Business is booming inside the 1st Avenue Hookah and Vape Shop in the Avondale neighborhood of Birmingham where Don Scott is fielding orders for hookahs and vapes and pipes during a respiratory pandemic.

The small vape and smoke shop remains open, omitted from a list of “essential” business but also not included among the businesses listed for closure under Alabama Gov. Kay Ivey’s stay-at-home order.

If people maintain 6-feet social distancing, and the capacity is restricted inside the store, the tobacco and electronic cigarette sales can go on.

“We are doing it safe here, we have hand sanitizers, and our sales have gone up,” said Scott. “They’ve not stopped.”

The fact that vape shops throughout Alabama remain open is a concern for anti-smoking advocates and state lawmakers who, in recent years, pushed for a crackdown on an industry accused at times of peddling flavored products to underage youths.

But what is going on in Alabama is not uncommon across the U.S., where governors have issued stay-at-home orders that do not address vape or smoke shops. According to a review of 40 state stay-at-home orders issued last month, “there isn’t a single state order that has designated a vape shop as an essential business,” according to Boot Bullwinkle, spokesman with the Campaign for Tobacco-Free Kids.

Even though vape shops are not considered “essential business,” they remain open in many cases, Bullwinkle said.

“For example, whereas some states require all non-essential businesses to close, some states allow non-essential businesses to stay open if they maintain social distancing rules, and some state orders specifically encourage non-essential businesses to adopt curbside delivery or other remote means to conduct their business,” he said.

‘Tragic’

That is the case in Alabama, where the state Department of Public Health – in a FAQ sheet answering questions about Ivey’s order – recommends that businesses like “tobacco stores” deliver products to people’s homes or meet customers at the curb.

The FAQ sheet also poses the following question, “Before asking whether you can legally do X, Y, or Z, ask yourself, ‘Is doing X, Y, or Z a good idea?’ If doing X, Y, or Z would increase the risk of transmitting COVID-19, try not to do it.”

Still, neon lighted “Open” signs remain affixed to the front doors of many vape shops around Alabama.

Some lawmakers are concerned they are allowed to remain open during a pandemic in which the spreading virus attacks the lungs.

“It’s very tragic,” said state Rep. Barbara Drummond, D-Mobile, who has backed legislation adopted last year that restricts stores from selling nicotine and vape products to people under 19. “If you look at the data coming out of the Department of Public Health, this disease is a great equalizer. But those with an underlying illness and with a bad habit such as smoking and vaping, they are (more) prone.”

The Campaign for Tobacco-Free Kids, in an Op-Ed piece published April 2 in the Denver Post, wrote that vaping may worsen the effects of COVID-19 by attacking the lungs, placing people who vape at greater risk than people who do not.

Dr. Alan Blum, director of the University of Alabama’s Center for the Study of Tobacco and Society, said the pandemic should allow smokers time to find better ways to control their nicotine additions through either “simple relaxation exercises” or other means such as eating more fruits and vegetables.

“We need to be sympathetic to those who are using electronic cigarettes to stop smoking, but at a time when one of the worst viruses we have ever seen is taking aim at our lungs, the last thing anyone should be doing is inhaling nicotine either from a cigarette or an e-cigarette,” Blum said. “Right now, the only sensible way to reduce one’s nicotine craving would be to use a nicotine-containing patch, gum or lozenge.”

Demand remains

Gregory Conley, president of the American Vaping Association and an attorney in New Jersey, said there is no evidence linking vaping to “any COVID-19 outcome.”

He said the past lung illnesses and deaths linked to vaping were the result of “illicit” use of THC-containing e-cigarettes dealt “on the black market.” The Centers for Disease Control and Prevention along with state and local health authorities, reported a spike in vaping-related lung illnesses in August and September 2019. But ever since then, the CDC reported in February, they’ve been on a decline.

Conley said that linking coronavirus and vaping is done by people “to generate headlines on their pet political issue.” He said that pushing for vape shops to close could lead to more people turning to cigarette smoking to get their nicotine fix during the pandemic.

In Alabama, 20.9% of adults are smokers, according to the most recent World Health Organization figures. That’s the 10th highest in the U.S.

Conley said that vape stores, like other small businesses struggling during the pandemic, “not hitting the revenue numbers they had three months ago.” Online sales, he said, are trended upward.

“But there is a demonstrated need for these products among ex-smokers who rely upon them to stay away from cigarettes,” he said. “The demand for the product who need it the most remains through the potentially life-changing pandemic.”

Lobbying strength

The ability for vape and smoke shops to remain open, while restaurants and bars are closed, has raised eyebrows among those who follow Alabama politics. Restaurants are allowed to deliver meals to houses and offer curbside service, but the delivery of alcoholic beverages in Alabama is prohibited.

Keith Herbert, a history professor at Auburn University who specializes in the history of Alabama and Southern culture, said effective lobbying by tobacco interests is probably one reason why the shops are spared from temporary closures.

He said that lobbying influences affected President Donald Trump -- who at one point expressed interest in tough crackdowns against flavored e-cigarettes – to relent to a more limited ban on sales of flavored vaping pods. Trump reportedly expressed regret, during a January phone call with Health and Human Services Secretary Alex Azar, for getting involved in vaping regulations.

Herbert compared the strength of tobacco lobbying to the restaurant and bar industry.

“Unfortunately, I suspect that if (restaurants and bars) had a national lobbying organization aligned with a particular ideological view capable of motivating the electorate, they might too have been spared from stricter regulations,” Herbert said.

Tobacco stocks, meanwhile, haven’t been hammered during the pandemic. Tobacco shops in Italy and France – among supermarkets and pharmacies – were a few of the businesses allowed to remain open during their lockdowns.

“Pragmatically, there is a case for keeping the ‘vice-related’ businesses operational; other countries kept their tobacco stores open throughout this period,” said Robert Blanton, chairman of the Department of Political Science and Public Administration at the University of Alabama. “Health reasons aside – and that’s a big aside – it would be difficult to force a smoke-to-quit (effort) during a quarantine period.”