“Peach is one of my favorite flavors to vape on, man, it’s always very smooth,” says Jaek Landsberger, a 20-year-old Vaporizer Specialist, as he helps a young couple pick out vape juice at Bongs & Thongs in downtown Ann Arbor. Beside him, framed by a Pulp Fiction poster, Jonah Creasman-Jones is blowing smoke rings in a sweet-smelling cloud that engulfs his head. Between puffs, he explains that he vapes to calm his nerves and to stay sober.

Bongs & Thongs, one of the many brick-and-mortar vape shops that have popped up around Ann Arbor in the last few years, sells vapes (often used interchangeably with ‘e-cigarettes’), science fiction-looking devices used to vaporize nicotine, cannabis, or flavoring for inhalation.

Marketed to young people?

Dr. Carol J. Boyd, who researches adolescent use of e-cigarettes through the U-M Addiction Center, says vaporizers and electronic cigarettes are disproportionately marketed to young people, who “perceive electronic cigarettes as generally less harmful than combustible cigarettes.”

According to Landsberger, “the companies who are doing this are not specifically marketing toward children. But,” he adds as he selects from his counter a bright box labeled ‘Candy King’ – described as a mouth-watering take on delicious gummy peach candy coated with a crystallized sugar – “that shouldn’t happen. That’s not okay with me, as someone who cares about the industry.”

Newly released results from U-M’s 2017 “Monitoring The Future” Survey suggest vaping is on the rise among teenagers, with 27.1% of high school seniors admitting to some form of vaping within the previous month. When asked what they thought was in the mist they inhaled the last time they used a vaping device, 51.8 percent of 12th graders said, “just flavoring,” 32.8 percent said “nicotine,” and 11.1 percent said “marijuana” or “hash oil.”

“We are especially concerned because the survey shows that some of the teens using these devices are first-time nicotine users,” said Nora D. Volkow, M.D., director of the National Institute on Drug Addiction, which helps to sponsor the annual survey. “Recent research suggests that some of them could move on to regular cigarette smoking, so it is critical that we intervene with evidence-based efforts to prevent youth from using these products.”

Vaping Feels Better

Rairigh Drum is far from a first-time nicotine user, as she became addicted to cigarettes at age fifteen, and is now thirty-one. E-cigarettes helped her quit tobacco cigarettes this past summer. “I’m not throwing burning trash in the street,” she says, “and I’m not making the whole block stink like tobacco. I feel a lot better. I don’t cough stuff up in the mornings. I feel better when I’m doing things like running, or doing long-distance hiking, or carrying heavy things. I don’t get out of breath.”

Landsberger echoes the benefits of vaping versus tobacco cigarettes. “I can run. I can taste my food,” he says. “The biggest thing was the sense of taste. Oh my god, it was mind-blowing.”

Still, Drum adds, “It’s nicotine. It makes your heart race, it constricts your blood vessels. I don’t think it’s in any way good for you.”

Easier to hide

Patrick Gaulier, a clinical case manager at Ozone House in Ypsi, estimates about half of his 20 clients (all between the ages of 18-24) vape. “I think my clients fall about 50/50 into two categories,” he says, “some transition from cigarettes to vaping and some start straight away vaping. I know for those who smoked previously, they talk about switching to vaping because there is a cost benefit and they can get away with vaping easier than smoking in apartments and cars.”

Health questions

Gaulier adds that most of his clients do not believe vaping has adverse health effects. “I’ve been at some conferences that have discussed some emerging research,” he says, “and most of it initially suggests that at the very least, vaping is a much healthier alternative to combustible nicotine and, at most, there are few negative health effects. I’m not a doctor so I can’t speak to any health effects I’ve noticed. What I can say with some degree of certainty is that marketing vapes as a way to reduce and eliminate nicotine use is misleading. Of all my clients who have transitioned to vaping with the intention of quitting nicotine altogether, none have successfully quit.”

Creasman-Jones, the Bongs & Thongs customer who says vaping has helped him stay sober, says that still doesn’t mean vaping is particularly healthy. “Honestly, there’s not many health advantages to it,” he says, “besides minimizing the amount of cancer-causing carcinogens that people ingest. There’s still going to be negative side effects such as nicotine addiction and chemical dependency, but it does help with protecting the people around you from secondhand smoke.”

Dr. Boyd agrees with him on that point, explaining, “There is probably little risk of second-hand exposure,” but she is concerned the general perception that vaporizers and e-cigarettes are harmless may “re-normalize” cigarette smoking. “We know virtually nothing about the long-term risks,” she says, adding that although research is ongoing, the safety of the added flavorings is “unlikely.”

Landsberger doesn’t think people should wait for years of research to be done to switch from tobacco cigarettes. “The United States government will tell you that everything in [vape juice] is in a cigarette,” he says, “that it’s awful for you. If you go over to the United Kingdom, on the other hand, the Royal College of Physicians states it’s 97% less harmful for the human body than smoking any kind of cigarettes.”

Dueling reports

The Royal College of Physicians’ report, Nicotine without smoke: Tobacco harm reduction (April 2016), states that although there are concerns vaping will re-normalize smoking, current data indicates “e-cigarettes are being used almost exclusively as safer alternatives to smoked tobacco, by confirmed smokers who are trying to reduce harm to themselves or others from smoking, or to quit smoking completely.” The report recommends that e-cigarettes should be regulated to reduce adverse effects, but that their development shouldn’t be discouraged, due to their effectiveness as a harm-reduction product for smokers.

On the other hand, the U.S. Surgeon General’s report Cigarette Use Among Youth and Young Adults (2016) proclaims “the evidence supporting the effectiveness of e-cigarettes as an aid for quitting conventional cigarettes remains unproven,” and also expresses concern about the presence of known carcinogens in e-cigarette aerosol – the sweet-smelling vapor cloud that fills the basement of Bongs & Thongs.

While the research is still up in the air, for Drum, the benefits outweigh the risks. “I do not recommend that anybody ever pick it up, but if you already smoke cigarettes, then you should probably switch to vaping,” she says. “I would say that it’s way healthier than cigarettes, but still not healthy at all.”