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Ex-Smokers Breathe Easier: E-Cigarettes Rise in Popularity But Health Questions Unanswered

  • Tammy Carpenter of Claremont exhales smoke from her eCigarette while Jazmyn Graf of Strafford makes change for a customer at Un-Dun in West Lebanon, N.H., on March 12, 2014. Employees and customers are welcomed to use their eCigarettes inside the store. (Valley News- Sarah Priestap)

    Tammy Carpenter of Claremont exhales smoke from her eCigarette while Jazmyn Graf of Strafford makes change for a customer at Un-Dun in West Lebanon, N.H., on March 12, 2014. Employees and customers are welcomed to use their eCigarettes inside the store. (Valley News- Sarah Priestap) Purchase photo reprints »

  • Un-Dun Employee Tammy Carpenter of Claremont reaches for a bottle of eCigarette liquid for a customer at Un Dun in West Lebanon, N.H., on March 13, 2014. Unlike regular cigarettes, there are hundreds of flavors of e-liquid, which is a solution that contains nicotine. (Valley News- Sarah Priestap)

    Un-Dun Employee Tammy Carpenter of Claremont reaches for a bottle of eCigarette liquid for a customer at Un Dun in West Lebanon, N.H., on March 13, 2014. Unlike regular cigarettes, there are hundreds of flavors of e-liquid, which is a solution that contains nicotine. (Valley News- Sarah Priestap) Purchase photo reprints »

  • Purchase photo reprints »

  • Before buying a carton of cigarettes, Darrol Sullivan of Grafton asks questions to Un Dun employee Jazmyn Graf of Strafford about her eCigarette at Un Dun in West Lebanon, N.H., on March 12, 2014. (Valley News- Sarah Priestap)

    Before buying a carton of cigarettes, Darrol Sullivan of Grafton asks questions to Un Dun employee Jazmyn Graf of Strafford about her eCigarette at Un Dun in West Lebanon, N.H., on March 12, 2014. (Valley News- Sarah Priestap) Purchase photo reprints »

  • Tammy Carpenter of Claremont exhales smoke from her eCigarette while Jazmyn Graf of Strafford makes change for a customer at Un-Dun in West Lebanon, N.H., on March 12, 2014. Employees and customers are welcomed to use their eCigarettes inside the store. (Valley News- Sarah Priestap)
  • Un-Dun Employee Tammy Carpenter of Claremont reaches for a bottle of eCigarette liquid for a customer at Un Dun in West Lebanon, N.H., on March 13, 2014. Unlike regular cigarettes, there are hundreds of flavors of e-liquid, which is a solution that contains nicotine. (Valley News- Sarah Priestap)
  • Before buying a carton of cigarettes, Darrol Sullivan of Grafton asks questions to Un Dun employee Jazmyn Graf of Strafford about her eCigarette at Un Dun in West Lebanon, N.H., on March 12, 2014. (Valley News- Sarah Priestap)

West Lebanon — About nine months ago, Matt Palombo was curious about how much money he was spending on cigarettes.

He smoked around a pack a day for eight years. Palombo knew it was an expensive habit, but it wasn’t until he sat down and crunched the numbers that he decided to get serious about quitting.

“I did the math and found out I was spending $2,400 a year on a habit that was killing me,” said Palombo, 26, of Enfield.

Palombo hasn’t smoked tobacco since. But he didn’t give up nicotine. Palombo still enjoys the soothing buzz of the stimulant, delivered via a cylindrical inhaler known as an “e-cigarette.”

The market for the devices is exploding, and many users are former smokers who credit “vaping” — a reference to the nicotine-laced vapor e-cigarettes emit — with helping them quit tobacco.

Health officials generally agree that e-cigarettes are less harmful than smoking, but questions remain about the consequences of inhaling the fine mist.

It is an unregulated industry; there has been little research on the health effects.

Just about anybody can mix and sell the flavored “e-juices” that are heated and turn into vapor, raising concerns about the chemicals that could enter a user’s lungs. And the quality of the devices varies widely.

“There is very little standardization, so every (e-cigarette) works a little differently. That creates a tremendous amount of variability,” said Susanne Tanski, a Dartmouth-Hitchcock pediatrician and the chairwoman of the American Academy of Pediatric’s Tobacco Consortium. “The experience for the user might vary dramatically, and you might not be vaping the amount of nicotine you think you are.”

The e-juices typically include a mixture of artificial flavoring, nicotine (either powdered or liquid) and propylene glycol, an odorless liquid that is “generally recognized as safe” by the U.S. Food and Drug Administration and used in everything from animal feed to fog machines at rock concerts. Vegetable glycerine produced from plant oils is sometimes substituted for propylene glycol.

