The Life and Death of the E-Cigarette

Angelo Franco

 

On August 7, 2019, the CDC announced that it was investigating about 94 cases of vape-related illnesses in 14 states. Less than a week later, the first vape-related death was reported in Illinois. It would take several months for the government to take a more severe approach to regulating the vaping industry. But vaping and e-cigarettes have been around for a very long time, and other countries had been taking steps to regulate the use and commercialization of e-cigarettes for more than a decade before vaping and vaping-related illnesses began dominating American headlines. There is a lot to be said about the slow progression of government involvement in e-cigarette regulation, especially because everything seemed to have snowballed in the second half of 2019; and the culprits, apparently, were unicorns and cotton candy.

 

The first documented reference to an e-cigarette in from almost an entire century ago when, in 1927, a man from New York named Joseph Robinson applied for a patent for a device that produced vapors for the purpose of inhalation. No record exists that this device was ever actually made, let alone commercialized in any way. Then, in the 1970s and ‘80s, Phil Ray (one of the inventors of the microprocessor) developed and more or less commercialized version of the e-cigarette; and while the venture was not successful, he and his partners are widely credited with adding the verb “vaping” to the language. It was not until 2003 when the first commercially successful e-cigarette was introduced to the market by Chinese pharmacist Hon Lik, which he invented as a method to help quit smoking, a habit that had killed his father (and there’s definitely a dark irony here). The e-cigarette then made its first appearance in America in 2006, being labeled for corresponding tariffs for a nicotine inhaler by the U.S. Customs and Border Protection agency.

 

It all goes up and back down the hill again from there.

 

By March of 2009, Turkey, Jordan, Canada, Australia, and Hong Kong had banned the sale and/or import of e-cigarettes (for some, at least e-cigarettes that contained nicotine), and the World Health Organization says it does not consider e-cigarettes a legitimate smoking cessation aid. This is significant because it is the definition of an e-cigarette (or rather, the changing definition of it) that has given everyone the most headaches, particularly in the U.S.

 

 

There is a common consensus that vaping is generally safer than smoking combustible cigarettes. But inhaling nicotine will always have adverse effects, and really putting anything into your lungs besides good old breathing air will also cause some trouble. Vaping itself, for instance, can cause throat irritation, nausea, and coughing, and the long-term effects are, of course, still unknown.

 

When e-cigarettes were introduced, many of them were marketed as a possible cessation aid to help heavy smokers, much the way Lik had intended. New studies show that vaping could help some smokers quit cigarettes, presumably by weaning the amount of nicotine that your body receives, similar to the way a nicotine patch works. But the long-term effects of vaping remain undetermined, and so governments and health organizations have been cautious to recommend vaping as a legitimate cessation method. The studies are so new, that we just don’t know if we’re really just replacing one bad habit with another.

 

This is where the first cracks start to show. There are plenty of testimonials about how vaping has helped smokers swear off combustible cigarettes. And as mentioned above, some studies suggest that this may well be true, although the rate of success is low compared to other true and tested cessation methods (like the patch or nicotine gum).

 

Nicotine, certainly, is extremely addictive, and controlling the amount of nicotine intake can help some people slowly lose dependency on it. But because this remains largely unverified, government and health officials have taken issues with vaping companies making the claim that e-cigarettes can help you quit smoking. This is true even when vaping corporations don’t flat-out make the claim, like Juul, which uses the campaign slogan, “Make the switch,” which many critics, including lawmakers, say it’s just a cloaked way of saying “quit.” 

 

 

Meanwhile, some states are beginning to take steps to regulate e-cigarettes. California tried to pass a law banning their sale, but then-Governor Arnold Schwarzenegger vetoed the bill, remarking that it should be up any adult to decide what products to consume, and alluding that labeling e-cigarettes as a “tobacco product” (in other words, that contains nicotine), the state may have overreached, since federal law already regulates tobacco products.

 

Since then, the Food and Drug Administration has been in contentious conflict with e-cigarette makers, attempting numerous times to regulate the product, sometimes effectively and other times not. E-cigarette companies successfully contended in a lawsuit against the FDA that they are tobacco products, and the FDA therefore has no jurisdiction over their regulation because it infringes Congress’s intent to withhold FDA’s authority over tobacco products (because of successful lobbying by Big Tobacco, presumably).

