Illness. Death. Bans. What’s next for vaping in Columbus?
Ambrose McDonald just wanted his dad to stop smoking.
McDonald, 23 of Columbus, was a teenager when he figured that his father might take to vaping if he started first, and he was right.
His father put down cigarettes for good, and eventually, he stopped vaping. But the younger McDonald kept at it and is now sponsored by two vaping companies. He has about 700 Instagram followers who can watch him blow vapor rings and show off his equipment. If customers use his promotional codes to buy vape juices online, he gets paid.
McDonald has pledged to quit before his daughter’s first birthday because “it’s an addiction that needs to be kicked.”
But he’s worried about people who could be like his father. People who might turn to vape products to stop smoking — one of several parties who might get caught up in the legislative fallout as the result of a dozen or so deaths and more than 1,000 lung injuries tied to e-cigarettes and vaping.
Politicians, medical experts and vapers in central and western Georgia are evaluating what the health concerns mean for smokers, teens who shouldn’t be able to purchase the products — but do — and vape shop employees trying to make a living.
Across the nation, attempts to limit use and access to certain e-cigarette products continue as vaping-related illnesses and deaths have become more prevalent. But Georgia lawmakers have said little about what that means for the state or what measures they would support to address vaping here.
What local, state lawmakers are saying
As of Oct. 1, 18 people have died nationwide as a result of vaping-related lung injury, and one of those confirmed fatalities was in Georgia, according to the CDC. A total of 10 vaping-related illnesses have been reported across the state.
The Georgia man who died was over the age of 35 and did not live in the metro Atlanta area, according to a report from the Atlanta Journal-Constitution. He had a history of heavy nicotine vaping but no history of vaping THC, the main mind-altering chemical found in marijuana.
Patients affected in Georgia were 18 to 68 years old — with an average age of 26 — and 78% of them are men. None of the Georgia cases were from the Columbus area as of Sept. 27, according to the Georgia Department of Public Health.
President Donald Trump announced in September that he wants to ban the sale of most flavored e-cigarette products. New York, Michigan, Rhode Island and Massachusetts have all issued a ban of some sort, Time Magazine reported. Other states like Illinois are considering legislation that would ban most flavored vaping products and outlaw e-cigarette use in indoor public spaces, according to the Chicago Tribune.
A lawmaker who represents Georgia, though, told the L-E that he believes flavors aren’t the most concerning issue with vaping.
“I worry the focus on flavors ignores the reality that it needs to be harder for underage people to obtain these products in the first place,” said U.S. Rep. Sanford Bishop, a Democrat whose district includes portions of Columbus and Macon. “Many of the people who have died from vaping-related illnesses were using counterfeit products not regulated by the FDA, which needs to be investigated. Any legislation regarding flavor bans needs to take into account the adults who are fighting a very real and deadly addiction to cigarettes, many of which are flavored as well.”
Republican U.S. Sen. David Perdue is a co-sponsor of the “Preventing Online Sales of E-Cigarettes to Children Act” but did not say if he would support a flavor ban in Georgia.
“Senator Perdue considers this to be a very broad, multi-faceted issue that will require input from researchers and the public health community,” according to a statement from Perdue’s spokesperson.
Gov. Brian Kemp did not respond to questions from the Ledger-Enquirer on whether he would consider a flavor ban or any other action regarding vaping in Georgia.
However, Kemp, along with the state Department of Public Health, is urging people to follow the CDC’s recommendation to consider not using e-cigarettes or other vaping devices while investigations are ongoing.
“Without knowing the specific cause of the vaping-associated illness, discontinuing use of e-cigarettes and vaping devices is the best prevention against becoming ill,” the statement reads.
State representatives Bonnie Rich, R-Suwanee, and Gerald Greene, R-Cuthbert, announced Thursday they will introduce legislation in 2020 to address vaping and e-cigarette use.
“It has become increasingly clear that vaping and e-cigarette use has become a major public health concern that we must address here in Georgia,” Greene said in a release. “I hope that by taking legislative action next session, we can prevent future vaping-related illnesses and deaths in our state.”
Some boards, counties and other municipalities in Georgia and elsewhere have already prevented vaping in public spaces.
In July, Atlanta implemented a far-reaching ban on smoking and vaping in restaurants, bars, workplaces and other public places, the Atlanta Journal-Constitution reports. Other larger cities like Augusta and Savannah have already included vaping in their smoking ordinances. The Board of Regents of the University System of Georgia adopted a 100% tobacco-free policy in 2014 that includes the use of vapes and e-cigarettes.
In Columbus, the city manager’s policy prohibits city employees from smoking or vaping on city property, City Attorney Clifton Fay said.
A smoke-free air ordinance that would have prevented smoking and vaping in workplaces and public spaces was proposed in 2017, but it was not passed by the Columbus Council.
Councilors Evelyn Turner Pugh, Judy Thomas, Bruce Huff and Evelyn “Mimi” Woodson asked Fay to draft the ordinance. Proponents and opponents of the measure swamped council meetings. The measure stalled, according to Fay and L-E archives.
Woodson said she hasn’t thought about reintroducing the ordinance in light of the illnesses.
“I’ll have to back with you on that one,” she said. “I haven’t really thought about it.”
