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Puffing through the great "vape" debate over electronic cigarettes

Recently, I started huffing vapors produced by heating up compounds used in some types of antifreeze. If swallowed, the liquid I'm vaporizing can be poisonous, even fatal, especially to children. No one yet knows what the long-term health effects of inhaling this stuff will be, yet it is cheap, widely available, glamorized in advertisements, and almost completely unregulated by the authorities. In some major cities, all of Arkansas, New Jersey, North Dakota, and Utah, and a growing list of towns and counties, it's illegal to huff this stuff wherever it's illegal to smoke tobacco.

So why am I using it? It sounds strange, even counterintuitive perhaps, but I'm using it to improve my health.

It is called "vaping," and the devices I'm using to "vape" are called electronic cigarettes or "e-cigs," whose rechargeable batteries heat up "e-juice" to release vapors I inhale. The flavored e-juice I use in my new e-cigs contains nicotine, though not all e-juices do. The more I've vaped, the fewer cigarettes I've been smoking. My smoke-weary lungs have been feeling increasingly better as a result, though my decades-long nicotine addiction continues-for now.

The e-cig industry was hatched in China about a decade ago, and arrived in the U.S. in the mid-2000s. Its remarkably rapid growth has been happening so fast, it's hard to track, but Wells Fargo Securities, in a series of recent reports put out by its "Tobacco Talk" survey team, now estimates it to be a $2.2 billion industry. The team predicts that it will reach $10 billion by 2017, and that by 2023, one of the biggest tobacco companies, Reynolds American, will realize $5.2 billion in e-cig revenue, compared to $3.1 billion it will reap from peddling traditional cigarettes.

Big bankers, in other words, are banking on the idea that e-cigs will be bigger than cigarettes within a decade. In Maryland, scores of retail vape stores and online e-cig businesses have sprung up in the past year, while three have opened in Baltimore City since last summer, with a fourth scheduled to open this month.

I followed e-cig media coverage for more than a year before making the leap. Navigating the rabbit hole of e-cig information is dizzying, as one is see-sawed from scary messages (Its ingredients are used in antifreeze! E-juice kills babies!) to rational claims that the technology reduces harm among cigarette smokers. While many questions remain about the long-term effects of inhaling the vapors from e-juice's ingredients-propylene glycol (PG), vegetable glycerin (VG), and the flavorings infused in them-the ingredients themselves are common and approved as safe for use in food by the U.S. Food and Drug Administration (FDA). Both PG and VG are used in antifreezes designed to reduce harm from accidental ingestion, such as those used in machinery involved in food production. Nicotine, meanwhile, is a powerful and addictive stimulant that can be highly toxic, so the recent rise in reported poisonings from e-juice has prompted a media frenzy-and the widespread use of child-proof caps by e-juice makers and warnings by industry leaders that users should take smart, responsible steps to ensure e-juice doesn't get ingested by children and pets.

The Centers for Disease Control and Prevention (CDC) on April 4 issued a press release saying that there have been 2,405 e-cig nicotine-poisoning calls to poison centers from September 2010, when there was one call, to February 2014, when there were 215, and more than half of them pertained to kids under 5 years old. To put this in context, though, poison control centers got more that 20,000 calls in 2012 alone about people poisoned by ingesting fluoride toothpaste, and almost all of them involved children 5 or younger.

Inhaled e-cig vapors have been shown in studies to have trace amounts of some harmful compounds-formaldehyde and acrolein, in particular-at levels far below those found in smoke from burning tobacco. As a review of such studies by Drexel University public health professor Igor Burstyn concluded last summer, "no evidence" currently exists that vaping exposes users to contaminants "that would warrant health concerns by the standards that are used to ensure safety of workplaces," and "exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern."

The FDA intends to regulate e-cigs by deeming them tobacco products under the Family Smoking Prevention and Tobacco Control Act of 2009, but the nine-step process of doing so is currently stuck on step four, as the White House Office of Management and Budget reviews whatever the FDA is currently proposing. In the meantime, the FDA says in a statement emailed to City Paper that "further research is needed to assess the potential public health benefits and risks of electronic cigarettes."

