They’re supposed to help smokers quit. But e-cigarettes aren’t as harmless as they seem

Jason Hoover thought he was having a stroke.

The emergency room paramedic was on his way to work at Coliseum Medical Centers one morning when his face went numb. By the time he got to the ER, Hoover was sweaty and pale. His heart rate and blood pressure were through the roof.

A co-worker immediately registered Hoover as a patient.

Doctors determined he wasn’t having a stroke, though. Hoover had overdosed on nicotine.

Hoover had started vaping about a year before, hoping to kick the smoking habit he’d picked up more than 20 years before, when he was 16.

But the high nicotine concentration in the homemade flavored liquid he’d bought at a mom-and-pop vaping store in Warner Robins had poisoned him. Doctors monitored Hoover for 12 hours, until the nicotine made its way out of his system.

Vapes, also called e-cigarettes, typically hold a liquid containing nicotine, flavoring and chemicals, which produces an aerosol vapor. They come in various shapes and styles and often resemble other items, such as pipes, cigars or even pens.

Often advertised as a safer alternative to cigarettes, vapes have come under fire in recent months. The Food and Drug Administration announced that it would limit sales of flavored e-cigarettes and strengthen age verification protocols to combat the growing amount of adolescent vaping.

The number of high school students who vape has increased 78 percent in the past year, according to a new report by the FDA and the Centers for Disease Control and Prevention. Middle school e-cigarette use rose nearly 50 percent.

As e-cigarettes have grown in popularity in recent years, one brand has dominated the burgeoning industry since its 2015 launch. Juul, a thumb-sized e-cigarette that looks more like a USB drive than a vaping device, controls over 70 percent of the market share.

Juul was created to help cigarette users quit smoking, e-cigarette company Juul Labs writes on on its website. But though the e-cigarettes spare users the hazards of tobacco smoke inhalation, they don’t protect them from the negative effects of nicotine, which is toxic and highly addictive.

Users plug a small “Juul pod” into the end of their device, which holds an “e-liquid formula” with a 3 or 5 percent concentration of nicotine, according to the FAQs section of Juul Labs’ website. That’s between 23 and 40 milligrams of nicotine per pod – the equivalent of about 200 puffs, Juul Labs writes.

The average American cigarette contains between six and 13 milligrams of nicotine.

The e-cigarettes have garnered popularity beyond former smokers. They’ve migrated to college campuses, high schools and even middle schools, captivating young people with their sleek design and sweet flavors, such as cucumber and mango.

Juul closely resembles a flash drive and charges in a computer’s USB port, so students can easily sneak them onto campus. Because the e-cigarettes are small and don’t create smoke, students can fairly discreetly take a hit without drawing attention.

Most schools have banned the vaping devices in recent months, but it took time for adults to recognize their presence on campus, at first.

Though Juul Labs claims its marketing doesn’t target minors, the FDA has criticized the company for its seeming appeals to young audiences, from fruity flavors to social media campaigns. In September, the FDA granted Juul and four other top-selling e-cigarette brands 60 days to submit plans to address youth access.

Days before the FDA released its new regulations, Juul Labs announced it would suspend sales of flavored Juul pods to the more than 90,000 retailers that sell its products and require age-verification measures to ensure that all future buyers are 21 or older.

But millions of Americans are already hooked on the electronic devices.

The trend hits Georgia

One in four Georgia high school students reported use of an e-cigarette at least once, the Georgia Department of Public Health reported this year. That number increased by 66 percent between between 2013 and 2017.

Gas stations across the state proudly advertise Juul products on their windows and outside their entrances.

At Mercer University in Macon, the e-cigarettes abound.

Mercer University junior Grace Terry doesn’t vape. She’s taken enough science classes to know that nicotine can damage your DNA.

“That’s kind of crazy that you’re, like, causing early aging to, like, look cool,” she said. But Terry has watched Juul take over her college campus.

The sleek e-cigarettes are part of a larger culture, Terry said – one that she sees on Instagram, in dorm rooms and as she walks around campus. And members of that culture pay a steep price to keep up with the latest trends.

Many of Terry’s co-workers at her summer job used Juul and other vapes. Each payday, she said, they’d blow two week’s worth of wages on flavor pods and colorful accessories.

Juul is more than just a vaping device. It’s a way to express yourself.

The USB lookalikes are also small and easy to use without attracting much attention, Terry said, which has bolstered their popularity in middle and high schools.

Juul Labs’ new action plan will require vendors to confirm buyers are at least 21 years old. But up to this point, gas stations and online sellers have allowed adolescent consumers to bypass the age requirement.

Some young people aren’t aware of the potential health risks of vaping, Terry said. Others choose to ignore them.

“If you’re like, ‘Oh, this is going to hurt you when you’re 50,’” she said, “‘You’re like, still got 20-something years!’”

Insufficient information

Even medical professionals don’t yet know all of the long-term health risks of vaping, said Dr. Norman Hetzler, a thoracic and cardiac surgeon at Coliseum Medical Centers. But they know how detrimental nicotine can be.

“There are some things we know just from following along (with) the tobacco industry and its effect on people,” Hetzler said.

Nicotine, he said, can increase the risk of cardiovascular disease, strokes and even loss of limbs.

And it’s not just the nicotine that can harm users. Many of the chemicals in vaping liquids are toxic and can cause cellular damage, Hetzler said. Researchers have yet to study all of the effects of those chemicals, but Hetzler thinks they’ll likely cause “a new crop of different cancers of the head and mouth.”

Hetzler is especially concerned about young e-cigarette users. Since their brains aren’t fully developed, adolescents are more likely to act on their impulses and pick up new habits, he said.

When teens use e-cigarettes, they rarely realize how much nicotine is in the vapor, if they know any is in there at all, Hetzler said. The adolescents try them for the fruity flavors and end up hooked.

“As long as there is a market for e-cigs, you will have e-cig companies making them,” Hetzler said. “So, rather than regulate them to death, I think the best thing is education of the consumer.”

Hoover wishes he knew more about the health risks of vaping. He’s done some Internet research on his own, but he said there’s not much information out there about the effects.

Hoover hopes to quit vaping soon. At first, he planned to wean himself off of cigarettes with e-cigarettes, and then eventually quit those, too. But four years later, he’s still addicted to both.

The father won’t let his 11 year old try either. He knows how powerful the nicotine rush can be and doesn’t think non-smokers should dabble with e-cigarettes.

“Don’t mess with it,” Hoover said. “There’s no sense in that.”

Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at https://www.facebook.com/smax1996 and on Twitter @samanthaellimax. You can also join her Facebook group. Learn more about Report for America at www.reportforamerica.org.

This story was originally published November 16, 2018 at 12:56 PM.