“All the suffering, stress, and addiction comes from not realizing you already are what you are looking for.”
~ Jon Kabat-Zinn, American Professor of Medicine
By Janey Bibolet Ward
Chances are if you grew up in the United States in the 70’s, you munched on candy cigarettes and cracker jacks from the snack shack during summer little league games, or swimming at the public pool. It was normalized as innocent fun to pretend to smoke; you could buy them everywhere, and many parents were smokers, around 37% of adults.
These fake sugar cigarettes were introduced in the 1930s when smoking was fashionable, and encouraged by massive marketing campaigns financed by big tobacco companies such as Camel, Lucky Strike, and Chesterfield. Vintage ads suggested reaching for a cigarette to curb food cravings and reduce weight gain, often going so far as to use the phrase, “doctors recommend these brands as safe.”
The early printed adverts targeted women, and made smoking attractive and desirable for the increasingly modern cosmopolitan middle-class lady, asserting herself in the world outside of the domestic realm. The packaging for the candy cigarettes mimicked the real thing, and used similar branding and imagery. Confectioners, and tobacco companies who ignored copyright or infringement laws, worked in tandem to promote their brands to a generation of future smokers.
Despite early warnings in the 1950s that cigarettes could be harmful to your health, causing throat and lung cancer, and highly addictive, ads continued to promote cigarette smoking, and were a highly lucrative source of revenue for national magazines, such as Time and Ladies Home Journal. As time went on, doctors were gradually removed from the campaigns, and fewer positive health claims were made.
Consumers became wary of smoking, and regulatory efforts ensued to curtail the marketing and promotion of cigarettes. The Federal Cigarette Labeling and Advertising Act of 1965 required that packages include the warning, “Caution: Cigarette Smoking May Be Hazardous to Your Health,” on the side panel of each cigarette package.
In the 1970s, President Richard Nixon signed the Public Health Cigarette Smoking Act, and advertising for cigarettes was no longer permitted on radio or television. This regulation did not include print ads in magazines, newspapers, or billboards. Tobacco companies faced more scrutiny over the intervening years leading up to the tobacco Master Settlement Agreement (MSA) in 1998. This forbade companies from targeting youth, and banned outdoor advertising, media placement, and sponsorships.
The Family Smoking Prevention and Tobacco Control Act signed into law in 2009 further regulated the marketing and distribution of tobacco products, required the disclosure of ingredients, and banned flavorings other than menthol.
Electronic Nicotine Delivery Systems (ENDS): E-Cigarettes
Profits aside, the rise of e-cigarettes was born of good intentions: to reduce the harmful effects of smoking, and the accompanying ill health effects. The idea was to create a device that delivered nicotine by heating up an oil that vaporized it, while not producing smoke or odor.
Early research began around 1930, along with the rise of the popularity of cigarette smoking in mainstream culture. Numerous patents were filed, and the idea was explored by many inventors, but failed to produce a commercial product. It was not until 2003 in Beijing China that the first viable product from Golden Dragon Holdings, created a device called, Ruyan, which means “like smoke.”
The developer was a smoker who lost his father to lung cancer, and was trying to find a nicotine delivery system that was less harmful to users, by eliminating combustion and smoke. Ironically, he maintains that he still uses both, and the e-cigarette did not replace his cigarette smoking habit.
Since the inception of this device, regulatory and legal challenges persisted, as the World Health Organization (WHO) and Food and Drug Administration (FDA) fielded lawsuits from consumer advocates. Agencies sprung up in support of e-cigarettes, such as the Consumer Advocates for Smoke-Free Alternatives Association (CASAA), that promoted the use of e-cigarettes as a safer path to smoking cessation, or the “safer” use of nicotine.
In 2007, two Stanford design graduates created a company that produced a vaporizer for the discreet use of marijuana called Pax, and later the e-cigarette brand, Juul. The meteoric rise of e-cigarettes, predominantly via Juul, brought the product to the masses. Using a sleek cartridge (delivery system) with disposable pods, smoking was discreet and easy to conceal. The nicotine product was available in a variety of flavors to appeal to new users, and quickly amassed market share.
In 2017, The Boston Globe called it “the most widespread phenomenon you’ve likely never heard of.” The article reported the rise of the number of youth using this product, and prompted the company to issue a statement that the product was intended for use in people 21 years and older.
The FDA declared youth vaping an epidemic in 2018, and issued an order to the five largest e-cigarette companies, 97 percent of the current market for e-cigs—JUUL, Vuse, MarkTen, blu e-cigs, and Logicor—to combat underage use. At the urging of the American Lung Association, legislation was introduced to raise the legal age to purchase tobacco from 18 years old to 21, and was signed into law in 2019.
In 2022 the Centers for Disease Control and Prevention (CDC) reported over 2.55 million U.S. middle and high school students used e-cigarettes in the past 30 days.The same year, the Supreme Court of California upheld a measure passed in 2020 to ban flavored vaping products, which was supported by 60% of voters. In 2023 the market for e-cigarettes generated a revenue of $8.28 billion dollars, and continues to market flavored products that entice children and young adults.
The FDA did not force removal from the marketplace, and instead, allowed these vapes to be sold without strict regulation. Nationwide, the level of nicotine supplied via e-cigarettes has been shown to be increasing, and the duration for addiction to take hold can occur within only a few uses or days.