The public-health community is divided on the issue. Some revered medical institutions, like the Mayo Clinic in Minnesota, advise against using e-cigs; Mayo says on its web site that "until more is known about the potential risks, the safe play is to say no to electronic cigarettes," while pointing those who want to quit smoking to the "many FDA-approved medications that have been shown to be safe and effective for this purpose." Other public-health experts see great promise in e-cigs as a safer alternative to smoking that can help people quit, often more effectively than other FDA-approved options.

Burstyn, in a recent interview with City Paper, says, "If all smokers switched to vaping, it would be the equivalent of them quitting, and it would change the world for the better, in my opinion." He adds that "all serious scientists are pretty much in agreement that e-cigarettes are the way to go," while public health professionals who say otherwise "are doing harm, clearly-every time a smoker doesn't switch to e-cigarettes because of their advice. It's smoking! One of the most harmful things we do, and so widespread. Their opposition to e-cigs is ideology, it's not science, and in the end you need to listen to the quality of their arguments and use your own brain."

In January in the Journal of the American Medical Association, an opinion piece by David Abrams of the Schroeder Institute for Tobacco Research and Policy Studies at the Johns Hopkins Bloomberg School of Public Health aired the same concerns about the risk of ideology trumping science in the public health community's reception of e-cigs.

"If e-cigarettes represent the new frontier," Abrams wrote, "tobacco control experts must be open to new strategies. Statements based on ideology and insufficient evidence could prevent the use of this opportunity before it becomes established as part of harm reduction strategy." Regulatory overreach, he suggested, "might support the established tobacco industry, whose rapid entry into the marketplace and history of making potentially misleading claims of harm reduction could promote poly-use of all their tobacco products, and thus perpetuate sales of conventional cigarettes well into the next century rather than speed their obsolescence." He added that "independent manufacturers of e-cigarettes could compete with tobacco companies and make the cigarette obsolete, just as digital cameras made film obsolete"-a prospect he calls "an extraordinary opportunity to end the cigarette century well before the 100th anniversary" of the first 1964 U.S. Surgeon General's Report on smoking and health.

The controversy over the relative risks of e-cig versus cigarette use "makes no sense to me," adds Michael Siegel, a physician and public health professor at Boston University. "I'd rather have people use a safer product than a dangerous one," he tells City Paper in a recent phone interview, adding, "there's no question [e-cigs are] safer than smoking." He estimates that e-cigs are currently "saving maybe thousands or tens of thousands of lives" of people who are quitting smoking by using them, and adds that "it's quite shocking to me, actually, when public-health advocates don't applaud people quitting in this way. It's the most promising innovation in my 25-year career."

The just-released 2014 U.S. Surgeon General's Report generally withholds judgment on e-cigs but allows that they are likely to be helpful as cigarette use-which the report blames for nearly 21 million premature deaths since 1964, and which, according to the CDC, was down from 42.4 percent of adults in 1965 to almost 18.1 percent in 2012-continues to be stamped out. "The promotion of electronic cigarettes," the report states, "is much more likely to be beneficial in an environment where the appeal, accessibility, promotion, and use of cigarettes are being rapidly reduced."

Convinced that vaping wasn't going to kill me faster than cigarettes, and might actually prolong my life if I could successfully replace cigarettes with e-cigs, on Feb. 16 I went to the Vapory (thevapory.net), Baltimore's first bricks-and-mortar "vape" shop on Preston Street in Midtown, and paid $57.46, taxes included, for a starter kit and two bottles of tobacco-flavored e-juice.

 

The Vapory is in the basement of 19 W. Preston St., so customers step down from the sidewalk to enter the small shop. Its aquamarine walls are crowded with framed prints of old art. Arrayed on nearly all available surfaces are curios: Victorian statuary, skulls, a small bronze of William Donald Schaefer, and figurines of the RCA dog, a caped Robin, and the Super Mario Brothers. The wares for sale-vaping devices, some of them strikingly similar in appearance to the hyposprays made famous by Star Trek's Dr. Leonard H. "Bones" McCoy, plus accoutrements like carrying cases and colorful tips and tanks, plus rows and rows of e-juice bottles-are in glass display cases. A small table and a couple of chairs are set up for sampling different flavors of e-juices. As if one needed to get more comfortable in this calm, cluttered, bohemian environment, there are two couches in the corner to settle into.

