Hartford Business Journal Special Editions

By Karen Ali Special to the Hartford Business Journal T he vaping industry added nearly $512,000 to the state's coffers last fiscal year, but not every- one thinks that's a good thing. Proponents see vaping — which typically involves a battery-powered device that produces a nicotine- laced vapor or aerosol inhaled by the user — as a less harmful alternative to smoking, and some studies have started to bear that out. But health experts in the state said they aren't yet ready to endorse the practice as a tool to quit smoking. Barbara Walsh, supervisor of the state Department of Public Health's Tobacco Control Program, said that long-term health effects of Electronic Nicotine Deliv- ery Systems, commonly called e-cigarettes or vaping, are not yet known. "We also know that the aerosol from [e-cigarettes] can contain ingredients that include ultrafine par- ticles, volatile organic compounds, such as benzene, a known carcinogen, and heavy metals, such as lead and tin, so DPH continues to work on smoke-free policies that include protections from exposure to secondhand aerosol as well as secondhand smoke," Walsh said. One UConn Health doctor is trying to build on the growing body of research on vaping and its health ef- fects, good or bad. Dr. Mario Perez, UConn's assistant professor of medicine at the Pulmonary, Critical Care and Sleep Medicine Department, is conducting a study that seeks to determine differences in how smoking and vaping impact airways. He said inflamed airways is one of the negative effects from smoking conven- tional cigarettes, so he is try- ing to determine if vaping has similar effects. As part of the study, he's as- sessing 50 vapers and compar- ing their results to 50 conven- tional cigarette smokers and 25 non-smokers. Other studies, Perez said, have shown that vapers may have increased upper airway respiratory problems — cough, sore throat, etc. — and recent- ly at least three studies have linked vaping with asthma in teenagers. Perez is currently collecting preliminary data. He started enrolling study participants earlier this year and plans to continue through this coming spring. One of Perez's study subjects is Geraldo Santiago, 24, of Hartford. Santiago, who works as a security guard, said he visited his UConn Health doctor after experiencing chest pain. He had only smoked cigarettes for about four months, but had been vaping nicotine for longer, about three years. A full CT scan didn't reveal anything to worry about, but his doctor recommended the study to him, which pays its participants. Santiago said he views vaping and smoking as "kind of the same thing," but he wants to stick to vap- ing because he views it as a healthier option. "It's just the fact that cigarettes contain way more chemicals than vape juice does," he said. Lesser of two evils? Many vaping proponents, including some doctors, believe vaping is a safer choice than smoking. England's public health department in 2015 said it believed vaping is 95 percent less harmful than smoking. Last year, the Royal College of Physicians said in a report that nicotine inhalation itself is "inherently unlikely" to contribute to the mortality or morbidity caused by smoking tobacco. "The main culprit is smoke, and if nicotine could be delivered effectively and acceptably to smokers without smoke, most if not all of the harm of smok- ing could probably be avoided," the report said, while acknowledging there are still uncertainties about the long-term impacts of the relatively new practice of vaping. But plenty of skepticism about vaping remains, particularly as a quitting tool. Former U.S. Surgeon General Dr. Vivek Murthy issued a report on vaping last year that said "evi- dence supporting the effectiveness of e-cigarettes as an aid for quitting conventional cigarettes remains extremely weak for adults and untested and nonexis- tent among youth." The report concluded that further research is needed, a task made more challenging by an array of factors. "The huge variety of products of different origin and design, the rapid emergence of new products, and the varied ways in which con- sumers use these products make the development of standard mea- surement conditions challenging," Murthy's report said. Perez shares Murthy's skepti- cism about vaping as a cessation strategy. "I do believe that further re- search is highly needed … as these products are accessible to the general public and very popular among school-age children," he said. The Smoke Free Alternative Trade Association, which rep- resents vaping stores in Con- necticut and other states, does not believe government regulation should treat vaping products the same as tobacco products. The Association's website argues that vaping prod- ucts are "the solution to a public health scourge." Vape Debate Doctors grapple with where e-cigarettes fit in for smoking cessation PHOTO | BILL MORGAN PHOTO | OLEGGG, SHUTTERSTOCK.COM UConn Health's Dr. Mario Perez collects a mucus sample from Geraldo Santiago, who is part of a study to determine some of the health effects of vaping. Electronic vaping is rising in popularity. THE GREATER HARTFORD HEALTH CARE RESOURCE GUIDE • Fall 2017 5

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