As the popularity of electronic cigarettes rises, West Virginia - the state with the highest rate of tobacco users - has seen a spike in residents who have tried "vaping" despite warnings from public health officials dubious of claims of its relative safety compared to cigarettes.
Nearly one in five West Virginia adults have tried e-cigarettes, according to the West Virginia Bureau for Public Health's 2014 Adult Tobacco Survey. Of those, more than 60 percent are current smokers, and more than one-third are younger adults between the ages of 18 and 24.
Nearly three-quarters of the e-cigarette customers in West Virginia are under the age of 35, according to the bureau.
E-cigarettes are battery-operated devices that convert a concentrated mixture of liquid nicotine, flavoring and various chemicals into vapor inhaled by the user. While the devices can resemble traditional cigarettes in appearance and use, they do not contain tobacco or many of the other carcinogenic additives common to traditional tobacco products.
The Food and Drug Administration attempted to ban e-cigarettes in 2009, determining them to be "drugs or drug-delivery devices," but a federal appeals court ruled that the agency did not have that authority in 2010. The agency is now moving to regulate them as tobacco products, which would subject them to the same taxes and laws as cigarettes, cigars and smokeless tobacco, although e-liquid does not contain tobacco and does not produce smoke. So far, the e-cigarette industry has remained largely unregulated, despite concern from public health officials who say the health impacts of e-cigs are uncertain.
"The science behind efficacy and safety claims for these electronic nicotine delivery devices is limited; however, several studies have shown various public health dangers from these products, including known carcinogens in nicotine solutions utilized in e-cigarettes," said Dr. Rahul Gupta, state health officer and commissioner of the Bureau for Public Health. "The West Virginia Division of Tobacco Prevention does not classify these products as a safe alternative to smoking, nor does it consider them an approved tobacco cessation or tobacco harm reduction tool. E-cigarettes will continue to keep their users addicted to nicotine."
Dr. Michael Brumage, health officer for the Kanawha-Charleston Health Department, said e-cigarettes have been proven to be harmful to fetal development in the same way traditional tobacco products are, and many have been shown to contain heavy metals, ultrafine particulates and cancer-causing agents like acrolein, a chemical most commonly used as a herbicide.
"They're not healthy, but the science does not yet conclusively prove whether they cause the same long-term health effects in adults as regular cigarettes," he said. "What we do know is that they cause deleterious effects on pregnant women and fetuses especially, and on adolescents."
According to the Centers for Disease Control and Prevention, e-cigarette use doubled among middle and high school students between 2011 and 2012. Of the roughly 1.7 million teenagers estimated to have used e-cigarettes in the U.S. in 2012, more than 160,000 had never smoked cigarettes. In West Virginia, more than five percent of those who reported using e-cigarettes were previously non-smokers, a statistic Gupta said is especially troubling for public health officials, because nicotine itself can have negative health impacts.
"The use of all tobacco and tobacco-derived products, in any form, places West Virginia residents at greater risk for negative health outcomes," he said.
West Virginia has the highest rate of tobacco use in the nation - nearly 30 percent of residents use tobacco. More than 30 percent of West Virginia adults who had tried e-cigarettes did so during an attempt to quit smoking, but Gupta said more traditional quitting methods are preferable to e-cigarettes, which still contain nicotine.
"Several non-tobacco methods have been shown to be proven and effective for quitting cigarettes, as well as other tobacco addictions," he said. "Medicinal nicotine also refers to nicotine replacement therapy that has been available since the 1970s as a therapy for smokers trying to quit. These products are highly regulated and monitored by the FDA. The total elimination of most all toxins in the FDA regulated, NRT is clearly preferable to any use of toxin-laden, addicting, disease-causing tobacco products."
Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.