"All out of Thug Juice, but I'm getting more soon," the Vapory's owner, 49-year-old Adam Fordham, tells a customer. Flavored with grape, watermelon, and menthol, Thug Juice is one of Fordham's best-selling e-juices, he says. Made by Bellingham, Wash.-based Mt. Baker Vapor, it's one of the two brands he carries, the other being Richmond, Va.-based Avail Vapor.

Fordham, a heavyset dandy of a man with a shock of swept-back greying blond hair, used to be an incorrigible smoker. "I was two packs a day for 29 years," he says, "and I was never going to quit, because I enjoyed it that much." He first tried vaping, he says, "so I could smoke and drink at a bar," and "I was very surprised that it replicated" smoking so well. Then "cheapness kicked in," he continues, as "I saw how much money I was saving. And that's what really did it for me-especially for someone who never had any intention of quitting smoking. So when that last carton of Marlboros had run out, I didn't buy any more. And now I'm nearing my one-year anniversary of no cigarettes. I've had four drags since, and I couldn't stand it."

Fordham opened the Vapory on July 27, 2013, after a long career in what he calls "materials management and supply operations. My first job was as a stockboy at Woolworth's, and I hardly ever left that. I did it for University of Maryland, did it for Johns Hopkins, and then I was working for a hospital that closed, so I was actually unemployed when I opened the shop. No one was answering my resumes, but I had a short little severance, and I saw how the business was growing, so I thought if I could find a decent space, I could open in time to be the first one in the city."

The kit Fordham sold to me was manufactured by Shenzhen, China-based Innokin Technology Co. and included two rechargeable batteries, a USB cable and plug for recharging them, and five "cartomizers" that you fill with e-juice and screw into the sleek, black batteries. The cartomizers are clear tanks topped by form-fitting tips and wicks inside them that carry the e-juice to the battery, which, when you push a button to turn it on, vaporizes the e-juice, allowing you to inhale the fumes through the tip. When the cartomizer runs low on e-juice, you add more from the bottles.

The nicotine content of the 25 milliliters (ml) of e-juice I bought from the Vapory-18 milligrams (mg) per ml-means it is the nicotine-equivalent of approximately 375 cigarettes, since each cigarette delivers about 1.2 mg of nicotine (an admittedly rough estimate). Thus, for a little less than $60, I purchased the ability to vape about the same amount of nicotine as I would take in by smoking almost 19 packs of cigarettes costing about $7.50 each-or $140, give or take a few bucks.

This was clearly a huge bargain compared to smoking cigarettes, and the potential savings grew eye-popping as the weeks passed. In March, I went to Bmore Vapes (bmorevapes.com) on Light Street in Federal Hill-the second vape shop to open in the city-and purchased three 10-ml bottles of e-juice containing 24 mg/ml of nicotine, flavored to taste like rum, whiskey, and honey-infused tobacco. Their higher nicotine concentration means each bottle contains the nicotine-equivalent of 10 packs of cigarettes. The three bottles cost about $15, potentially replacing about $225 worth of smokes.

I added to my e-juice collection at Gypsy Vape (gypsy-vape.com), a recently opened shop just inside the Beltway on Route 40 West, by buying three 12-mg nicotine bottles flavored to taste like spiced tobacco, rum, and caramel coffee. Then I returned to the Vapory to buy three more cartomizers for another $15, so I could have eight cartomizers to match my eight flavors.

All told, I've spent a little over $100 to become a well-stocked vaper-and my e-juice supplies, which look likely to last me for months to come, contain the same amount of nicotine as roughly 1,275 cigarettes, or about 64 packs, which would have cost me in the neighborhood of $500.

I'm about six weeks into vaping now, and I'm still buying and smoking cigarettes. But the amount I'm smoking has regularly decreased as I've come to enjoy vaping more and more to satisfy my need for nicotine. Whereas I used to smoke a half-pack a day, usually a little more, I recently re-upped after taking five days to go through a pack. So I'm at about four cigarettes a day: one in the morning, two during the day, and one before bed. That's puts me within reach of quitting entirely-which I now intend to do, since, unlike ever before in my long smoking career, it seems like a reasonably obtainable goal.

 

When I tell Fordham I'm still smoking, albeit less and less, he tries to encourage me by gently shaming me. "What's the point?" he says. "Segue, dude, you gotta segue."