Nearly all of the reusable e-cigarette devices and liquid sold in stores like Un-Dun, a West Lebanon retailer, come from China. However, domestic manufacturers have begun appearing, too.

Vermont Vapor, in Castleton, Vt., began making e-cigarette liquids — which are sold in packs of cartridges — in June 2009.

Since then, business has grown substantially and the company ships products to more than 25 countries, said the company’s president, Adam Tredwell.

Except for the flavorings, all the ingredients the company uses in its e-juices are U.S. pharmaceutical grade, Tredwell said.

Tredwell has no formal training to make e-juice, saying that he learned how to do it by “spending a lot of time in the library.”

“For the most part, it required figuring it out for ourselves,” he said.

He was reluctant to say his products were absolutely “safe” because he didn’t want to run afoul of FDA laws surrounding such claims. Still, he said he is confident in the quality of his products. He also worries when he hears stories about home chemists selling e-juice. They could be mixing all kinds of chemicals without anybody knowing what they are, he said.

“With the rate it’s taken off and these companies popping up that are claiming to manufacture them, who knows?” he said.

Generally, the vapor is not believed to be as harmful to a smoker’s lungs as tobacco tar, and Tanski, the pediatrician, said she suspects it is safer than cigarette smoking. But just because concert-goers can safely tolerate propylene glycol vapor at a show doesn’t mean that they should breathe it directly into their lungs, Tanski said.

“There has never been a long-term study on the use of propylene glycol in a cartridge like this,” she said. “We also don’t know what happens if someone uses multiple cartridges a day.”

Users are also simply feeding an underlying addiction and doing nothing to address the issue, said Alan Rogers, a family physician with Valley Regional Hospital.

“Nicotine is an addictive drug,” said Rogers, who practices in Newport. “Yes, you’re getting rid of all the tar and carcinogens being embedded in your lungs, but you still are addicted to nicotine.”

Every week, patients of all ages tell Rogers that they have begun using e-cigarettes as a way to stop smoking. He is most concerned for his younger patients, who are attracted to the image of smoking and believe vaping is absolutely safe.

“We still don’t know what it does to young people,” he said.

The American Lung Association has said it is “very concerned about the potential safety and health consequences” from using electronic cigarettes. And yet, many people who use e-cigarettes say their personal health has improved.

“It makes my lungs feel a lot better,” said Tammy Carpenter, 38, of Claremont. “I’m able to breathe.”

Carpenter is the store manager at Un-Dun, which sells its own branded e-cigarette “kits” and liquids in flavors ranging from mint chocolate chip to blueberry. The most popular, she said, is a fruit cocktail called “sour and sweet.”

She and other employees use e-cigarettes, which some wear dangling from straps around their necks, in the store.

Besides delivering nicotine, e-cigarettes have satisfied other cravings, they said. The vapor simulates the “throat hit,” that sensation when smoke travels into the lungs, Carpenter said.

Additionally, it eliminates what smokers did not enjoy about their old habit — the smell — while also being cheaper.

A 20-milliliter bottle of e-juice that costs $13 to $15 is equivalent to two cartons of cigarettes, for which Carpenter would pay $100, she said.

E-cigarettes appeal to people who use smokeless tobacco, too. John Paquette, 20, said he gave up chewing tobacco a month ago in favor of e-cigarettes.

In fact, it’s become something of a phenomenon among his co-workers at Dartmouth Printing, he said. One other employee used to smoke a pack and a half of cigarettes a day, but has become a e-cigarette convert, he said.

“He said he tried everything (to quit smoking),” Paquette said. “And this was the only thing that helped him quit.”

But not everyone who uses e-cigarettes gives up tobacco.

Carpenter and several of her Un-Dun coworkers continue to smoke conventional cigarettes, though all had cut back.

Angela Avery, 42, of Strafford, said she hates everything about smoking — the smell, the expense, the consequences for her health.

Since she began smoking e-cigarettes, she has reduced her tobacco use but still smokes about a pack every week.

“I don’t have any will power,” Avery said.

Tanski, of Dartmouth-Hitchcock, said she is concerned about “co-users” like Avery because e-cigarettes are pushing more chemicals into their bodies without helping them eliminate the harmful effects of smoking.

Cutting back cigarette use doesn’t do as much to improve a person’s health as many smokers believe, she said, and certainly is not as good as quitting.

“I would love there to be a great body of evidence that shows this is a great way to quit,” Tanski said. “But we just don’t know yet.”

So far, it has worked for Palombo, of Enfield.

He said he can hold a cigarette and not crave it at all. He continues to research online about the potential adverse health effects of e-cigarettes, and suspects that vaping may have exacerbated his allergies, though he can’t say for sure.

But he does feel better.

“Coming off smoking,” he said, “I noticed I can breathe now.”

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.