Imposing limits on the strength of nicotine in these products can help to reduce addiction rates in the youth population. A study from Nicotine and Tobacco Research, “Trends in Nicotine Strength in Electronic Cigarettes Sold in the United States by Flavor, Product Type, and Manufacturer, 2017–2022” states:
“From January 2017 to March 2022, the monthly average nicotine strength of disposable e-cigarettes increased substantially and exceeded prefilled pods since May 2020. E-cigarettes with menthol flavor and youth-appealing flavors, like fruit, also had sharp increases in monthly average nicotine strength. Among the top 10 e-cigarette manufacturers, monthly average nicotine strength increased or remained unchanged at a high nicotine level for all manufacturers’ products, except Juul Lab’s products. Comprehensive strategies including restricting sales of all flavored e-cigarettes, restricting youth tobacco product access, and imposing maximum limits on nicotine strength may help reduce youth e-cigarette use and increase tobacco cessation.”
What’s In ‘Em?
E-cigarettes contain volatile organic compounds (VOCs) that are carcinogenic, including nicotine, heavy metals such as nickel, tin, and lead, ultrafine particles that can be dangerous when inhaled deep into the lungs, and flavoring such as diacetyl, a chemical linked to serious lung disease.
A single cartridge can contain enough nicotine to equate to a pack of cigarettes, or more than the equivalent of 200 puffs, ensuring a highly addictive outcome within a very short time. In 2020, the CDC reported 2,807 cases of vaping use associated with lung injury (EVALI), and 68 deaths. The outbreak of lung injuries and deaths related to e-cigarettes and vaping was strongly correlated to products also containing THC. Specifically, the lung fluid of hospitalized patients contained high levels of vitamin E acetate, a chemical used as a thickening agent in vaping devices. Other chemicals used included the following:
- Diacetyl: A food additive, used to deepen e-cigarette flavors; known to damage small passageways in the lungs
- Formaldehyde: A toxic chemical that can cause lung disease and contribute to heart disease
- Acrolein: Used as a weed killer, this chemical also damages the lungs
A 2021 study, “Characterizing the Chemical Landscape in Commercial E-Cigarette Liquids and Aerosols by Liquid Chromatography–High-Resolution Mass Spectrometry,” published in the journal of Chemical Research in Toxicology found that people who use vapes are exposing themselves to a number of unknown substances that are not disclosed by the manufacturers and are at risk from severe adverse health outcomes. From “Johns Hopkins Researchers Find Thousands Of Unknown Chemicals In Electronic Cigarettes”:
“Existing research that compared e-cigarettes with normal cigarettes found that cigarette contaminants are much lower in e-cigarettes. The problem is that e-cigarette aerosols contain other completely uncharacterized chemicals that might have health risks that we don’t yet know about,” said senior author Carsten Prasse, an assistant professor of environmental health and engineering at the Whiting School of Engineering and the Bloomberg School of Public Health. “More and more young people are using these e-cigarettes and they need to know what they’re being exposed to.”
The first study of this kind using chromatography/high-resolution mass spectrometry, a chemical fingerprinting technique, mapped the compounds found in vaping devices, and summarized the research:
“The number of compounds detected increased from e-liquids to aerosols in three of four commercial products, as did the proportion of condensed-hydrocarbon-like compounds, associated with combustion. Kendrick mass defect analysis suggested that some of the additional compounds detected in aerosols belonged to homologous series resulting from decomposition of high-molecular-weight compounds during vaping.
Lipids in inhalable aerosols have been associated with severe respiratory effects, and lipid-like compounds were observed in aerosols as well as e-liquids analyzed. Six potentially hazardous additives and contaminants, including the industrial chemical tributylphosphine oxide and the stimulant caffeine, were identified and quantified in the e-cig liquids and aerosols analyzed. The obtained findings demonstrate the potential of nontarget LC-HRMS to identify previously unknown compounds and compound classes in e-cig liquids and aerosols, which is critical for the assessment of chemical exposures resulting from vaping.”
This study is compelling in that it disproves the theory that vaping and e-cigarettes are less harmful than cigarette smoking due to a lack of combustion or combustible chemicals. The findings prove that combustion does in fact take place, and chemicals not disclosed may be just as harmful if not more so in contributing to rapid onset lung disease and potentially even fatal outcomes in some patients.
It has long been established that smoking leads to cardio-pulmonary disease, and a study published in the New England Journal of Medicine, “E-Cigarette Use, Small Airway Fibrosis, and Constrictive Bronchiolitis” found evidence of rapid onset restrictive lung disease in patients.
“Popcorn Lung,” bronchiolitis obliterans (BO), has been found as a result of using e-cigarettes, and there is no treatment. It is directly linked to inhaling Diacetyl, which was used as a food additive to add the butter flavor to popcorn. When inhaled, it causes permanent scarring of the lungs’ small airways.This is conclusive evidence that the manufacturers are deliberately misleading consumers, and targeting youth with a highly dangerous product.
Choose You; Forgo the Cig
Though easier said than done, you can follow others’ success stories. One school of thought says in order to quit smoking or vaping, you need to give your body at least a week to adjust, and then it becomes a mental decision. Your body will need several days to detoxify from nicotine, and can begin to heal from the effects of this powerful addictive substance.
While it can be challenging to go “cold turkey,” it may be the quickest way to get over the mountain. Consider substituting something else in its place that may also serve as a stress-reducer, such as physical activity, walking in nature, or meditation.
Adaptogens, such as ashwagandha and turmeric, can be helpful for managing stress, and provide nourishment at the same time. Research has shown adaptogens have neuroprotective qualities to help manage the biological stress response, and can help to regulate the neuroendocrine-immune system.
Pull in support: Telling others you’re close to that you no longer vape may help give you a boost of empowerment, and that needed oomph and inspiration to change your behavior, and allow a transformation to occur.
Additional resources:
- Free online meetings at Recovery 2.0
- Natural Remedies to Help You Quit Smoking
- Truth Initiative: Quitting Smoking / Vaping
- Smokefree.gov: How to Quit Vaping
This article is not intended to give medical advice. Please consult your trusted healthcare provider.
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Published on August 17, 2023.
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