Stories about customers who've successfully quit smoking start flowing out of Fordham. "I have one guy, he smoked as much as me," he recalls. "He came in on my second day in business, and he hasn't smoked since, and since then people come in because they know Larry quit."

Asked to describe the demographics of his shop's customers, Fordham says: "It's like smoking, there's hardly a demographic because it's everybody-all races, walks of life." And he's clearly satisfied with the sociability of his new career. "I've definitely met a fascinating bunch of people since I started this," he says, before telling an anecdote to illustrate the unlikely camaraderie that arises among those in the vape culture.

"I had one customer who was in here, a University of Baltimore law student," Fordham recalls. "Then in came this artist who does drag once in a while, these MICA students, and there was a PhD candidate at Hopkins. They all came in about the same time, and everyone's just really talking about vaping."

"The UB student," Fordham continues, "after everyone else left, he was like, 'You know, I don't think in any other social situation we would have had a conversation, even if we were in the same bar as each other, which is unlikely. But we're all talking about this vape, and it's completely different from the normal crowd I would have met. And these are all people who have started vaping and quit smoking, and almost every one of them is surprised, because they've all tried to quit before, and nothing ever worked. And when it works for them, they are very supportive of everybody else.'"

The most prevalent types of e-cigs, known as "cigalikes," are sold at convenience stores and gas stations, with brand names like blu, NJoy, and Blaze, often in either disposable or rechargeable models. They cost about $5 to $10 each for disposables, or $20 to $70 for rechargeable kits, and offer fewer varieties of flavors, often packaged in cartridges rather than e-juice bottles for use in refillable cartomizers. So cigalikes are more expensive to use over time than the e-cigs sold at vape stores, which cater to those looking to customize their vaping experience with a variety of higher-powered technology and nearly limitless flavor options.

Despite the higher cost over time of disposables and fewer choices, some cigalike users have found them quite useful for quitting smoking. "I was a smoker for ten-plus years," explains Adam Sahhar, captain of Urban Pirates, which runs playful excursions on the faux-pirate ship Fearless out of Fells Point. "Most days I would smoke a whole pack of cigarettes," he continues, and "when I decided that I could no longer justify the cost, smell, and harm to my body anymore, I decided to try the blu disposable brand, to work my way off smoking. I stopped smoking cigarettes altogether within a week and have not lit up in over a month." He adds that using blus "is cheaper and has saved me over $100 in one month."

Sahhar's experience with cigalikes may have once been more common than mine, involving cartomizers and a host of tasty flavors. But vape culture centered on what is purveyed online and at vape stores rather than cigalikes from convenience stores is a growing phenomenon. The Wells Fargo Securities team in late March estimated that roughly 60 percent of all e-cig sales is happening in this hard-to-track segment of the economy, and puts the number of vape stores in the U.S. at about 5,000.

In Maryland, the Legal Resource Center for Public Health Policy at the University of Maryland School of Law has tried to keep tabs on the growth of vape shops. Its deputy director, William Tilburg, says, "I don't have a comprehensive list," but "the list we have" amounts to "32 bricks-and-mortar shops around the state."

City Paper's attempt to create a list based on new business filings at the Maryland Department of Assessments & Taxation (MDAT), where anyone starting a business goes to file incorporation or trade-name application papers, is also incomplete by necessity. But it indicates that the vape-shop explosion in the Free State is remarkably active-and that Tilburg's crew has some catching up to do.

Joining the parade of newly forming Maryland vape businesses in March were the Vape Shop in Sykesville, the Vapor Kingdom in Glen Burnie, MD Vapor in Thurmont, Vaperista in Easton, the Vapor Vault in White Plains, Vapor Trails in Hagerstown, Vapeculture in Gaithersburg, Vape Puffin Stuff in Cheltenham, Vape Jungle in Owings Mills, and DC Vapor and Vapor VII in Germantown. In February, there was Gypsy Vape, Vape Exchange in Germantown, Vapor Worldwide in Bethesda, The Vapepad in Odenton, and Vapin Time in College Park. And in January came the Vaper's Knoll in Pasadena, All Day Vapors in Reisterstown, Vapor-Tek in Elkridge, Vapestore USA in Essex, Vaper-Café Timonium, Vapor Gators in Stevensville, and Vaporrise USA in Hagerstown.

