Might teens get hooked on e-cigs?

Electronic cigarettes also can help smokers quit, some say


Joe Ragan, a customer of The Grab Bag Co., samples a variety of flavors to use with his electronic cigarette Friday, September 27. Ragan, a former pack a day cigarette smoker, said he started using the e-cigarette about three months ago and is using it to wean himself off of nicotine. At back is store owner Gregory Giesecke.

Doug Finger/The Gainesville Sun
Published: Sunday, October 6, 2013 at 6:01 a.m.
Last Modified: Sunday, October 6, 2013 at 7:20 p.m.

Walk into The Grab Bag Co. in northeast Gainesville, and the scents are somewhere between a candy store and a perfume shop. The bright turquoise walls, bamboo wall hanging and paddles on the walls give a beachy feeling that's intentional.

"Whenever I think of health, I think of beaches," said Ashley Gallagher, co-owner of the store, which opened in June to help smokers quit through a controversial method: electronic cigarettes — battery-operated vapor cigarettes that contain nicotine but none of the other toxic materials in traditional cigarettes.

Instead, liquid bottles boasting flavors such as "Hawaiian punch," "smurfberry" and "Mello tobacco" — made with candy flavors, vegetable glycerin and propylene glycol — fill the e-cigarettes. The alternatives to regular cigarettes are designed to focus on flavor, while still giving people the sensation of blowing smoke as they ingest nicotine at amounts that can decrease over time.

"I haven't had anyone go up in nicotine levels," Gallagher said, adding that most customers — namely lifelong smokers looking to quit — gradually decrease their nicotine levels.

"It's so awesome to see someone who has smoked a pack a day for 40 years quit," Gallagher said.

E-cigarettes worrisome

The boon in e-cigarettes has some experts concerned, however. The Centers for Disease Control and Prevention recently released data showing that nearly 1.8 million middle and high school students had tried e-cigarettes last year, which had doubled since 2012.

In Florida, the number of high school students who tried e-cigarettes doubled between 2011 and 2013, even though the number of teen smokers has decreased significantly since the Tobacco Free Florida program launched in 2007. The smoking rate among high school students in Florida was 8.6 percent, far below the national average of 15.8 percent.

Alachua County has fewer young smokers than the state average: 5 percent of people between ages 11 and 17 had reported smoking in a 30-day period, compared with 6.1 percent nationwide, according to the 2012 Florida Youth Tobacco Survey.

Shannon Hughes, the Tobacco Free Florida program bureau chief, said program administrators worry that e-cigarettes could be a gateway for teens to pick up real cigarettes. Moreover, e-cigarette advertisements risk making the habit seem like the new cool thing to do, Hughes continued.

"We are concerned about the potential of e-cigarettes to normalize smoking again," she said.

And e-cigarettes do still contain nicotine, an addictive substance.

"A teen is much more susceptible to addictive properties," Hughes said. "Nicotine is not a healthy chemical to be putting in your body. They are still smoking. They are still getting nicotine."

Although many states have outlawed the sale of e-cigarettes to minors, Florida is not one of them.

However, stores in Gainesville that carry e-cigarettes say they don't sell to minors and that minors rarely come into their stores for e-cigarettes.

But Dr. Karen Martinez, a pediatric resident at UF Health Shands Hospital, said she has been shocked at the number of young people in her clinic who have tried e-cigarettes. A recent informal survey of her patients over a two-week period showed that 10-15 kids ages 12 and older had tried e-cigarettes, which they had received from their parents or from their friends' parents.

"I feel like we've made huge strides with traditional cigarettes. It would be unfortunate if e-cigs created a whole new generation of people addicted to nicotine," Martinez said.

E-cigarettes: lesser of two evils?

For some experts, however, e-cigarettes are a much safer option than real cigarettes, and they argue that if teens are inclined to try smoking anyway, they are better off smoking e-cigarettes.

"If a teenager is interested in smoking and keeps e-cigarettes instead of Marlboros, that's a good thing," said Igor Burstyn, an associate professor of environmental and occupational health at Drexel University in Philadelphia.

Burstyn compares smoking to teen sex. "You can't stop them from having sex. You can only give them condoms," he said. "If you accept that people will consume nicotine and smoke, which history has shown is the case, then the only question is what can they do to not make them sick?

"If it doesn't have any negative health consequences, as far as I'm concerned, let them do it," Burstyn continued. "There is no evidence that they should worry about major health consequences of e-cigarettes, either for consumers or bystanders."

A way to quit smoking?

There is some scientific evidence that e-cigarettes help smokers quit more effectively than, say, nicotine patches. A recent study in the British journal Lancet found that e-cigarettes were slightly more effective as a smoking cessation technique than other methods.

That's what the owners of The Grab Bag say they have found. Many of their customers are lifelong smokers who walk in with the goal of giving up cigarettes. Gradually, many of them also give up nicotine because the pleasurable flavors of the liquids used in the cigarettes help displace the craving for nicotine.

"You find what flavor is good for you. I go for the fruits: blueberries, cranberries, strawberries," said Liz Anderson of Melrose, who goes to The Grab Bag once a week for refills.

Anderson had smoked about a pack of real cigarettes a day for more than 10 years. "I started (smoking e-cigarettes) May 10, and I've been cigarette-free ever since.

"I can run without gasping for air. I can breathe deep, and you don't hear the wheezing in my chest," Anderson said, adding that she can even "vape" — a term for smoking e-cigarettes — around her nieces and nephews because there is no toxic second-hand smoke.

And now whenever she's around cigarette smoke, "it's a very big turnoff. That's what I smelled like for 10 years. I almost want to apologize."

State officials still wary of e-cigarettes

Hughes said she still is concerned e-cigarettes will become a new addictive habit and argues that their safety and effectiveness in helping people quit smoking have not yet been proven.

"We're trying to learn as much as we can and are anxiously awaiting the FDA to come out with its regulation on e-cigarettes," Hughes said.

Meanwhile, Hughes urges smokers who wish to quit to get counseling and other help through the health department's resources: www.tobaccofreeflorida.com.

Contact Kristine Crane at 338-3119 or kristine.crane@gvillesun.com. Correspondent Meghan Pryce contributed to this report.

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