What bans mean for local vape shops, customers
Mike Reynolds was in his mid-thirties when he started puffing on cinnamon, cola, mint chocolate and vanilla custard. Reynolds, a co-owner of Columbus’ Rivertown Vapor, was a smoker for two decades. He said vaping was the only thing that got him to stop.
He said business has been up and down over the past several months. But news about the deaths is slowing traffic even more.
“Smoking kills hundreds of thousands of people a year,” he said. “It’s just crazy to think that now a lot of people think vaping is more dangerous than cigarettes — which in my mind is just absurd.”
E-cigarette use is not approved by the U.S. Food and Drug Administration as an aid to quit smoking, but Harvard Health Publishing cites a February 2019 study that supports the idea that vaping may help some smokers quit.
Dr. Sebastian Montgomery, a second-year internal medicine resident at Coliseum Health System in Macon, said it took decades to see the damage associated with smoking cigarettes and decades more to change people’s perception of smoking. There’s still not a lot of data on vaping.
“The vape products have only been on the U.S. market since 2006 and it wasn’t really until about 2010 that it became more popular for use,” Montgomery said. “Overall, the truth is — we don’t know enough.”
The biggest concern to many in the medical community is the resurgence in smoking among young adults and teenagers, Montgomery said.
The FDA reports that e-cigarette use increased 78% among high school students (from 11.7% to 20.8%) and 48% among middle school students (from 3.3% to 4.9%) from 2017 to 2018.
A 2013-2014 survey reports that 81% of youth e-cigarette users cited the availability of appealing flavors as the primary reason for use.
The Muscogee County School District did not respond to questions asked by the L-E about vaping trends among students and if vaping is an issue at schools in the district. Principals at Kendrick and Carver high schools said their schools have not had any issues with vaping.
“Teens are more susceptible to many of the impacts of toxic substances as their bodies are still in development,” Montgomery said. They are perhaps, more importantly, more susceptible to the pressures of those around them. ... What we are seeing is in direct contradiction to the years prior to vape introduction to the market. Teens were turning against smoking cigarettes. It was no longer ‘cool.’ Vaping has changed this.”
Reynolds, the vape shop owner, said a better way to keep products out of the hands of children would be to limit where the items are sold, not ban certain flavors. A flavor ban, he said, would be detrimental.
“For the most part, dedicated vape shops do a good thing in carding people and turning away sales to minors that may not be getting done at some gas stations, convenience stores, online (and head shops,)” he said.
But a 2018 study of California vape and tobacco shops revealed that nearly half of the retailers didn’t check IDs, Reuters reports. Teen vapers are also using eBay and other online marketplaces to dodge age restrictions, online news network The Verge reports.
What are some health risks?
For older people who were smokers, it’s possible that vaping could be healthier for them over smoking. But the data just isn’t there yet, Montgomery said.
“A 60-year-old who was smoking cigarettes for years and has now taken up vaping likely has disease already proven to be caused by their cigarette use,” he said. “Vape-caused disease is not only hidden in these patients, but also potentially — and much more research is needed into this before we know enough to make any convincing statements — a safer alternative to cigarettes smoking.”
Teens and young adults, however, should stay away, Montgomery advises.
“Teens, on the other hand, are not smoking cigarettes and suddenly taking up vaping flavored and other adulterated pods. The end results are disease we would otherwise not be seeing in these individuals with few other medical conditions, making it easier to see the direct effect of the vaping on the patients,” he said.
Initially, the prevailing thought was that nicotine vaporized products were a safer alternative to smoking traditional cigarettes because there’s no tar, the particulate matter that is the main cause cancers and lung damage, Montgomery said.
But there are concerns from recent data, he said.
- Nicotine has known carcinogenic effects and can damage blood vessels over time.
- Flavoring could be pooling up in a user’s lungs, causing pneumonia
- “Second-hand aerosol” could affect people who are around vapers.
“Generally speaking, your lungs were made to breathe in clean air and anything that isn’t clean air is or has the potential to be damaging to your lungs,” Montgomery said. “Studies of these vape products have still found carcinogens in them. ...They’ve still found things like heavy metals … that’s not where your body can process it.”
Investigations into the vaping-related illnesses nationwide are being conducted by the CDC, the FDA and state health departments, according to the CDC.
Findings suggest products containing THC play a role in the recent outbreak but no single product or substance has been linked to all lung injury cases.
“This complex investigation spans many states, involves hundreds of patients, and involves a wide variety of substances and e-cigarette, or vaping, products,” the CDC writes.
The CDC recommends that users consider refraining from using e-cigarette or vaping products. Anyone who uses an e-cigarette or vapes should not buy products off the streets or add substances to products.
By the numbers
As of Oct. 1, 1,080 cases of lung injury associated with the use of e-cigarette or vaping products have been reported to Centers for Disease Control and Prevention from nearly every state and 1 U.S. territory. There have been 18 confirmed deaths, and more deaths are under investigation.
The CDC has complete sex and age data on 889 cases.
70% of cases are male.
81% of patients are under 35 years old.
The median age of deceased patients was 49.5 years and ranged from 27-71.
The CDC has information on substances used in e-cigarette or vaping products in the 3 months prior to the onset of symptoms in 578 cases.
About 78% reported using THC-containing products; 37% reported exclusive use of THC-containing products.
About 58% reported using nicotine-containing products; 17% reported exclusive use of nicotine-containing products.
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This story was originally published October 3, 2019 at 5:00 AM.