That's 23 new vaping enterprises in Maryland since the beginning of the year, and is likely not the complete picture. In Baltimore City, for instance, sisters Margee Brooks and Monica Schubel opened Mystic Vape (mystic-vape.com) earlier this year on Falls Road in Hampden, becoming the city's third vape shop. "These shops are popping up all over," says Brooks, who was attracted to the prospect of opening one by Schubel, who quit smoking by using e-cigs. "I knew nothing about it before then," Brooks continues, "but I came into this business saying, you know what, financially this is going to work. I believe in it."

A fourth city vape shop, District Charm Vapory, is set to open on Washington Boulevard in Pigtown on April 11, according to an email from Rachel Alexander, who co-owns the business with Laura Greeley.

The pace appears to be picking up, since City Paper's MDAT business-filings search counted over 30 new vape businesses forming in Maryland in all of 2013. Last year's new arrivals included the Vapor Hut in Oakland, the Vape Vine and Mean Street Vapor in Glen Burnie, Vape Bros in Ellicott City, the Vape Lounge in Bel Air, Vaping Apes in Forestville, Vape Social in Rockville, Great White Vape in Arnold, Vapor Jacks in Silver Spring, Vape Daddy in Damascus, and Vaporiot in Dundalk.

Clearly, Maryland's vape scene is burgeoning as customers look for more choice and convenience. To Fordham, what he's been seeing among his growing customer base is surprising: "It's the closest thing to religious converts that I can think of." He's also surprised at his own transformation: "I never thought I'd be, like, turned into an advocate, you know, some kind of activist or something. I just didn't see that coming."

 

"I never wanted to be an activist in my life, for anything. For anything. It never even crossed my mind," says 43-year-old Ron Ward, an attorney who last year opened up The Vapers' Edge, a vape shop in Parkville. "And then I started these things," he says, holding up his e-cig, "and here's the answer to a problem that I've been looking for my entire life. And within six months I was an activist, full on. It's exciting, and being a vendor is very exciting. It's like throwing the rope back over the fence for people, to help them find an alternative to smoking. And they're thankful. I have people thank me during the course of the day."

Ward is a board member of CASAA, the acronym for the Consumer Advocates for Smoke-free Alternatives Association, and now finds himself calling and writing legislators weighing how to regulate e-cigs. He did so in Maryland, urging the state not to institute a proposed ban on e-cig sales while supporting a measure to prohibit sales to minors, and both bills ended up how he'd hoped they would.

As vaping grows more widespread and acceptable, Ward says, "there is power in numbers. We're very enthused" as the vaping community grows more organized. "Vapers aren't like smokers," he says, observing that, "when the smoking ban went down" in 2007 in Maryland, "there weren't hundreds of smokers descending upon Annapolis to fight against these bills. Vapers are very enthusiastic and want to get involved. So the more vapers we have on board, the more numbers we have, the more we can fight these bans."

Carl Phillips, a public-health scientist and longtime proponent of tobacco harm reduction who serves as CASAA's scientific director, believes proposed bans and heavy-handed regulation that may threaten to undermine the e-cig industry are being aided by an inherent irony resulting from an important federal appellate-court decision in 2011 that essentially bars e-cig manufacturers from making claims that their products can help people quit smoking.

"It would be enormously beneficial if they could just tell the truth," Phillips says, "but instead they have to resort to messages about how it's a cool alternative to smoking. They are stuck advertising this way, and then they are criticized for using these marketing tactics."

Boston University's Siegel agrees, saying that allowing e-cig makers to "make a therapeutic claim is the best thing they could do, since it would allow these companies to inform consumers that they are safer than cigarettes, which is the truth. Instead, companies go to other tactics-how sexy it is, how you can use these where you can't smoke."

Siegel points out that "many decisions in public health are made in the absence of complete data"-a real problem for e-cigs since "they just came on the market and there hasn't been enough time for thorough study yet"-yet "no one is claiming they have short-term effects, the only question is long-term effects, and it takes a very long time to establish what they might be." New drugs are approved by FDA and "put on the market without any understanding of their long-term effects all the time," he adds, so such decisions "often have to be made with uncertainties." The bottom line, he says, is, "we should be doing everything in our power to combat smoking, and e-cigarettes are helping many, many people do just that."