 

The FDA then tested two brands of e-cigarettes to try and produce some sort of proof on its dangers, and it published its findings less than two months later in a widely criticized study. In the meantime, President Obama signs the Family Smoking Prevention and Tobacco Control Act, which finally gives the FDA the control it wanted to regulate some tobacco products. Significantly, the FDA still cannot ban nicotine and cigarettes, but now it does have the power to do away with e-liquid flavorings. This authority was given to the FDA in June of 2009, and it would take over a decade for the agency to take firm action against vaping companies.

 

 

By 2019, vaping had become a multi-billion-dollar industry, and it was taking a big swipe at teenage smoking. Over a quarter of high school students reported having vaped in the past 30 days. And the attraction to vaping, especially among teens, is understandable: Vaping devices are slick and cool; they can be easily hidden from parents and guardians; they doesn’t leave the lingering smell of tobacco on your fingers like normal cigarettes do; and e-liquids taste really, really good. With e-liquid flavors like Bazooka Joe Bubble Gum, Zombie Blood, and Unicorn Milk, e-cigarette brands have been accused of marketing to the most vulnerable—teenagers and young adults who are impressionable and easily persuaded.

 

A former director of the CDC, who had been warning of the growing popularity of vaping in adolescents as far back as 2013, even chastised the lack of action by federal agencies, remarking that the moment an e-liquid with cotton candy flavor hit the market should have been a call to action. These are, after all, the same e-liquids that the FDA had been given authority over back in 2009.  

 

Juul executives, on their part, back in 2018 asserted that it was never the company’s intention to target and sell to adolescents, but it was a byproduct of clever marketing strategies set forth by a small company that saw incredibly rapid growth in the face of demand. And Juul’s chief administrative officer, by the way, also emphasized back then that vaping is a way for mature smokers to receive their fix of nicotine without the harm from traditional cigarettes, and therefore with a promise of not having to die from it (again, more dark irony here). Juul’s CEO would later step down amid the vaping-related illnesses and deaths.

 

By mid-September 2019, the FDA had about 530 cases of lung disease related to vaping, with at least eight deaths, and states had begun to take action again. Massachusetts and Michigan banned the sale of all vaping products, including flavored and unflavored e-cigarettes containing nicotine, while Maine and New York weighed similar moves. Before the month was over, there were over 800 cases of vaping-related illnesses and four more lives had been claimed.

 

 

In November, now with over 2,000 sick people and 39 dead, the CDC, in an attempt to find out the cause of the illness and to ascertain if it was infectious or not, had found a likely culprit: vitamin E acetate in e-cigarettes. Even so, the CDC left open the possibility that there may be other harmful toxins found in vaping products that are yet unknown, and that it may not be just one thing causing people to fall sick. Besides, researches still don’t understand exactly how is it that vitamin E acetate, a sticky honey-like substance, is actually causing the illness; testing in animals is ongoing.

 

At the beginning of 2020, the Trump administration moved to ban flavored vaping products, at least partially so. The FDA announced it would ban the sale of flavored cartridges, like ones used in the Juul pen-like devices, except for tobacco and menthol. But e-liquids would still be commercially available; these are the ones are that are used in vaping devices that come with a refillable reservoir tank (and are generally bulkier and not as sleek as the devices that use a cartridge). With the partial ban, the Trump administration sought to appease some concerned demographics—like suburban mothers—while still allowing adults to partake in flavored vaping with the use of a refillable device.

 

There’s still a lot that remains unknown, and with studies only now getting underway, it may be a long time yet before we have conclusive evidence of the long-term effect of vaping. Just like cigarettes were ubiquitous and thought harmless when they first appeared on the market, it may take some time before we truly understand how vaping affects us. We can only now wait to see whether vaping may indeed be a way to help smokers quit under an observed treatment, or if it will prove to be just another harmful habit.

 

Author Bio:

 

Angelo Franco is Highbrow Magazine’s chief features writer.

 

For Highbrow Magazine

 

 

Image sources:

 

--Lindsay Fox (Wikimedia.org, Creative Commons)

--Sarah Johnson (Pixabay, Creative Commons); blog: https://www.blacknote.com/e-juice/

--FDA.gov (Creative Commons)

--Vaporvanity.com (Wikimedia.org, Creative Commons)

--WhiteHouse.gov (Flickr, Creative Commons)

 

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