Story by Katie Rice
Video by Tierra Marsh
Photos by Brian Batista
Graphics by Sarah Sharpe
CHAPEL HILL, NORTH CAROLINA — Daniel Horbich takes a drag off his e-cigarette, and it crackles as the coil heats the liquid. He breathes out a white cloud, which evaporates into the living room of his apartment over couches, cat toys and vials of vape juice clustered on the table.
Horbich has been vaping for two years. At 32, he’s dealing with the consequences of smoking cigarettes between the ages of 13 and 29. At 19, he was diagnosed with restrictive lung disease, which restricts his lungs from fully expanding, and knows every flare-up of his condition could be his last.
He often smoked two to three packs of cigarettes a day, and vaping gave him the ability to quit cigarettes that nicotine patches, pills and cold turkey never did. Aided by his e-cigarette, he was able to quit smoking over the course of a year. Vaping allows Horbich to relax without causing as much damage to his lungs — and no, it doesn’t cause him any breathing problems, he said. In fact, it’s done the opposite.
“When I picked up vaping, a lot of my episodes of coughing fits or having trouble breathing cut down immensely, from every morning to once a month,” he said.
Vaping has become so ubiquitous in the United States that it’s not uncommon to find a vape shop in every shopping center. The increasing visibility of vaping raises questions about the safety and popularity of the product, especially among young adults.
Popularity among teens
The 2017 Youth Risk Behavior Survey conducted within Chapel Hill-Carrboro City Schools found tobacco use and e-cigarette use for high school students in the past 30 days decreased from 19 to 13 percent.
However, the study found the percentage of middle school students who used a vapor product in the past 30 days increased from 1 to 3 percent. The trend of children trying vapes younger is worrying, said Mehmet Kesimer, associate professor of pathology and laboratory medicine at the UNC School of Medicine. Kesimer is concerned that vaping is a gateway to cigarette use.
“Most of the vapers in that age, in the middle school and high school age, they end up starting cigarettes,” he said.
Kesimer is a member of the Tobacco Center of Regulatory Science and the Marsico Lung Institute. Last year he co-authored a study that found vaping induced a similar immune response in the lungs as smoking. These proteins respond to inflammation and are found in the lungs of long-term smokers who develop respiratory illnesses like chronic obstructive pulmonary disease. More research is needed to establish a definitive link between vaping and lung diseases, but these results suggest vaping may not be as safe as people think, Kesimer said, especially since the FDA doesn’t regulate flavored vape liquid.
Aside from being a gateway to smoking, research says vaping is not an effective way for people to quit smoking, Kesimer said. People who use vaping as a cessation device have a 35 percent success rate of quitting cigarettes entirely.
“Less about disaffected young people”
Alex Letica started smoking when he was 18, after a summer working in the restaurant business exposed him to a culture of heavy smoking. He transitioned to vaping after nine or 10 months of smoking, and quit vaping after a year. Letica is now 21 and a senior at UNC-Chapel Hill.
“I have asthma, so it (smoking) was really aggravating it, and I thought vaping would aggravate it less than actually smoking, but over time it still sort of had the same effect,” he said.
He quit after he tired of having a near-constant cough while vaping, and he realized his budget couldn’t sustain the habit. He credits his current state of relatively good lung function to the fact that he spent the majority of his nicotine habit vaping instead of smoking.
Letica admits that he started smoking and vaping because he was young and easily influenced, but he said he thinks a lot of teenagers and young adults don’t have the same attraction to nicotine products. He said he thinks vaping especially has become uncool as it has become more mainstream.
“Hipster bros with their, you know, their scarves and beards started doing it more, and it was less about disaffected young people staring into the night sky while they vaped,” he said.
Legislation
State Rep. Gregory Murphy, R-Pitt, is a sponsor of House Bill 435, which proposes gradually raising the minimum age for purchasing tobacco products and vapor products to 21.
Murphy said it’s been found that 90 percent of people who become addicted to nicotine and nicotine products do so before the age of 21, and he hopes this bill — which has been sent to the Rules Committee but has not yet been heard — will reduce that rate.
Tobacco use is an “adult decision,” he said.
“We would prefer that we can get people out of high school before they feel like they need to try these type of products,” he said.
Murphy is a practicing urologic surgeon at Vidant Medical Center in Greenville, North Carolina. The only physician in the North Carolina General Assembly, he sees the health effects of tobacco use firsthand. He considers vaping to be a bridge to nicotine addiction and tobacco use.
“It still is a nicotine product, it still is an addictive product, and to say that it is any less dangerous is disingenuous at best, and it still will continue to foster a lifelong propensity for using tobacco products,” he said.
Durham’s vape culture
David Traister owns RTP Vapor in Durham. RTP Vapor’s clientele are Research Triangle Park employees of all ages — except minors, Traister emphasizes. Most of his customers are people who used to smoke cigarettes but switched to vaping, but there are a few vapers who have never smoked cigarettes.
Traister was a smoker for 20 years, and he said he tried everything to help himself stop before he discovered vaping in 2014 and never looked back. In almost four years of operating RTP Vapor, he’s seen many customers start vaping to quit smoking.
“People really have success with vaping to stop smoking,” he said. “I think I’ve personally seen hundreds of people that have stopped smoking.”
Vaping is not as harmful as smoking, Traister said, and the research he trusts proves it. He follows vaping research, and he prefers the findings of the Royal College of Physicians of London because the researchers are, in his words, “less tainted” by the lobbying power of big tobacco than those in the United States. Research published by the Royal College of Physicians in 2016 found e-cigarettes are effective at helping smokers quit smoking, and the health hazards of long-term vaping comprise around 5 percent of the harm of smoking tobacco.
“The way I’d like to see the future of vaping is that it will be recognized as a legitimate smoke cessation device,” he said.
In the meantime, vape culture provides a welcoming space for people to relax and share a common interest, and vape shops help foster and grow the culture.
“I think the vape shops are like, what used to be the barbershop, where people come and feel more free to talk and express their opinions and just relax a little bit from the everyday,” he said.
A frequent customer at RTP Vapor, Horbich said he has connected with others through vaping and appreciates the support network other vapers provide, especially since a lot of vapers are ex-smokers like himself.
If more research were to be released proving vaping was unhealthy, Horbich said he’d like to say he’d quit, but he doesn’t anticipate quitting. After all, he smoked cigarettes for over a decade knowing their health risks.
“I like it personally,” he said. “So if I change it, it’s my choice, but I don’t see me doing that anytime soon.”