Here in Baltimore, Bmore Vapes owner Cornelius Sylvester says he's seen it all when it comes to the controversies over e-cigs. He's been in the business since 2009, when he started out working for Max Cigs, an e-cig company based in Texas, where he was living at the time. "Now that it's popular," Sylvester says, "everyone's putting out so much misinformation, it's crazy. Is it 100 percent safe? Nope, but nothing is. But is it safer? Is it a safe alternative? Yeah, it is."

Sylvester and industry activists like CASAA's Phillips and Ward agree that the e-cig industry needs regulation, but they're worried that whatever gets put in place could threaten e-cigs' availability to consumers whose health could be improved and lives lengthened by using them to quit smoking.

"There should be guidelines," Sylvester says, "a lot of just basic regulations for this industry that would make everything so much simpler and promote safety." He worries that, instead, "it's going to be, take out as many small people like me as possible, replace them with electronic cigarettes in small pen styles from the big tobacco companies, and let the big pharmaceutical companies, who have rival quit-smoking products, do the dirty work and come down and wipe us out. All that'll be left are the big tobacco companies, who are going to work with the FDA to do it this way, and pretty much take over the market."

Time will tell whether Sylvester's pessimistic vision turns out to be prescient or misplaced. In the meantime, though, his business is booming. He says he now has nine employees and will need more as he expands to a new, bigger location in Baltimore County, and another in the planning stages at Arundel Mills Mall. He says some small e-cig companies' growth is staggering.

"I know one guy, I sold him his first e-cigarette in Texas," Sylvester says. "Since then, he opened up his own store, doing online sales, and he did over $50 million last year. I'm like, wow."

 

"The people you're talking to are already the converts," says Pamela Clark, a public health research professor who is director of the new University of Maryland Tobacco Center of Regulatory Science (UMD-TCRS), when I mention the raft of stories vape connoisseurs have told me about people quitting smoking by switching to vaping.

"They're the born-again breathers, and they're passionate," Clark continues. "They're the ones who show up and testify at government hearings. They're really part of the subculture, and they go to vape fests and are technologically oriented and disdainful of cigalikes," which increasingly are produced by big tobacco companies. "The tobacco industry is not involved with" the vape stores' products so far, which she calls "very funky looking," and she believes that "many of [their customers] were never smokers."

She worries, though, that the rise in vape culture "may re-normalize smoking" thanks to "advertising on television," turning back the ebb tide that cigarette use has seen for decades until now, when "it's down below 20 percent of the population," while also reversing the decline in teen smoking. On the other hand, she says, putting the brakes on e-cigs' growth presents an "ethical dilemma," because "a lot of people will anecdotally quit with them," presenting a "problem of denying these things from people who want to quit."

Clark, who says she got her first grant to study e-cigs in 2011, is guiding UMD-TCRS as it embarks on major new e-cig research funded last year by the National Institutes of Health in collaboration with the FDA. Some of the defenders of vape culture cited this forthcoming study when, in March, the Economic Matters Committee of the Maryland House of Delegates held a hearing on House Bill 1291, which sought to ban vaping wherever smoking is already banned by law in Maryland.

Cheryl Zolnierek, who goes by the nickname "Vape Mom" as vice president of Maryland Vapers (mdvapers.org), a group that hosts social meet-ups and an online community of vapers and vendors, asked the committee to "please, wait until this study is released, see what they have to say," before passing an indoor-vaping ban. Lobbyist Bruce Bereano, representing the Association of Tobacco and Candy Wholesalers in opposing the bill, urged the committee to "await objective, concrete scientific facts and evidence before acting" and pointed out that Prince George's County, which had been considering passing an indoor-vaping ban last year, decided it would hold off until the Clark-led study produced results.

The bill's sponsor, state Del. Aruna Miller (D-Montgomery County), told the committee to "err on the side of public safety" and allow the proposal to go forward to a floor vote, since it's "like the wild, wild West out there" with "no FDA oversight." She claimed that "many of these studies that have been conducted" are "not conclusive" as to the risks of vaping, which may be a "gateway product" leading nonsmokers to pick up cigarettes.

Joining Miller in support of the bill was Donald Shell, head of the Maryland Department of Health and Mental Hygiene's Cancer and Chronic Disease Bureau, who said that reported e-cig "nicotine overdoses" in Maryland had increased from seven calls in 2012, two involving children, to 11 in 2013, nine of them kids. He added that "we are not clear what the potential risk is at this time" from vaping.

