to the FDA in support of a ban on e-cigarette sales to youths. The spokesman, David Sylvia, says Altria is only selling the Mark Ten e-cigarette in one state, Indiana, so far. Altria advertises in magazines and online, Sylvia says, and he declined to say whether the company plans to expand into television advertising.
It wasn't Jenny McCarthy who convinced 48-year-old Raul Martinez of Chimayo to switch to vaping after two decades. It was the fact that Martinez, a cyclist, was struggling on his bike.
"Smoking was defeating the purpose of everything I was doing," said Martinez, a bald, genial city of Santa Fe employee. He was stocking up on juice at 31 Vapors, a cozy little shop run by a husband and wife, whose niece designed the collage of vintage Mickey Mouse images that hangs on the wall. Martinez takes another vape and continues, telling me about his personal best last month in a 55-mile road race in Acoma.
"Quitting smoking eight months ago was one of the hardest things I ever did," he said. "But I beat a guy in that race in Acoma who I've never beaten before. And I beat him on a hill. I never thought I'd be able to quit smoking, but I did. And I beat that guy on a hill."