What a doctor learned from a visit to an e-cigarette store

From gas stations to grocery stores, slender cylinders of nicotine “e-juice” seem to be available everywhere. On my drive to work, in fact, 2 new e-cigarette shops have opened their doors in just the last 3 months. So I was not surprised to read a recent report suggesting a rise in the number of teens trying e-cigs.

E-cigarettes deliver nicotine by heating nicotine-containing fluid into a vapor that is inhaled. A user does not “smoke” an e-cig, they “vape.” The devices and e-juice are not regulated by the FDA, have no age limitations to purchase, and are outside of current tobacco tax codes. Not only does this create the trifecta of quick and easy business pop-ups, it also creates a huge concern among docs who care for kids. Most would agree that unregulated and easy access to nicotine — one of the most addictive stimulants on the planet – is not good.

I try to learn about new fads and trends, within reason, in order to more effectively coach my teen patients on healthier lifestyle choices. E-cigs are no exception. So for the sake of my own curiosity and honest education, I dropped into the newest vape shop near my office to learn from a user and expert.

The owner of the small shop was generous with his time and information. He shared his expertise of 3 years in vaping after a 10 year love of Marlboro reds. After full disclosure of my purpose and intent, he showed me the devices and explained how they worked along with the selection of e-juice flavors proudly made by his own hand.

As I chatted with my friendly e-cig enthusiast, one theme kept recurring. Despite the faddish popularity and more “mainstream” availability, the vast majority of his vaping clients have been using e-cigs for years. In fact, most of his customers were using the nicotine delivery device to replace former addictions to tobacco smoking. The owner himself started vaping to get off cigarettes, proudly claiming, “I’ll never touch another Marlboro, but I’ll never stop vaping.”

His offhanded comment pointed squarely to part of the e-cig debate. Although little reproducible research exists, common sense dictates that inhaling a vapor of inert agents holding a calculated amount of nicotine may be less harmful to the user than traditional tobacco smoking with all its known carcinogens. Those who vape believe it is a better alternative to tobacco smoking.

The problem, however, is that nicotine is nicotine is nicotine. Just like the experience of my vaping friend, regardless of how it is consumed, addiction often remains. The difference, however, is rather than sporting yellow-stained fingertips and chimney-like breath, addicted vapers carry hot pink bedazzled tubes filled with tutti-frutti laced liquid.

Current medical evidence cannot recommend one addiction over the other.

I as stood in the shop, I continued to listen to the kind man’s enthusiastic stories explaining his hobby and craft. He would frequently pause to inhale from the e-cig hanging around his neck on a light blue lavaliere. Vapor slowly, nearly constantly, listed from the corners of his mouth.

From the other side of his display counter, the exhaled vapor of polyethylene glycol was barely noticeable. Almost pleasant. A faint tutti-frutti was all I smelled.

That’s when it hit me.

Do I believe that e-cigs create a dangerous illusion that could create a new generation of nicotine-addicted? Absolutely.

Am I concerned that young people will be enticed to experiment with these gadget-like devices under the false pretense they are a “safe” smoking alternative, or use the device to consume other dangerous drugs?Absolutely.

But for a parent who has an existing psychological and physical addition to nicotine, would I rather them vape than smoke cigarettes around my young patients?