Del. Melvin Stukes (D-Baltimore City) signed on as a co-sponsor of Miller's bill, and says in an interview with City Paper that "nobody knows what's coming from these things," adding, "I did hear there are some things involved with the vapors that are hazardous." Another co-sponsor, Del. Dan Morhaim (D-Baltimore County), who is a physician, adds that he's heard e-cigs "help people quit" smoking, but "that's not proven," adding, "it's always good to err on the side of caution until the facts are clear."

But at the committee hearing, vaping proponents argued that enough is already known to avoid banning the convenient use of this promising smoking-cessation technology. "Vaping is 99 percent less risky than smoking," said CASAA's Phillips. The suggestion that "a bystander would be harmed" by vaping is "misguided," he said, since the toxicity of vaping "is far below the level to create any health concern," and "that's the exposure to the user herself." People who switch from smoking to vaping, Phillips continued, "are reducing their health risk almost as much as if they'd quit cold turkey," and if Maryland law was changed to "take away that convenience" of vaping indoors in public places-like bars, restaurants, and even vape shops-"more people will keep smoking and die from it."

Also testifying against the bill was Bill Godshall, the founder of SmokeFree Pennsylvania and a CASAA advisor, who said the bill, if passed, would "protect cigarette markets" by creating disincentives for smokers to start vaping, a practice that he estimates has "replaced about one billion packs of cigarettes in the U.S. in the past five years," while "last year, U.S. cigarette sales dropped by 4.6 percent as e-cigarette sales skyrocketed to replace them." The more vaping goes mainstream, the more it "denormalizes cigarette smoking," Godshall argued, adding that just as e-cigs have burgeoned, "teen smoking has declined to record lows."

Godshall's teen-smoking point was meant to counter widely cited data from the CDC, which he mentioned to the committee, finding that high-schoolers' e-cig use rose from 1.5 percent to 2.8 percent from 2011 to 2012. When these findings were released, CDC director Tom Frieden surmised publicly that they raise the specter that e-cigs are a gateway to cigarette smoking. But the CDC also found that 9 out of 10 high-schoolers who reported vaping were already cigarette smokers and that teen smoking overall had declined-facts they released belatedly, and which suggest that many vaping high-schoolers may be dual users on the road to quitting cigarettes or have already fully switched to vaping.

Boston University's Siegel found CDC's behavior in releasing its data in successive bites highly suspect, writing on his blog, The Rest of the Story: Tobacco News Analysis and Commentary (tobaccoanalysis.blogspot.com), that "CDC officials certainly had plenty of opportunity to let the public know that there was no discernible increase in cigarette smoking among youth concomitant with the observed increase in e-cigarette use," and the fact they reported the former only after the media rippled with news of the latter, suggests they've come to "a pre-determined conclusion that e-cigarettes are evil."

In the end, the Economic Matters Committee voted 19 to 3 to stop Maryland's proposed indoor-vaping ban in its tracks. Bereano, in an interview after the vote, says it's likely the majority struck the bill down "because they are sensitive to business and cautious about government regulation of business and business products," especially since, given the reliability of information currently available, "they couldn't call vaping dangerous and harmful." Stukes, though, says that while the proposal is "dead for now, it will be back next year."

 

"I smoked 31 years," says Rick Willard, a 47-year-old retired Baltimore City cop. "I was doing almost two packs a day. I would raid houses with a cigarette in my mouth. In Edmondson Village, my nickname was the Marlboro Man. I always had a cigarette. I would chase a bad guy down the street for a couple of blocks, and I'd have to stop and smoke a cigarette to kick-start my lungs."

Willard is telling war stories of his days as a chronic smoker while sitting in the lounge area of Gypsy Vape, a shop he recently opened with his longtime friend and fellow former Baltimore cop Kevin Hoff. "I tried the patch, gum, Chantix, hypnosis-everything you could imagine to quit smoking," Willard continues. He discovered e-cigs about five years ago, he says, and "quit smoking 100 percent on January 17 of 2013." He says he's cut the nicotine content of the e-juices he vapes to 6 mg/ml, sometimes as low as 3 mg/ml, and "I could probably go to zero," but, "I have no intention of quitting." But "once you switch all the way," he continues, "after a couple of weeks, you're going to see a difference in how you feel. I could barely walk up a flight of steps without getting winded before. Now, I can run five miles. I feel better all over, my whole body."

Hoff, a longtime Goth and Renaissance Festival enthusiast, says, "I vape no nicotine. I have no wish to vape nicotine, and half the vapers out there don't vape nicotine." He was "a hookah smoker before I got into vaping," he explains, but grew worried about "what they put in that charcoal" used in hookahs, and "how much of that is still getting through the water filter." So he switched to vaping-and now he enjoys something that may be the only aspect of vape culture that is controversial among vapers themselves.

It's called "cloud chasing," and it involves exhaling mass quantities of thick vapor, enough to fill a room, much like a theatrical fog machine can. Those who build the e-cigs that can do it have to be hard-core geeks about the vaping technology. When I ask Hoff what he uses to chase clouds, he says this: "I'm running a 20-gauge, four-wrap wire on an IGO-W drip atomizer that subohms at about anywhere from .06 to .13." This is how cloud chasers talk.

Ron Ward, the lawyer with the Parkville vape shop, tries to be tolerant about cloud chasers. "I'm libertarian by nature," he explains, so, "I have no problem with it at all." But he clearly does, based on what he says next: "If you do blow industrial size clouds of vapor in public, it's going to ruin it for the rest of us. It's going to be what they point to when they say these things should be banned indoors, because people are being disrespectful. It honestly creates such an immense amount of vapor that it could be offensive to a lot of people. It's offensive to me, and I'm a vaper."

Cloud chasing "started in the Phillipines," Ward continues, "I'd say it's been a year and a half, and it's become very, very popular. Culturally, it seems to be mostly young people and hobbyists, people in their 20s who like to rebuild things and want to build something that makes the most vapor."

Or people like 48-year-old Hoff, who says he wore a blue Mohawk for part of his six years on the police force, and the last thing most people would think when looking at him is "ex-cop." But Willard, who looks every bit the ex-cop, echoes Ward's concerns. While cloud chasers "do it everywhere" because "it's fun and they enjoy it," Willard says, "sometimes people aren't responsible. If they really thought about the future of vaping, they wouldn't sit in a Chuck-E-Cheese and subohm and blow a cloud, because the perception of that cloud, after years of indoctrination of what smoke is, people don't understand it. And then they get fearful for their kids."

But the geek factor involved in cloud chasing is indicative of a larger theme in hardcore vape culture, one in which, unlike with people trying to quit smoking, nicotine isn't really part of the picture.

"Probably 50 percent of our customers don't even do nicotine," Hoff explains. "A lot are people who were into hookahs, without nicotine, so we supply non-nicotine e-juice to a lot of people who just enjoy vaping, who just have a pastime where they sit around and socialize. Now, a lot of young people are going to vape shops the way, when I was younger, we used to bar-hop. It's kind of like a hobby to a lot of people, and they go around and collect things, build things, look at things, collect the different mods, the different drippers"-component parts of high-end e-cigs that people build themselves, so they can control the ohms and voltage of the batteries and the amount of e-juice delivered.

"It's a whole different subculture that is literally springing up overnight," Hoff says. "I can't remember a subculture that sprang up this quickly."

But "our primary customers," Hoff adds, "are people who want to quit smoking. They've tried everything. They come here, and we sell them just the basic kit to get started on their journey. And it works. They're surprised that they're not doing cigarettes anymore, and the thought of smoking turns their stomach."

Hoff's wife, Jennifer Langenfelder, pipes in: "One thing I don't miss is smelling like a cigarette." She was a pack-a-day smoker until the shop opened, three weeks earlier, and hasn't had one since. "It's gotten to the point where I can smell it on somebody, and it just makes me want to gag. You get to the point where it just smells and tastes disgusting."

"That's how we can tell if our customers are being honest or not about quitting," Hoff concludes. "You don't get that smell, you know it's working."

For now, I still carry that smell-though less so, given that I'm smoking only three or four cigarettes a day. I look forward to the day I can go to the Vapory or Gypsy Vape or Bmore Vapes, and they'll notice I don't reek.

Copyright © 2015, The Baltimore Sun
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