Up in smoke: How vaping might save smokers

Throat hits, unicorn milk and clouds of vapour billowing in the streets. E-cigarettes are changing the face of smoking, but vapers are trapped in a curious legal limbo, writes Lee Umbers.

Throat hits, vaper's tongue and unicorn milk.

Welcome to the world of vaping, the e-cigarette phenomenon rising as rapidly as the clouds of vapour billowing out of the mouths of users throughout New Zealand.

Vaping is the use of a battery operated device to heat a liquid into an aerosol then inhaled as mist.

Ben Pryor, who owns e-cigarette retail Vapo, estimates New Zealand has 100,000 to 200,000 vapers, as people continue to look for ways to quit smoking tobacco.

"The growth we have seen has been exponential," says Pryor, who founded Vapo about three years ago.

Yet regulations around the industry are as cloudy as vape smoke itself. The sale of nicotine-based products for e-cigarettes is illegal in New Zealand. But the Ministry of Health confirmed there have not been any prosecutions over this.

People can import up to three months' supply of nicotine-containing e-liquids for their own use, but cannot sell or supply them.

However, vapers tell the Herald on Sunday they can easily get e-liquids containing nicotine at some vape stores. It leaves a murky legal situation where the law is broken in plain sight, but there is no political will to police it.

Vapo is a kind of ground zero in this curious legal limbo.

Streams of vapour spout forth dragon-like at the testing stand at Vapo's K Rd store as customers trial richly flavoured e-liquids.

Flavours such as apple pie, butterscotch, chai tea and tiramisu, as well as brand names like Unicorn Milk (strawberry and cream), add to the novel appeal.

Trained staff mingle with clients, helping them select e-liquids and choose e-cigarette devices varying from pen-shape to stylised box-shaped mods.

Vaping supplies at Vapo, Karangahape Road, Auckland. Photo / Michael Craig

Customers may prefer a "mouth to lung" vaper — the vape being drawn into the mouth first and then pulled into the lungs in a second motion, more closely resembling cigarette smoking. Or want a "straight to lung" vape, which can produce huge amounts of vapour.

And they experiment with which "throat hit" — the feeling of inhalation — suits them best.

"A big part of starting your vaping journey is making sure you have the right hardware and the right e-liquid for you," Pryor says.

He started Vapo as an online business from his Auckland home, but now boasts stores in Mt Eden, Onehunga, Karangahape Rd and Takapuna. He supplies non-nicotine e-cigarette products to 62 SuperValue and FreshChoice stores and 20 Countdowns, Pryor says.

Many similar stores have sprung up — Shosha, Vaporized, the Vape Merchant and more; all promising a healthier life.

Vapo has a wide range of customers, Pryor says. "We designed our stores and our service to cater to all ages and demographics."

But it will not sell to anyone under 18. And it will only sell to ex-smokers.

"Our staff are trained not to supply products to people unless they are looking to substitute vaping for cigarettes.

"I smoked for about four years. It started off as social smoking but began to build into more than that before I swapped out cigarettes for vaping."

Vapo recommended customers switch immediately, "without supplementing vaping with smoking, as our experience has shown this has the highest success rate for those looking to eliminate smoking altogether". "In saying that, every customer is different so we offer personalised support to help people on their vaping journey."

That journey can include finding out how to overcome "vaper's tongue", a temporary diminished sense of taste during vaping.

Costs of starting vaping can be as low as the price of a packet of cigarettes, Pryor says. Vapo offers a vape device with a disposable pod of e-liquid he says has the equivalent puffs to at least two packets of cigarettes for $29.

Mitchell Lowe, general manager at Vapo, Vaping supplies, Auckland. Photo / Michael Craig

Vapo's own e-liquids cost $18-$20 for a 30ml bottle "that will last approximately one week for an ex-pack-a-day smoker [depending] on what device the vaper is using".

The e-liquids are produced from pharmaceutical-grade propylene glycol/vegetable glycerin and food grade flavouring.

As each flavour is designed it is sent to an Australian laboratory for safety testing.
"We have invested heavily in an ISO7 certified laboratory and emissions testing through an independent laboratory to ensure our products are of the highest quality," Pryor says.

Vaping "has to be one of the fastest-moving industries in the world with regard to innovation". "In the last couple of years we have seen an extraordinary leap in technology."

There is also a strong feeling of community among vapers.

"Transitioning from smoking to vaping is a significant achievement and this provides a strong foundation for the community aspect of vaping. It seems everyone is willing to help others out and provide support for new vapers.

"We witness customers every day helping out new customers and we encourage a community based environment in our stores."

E-cigarettes are in the unusual position of the technology having left the science, and the law, far behind.

National had planned to change the law regulating e-cigarettes, proposing legalising the sale of nicotine products and introducing regulations such as restricting their sale to people 18 and over.

Associate Minister of Health Jenny Salesa told the Herald on Sunday that is under consideration by the new coalition Government.

Nicotine is banned in e-cigarettes in Australia unless approved by a doctor. The UK regulates the strength and amount of nicotine being inhaled.

"I don't believe it is a secret that nicotine e-liquid is available in the market," Pryor says. "The most important thing for retailers is to understand they owe a duty of care to the customers.

"As these products are not currently regulated in New Zealand, it is the responsibility of companies selling e-liquid to ensure customers receive products of a high standard and are given the necessary education at the point of sale to use these products safely and effectively.

"Taking strong precautions during this period of uncertainty will give New Zealanders the best chance of accessibility to these potentially life-changing products in the future — the benefits of which we have seen in the UK where now 3 million vapers no longer smoke."

Vapo's range of flavours are a great hit. Photo / Michael Craig

Pryor, who believes regulation is paramount, says legislation on the burgeoning e-cigarette industry is "squeezed" between the Medicines Act 1981 and the Smoke Free Environments Act 1990.

"There is a need for clarity around the scope of restriction of nicotine-containing products", he says, including "e-liquids containing synthetic nicotine or nicotine derived from sources that aren't tobacco".

The legal situation is complicated by the lack of research into whether e-cigarettes help people quit long-term and what lasting impact they have.

A survey of Kiwi vapers, led by Massey University senior lecturer in environmental health Dr Penny Truman, found most people started smoking e-cigarettes to quit smoking tobacco. And for the majority, it worked.

The 2016 online survey recruited 218 people, ranging from under 20 to about 70, through vaping and quit-smoking networks.

Almost all had been smokers, but three-quarters no longer smoked and the remainder had significantly reduced their tobacco use. Three weren't smokers before starting vaping and they hadn't gone on to smoke tobacco.

Participants experimented widely with different vaporisers and e-liquid strengths and flavours during their transition from smoking to vaping.

"There was an exploratory stage," Truman says. "They didn't always switch completely straight away."

But once they found the right device and e-liquid, most managed to quit smoking tobacco.

Many of the participants were "very enthusiastic" about vaping.

"Why were they enthusiastic? Because [vaping] had really helped them to stop smoking. That was a huge message that came across, that there was a large number of people who felt that way."

Dr Lindsay Robertson, from Otago University's department of preventive and social medicine, agrees e-cigarettes are a significant reason the face of smoking is changing.

"They [have] grown in popularity worldwide, over quite a short amount of time."

But she is the lead author of a new study by Otago University that found switching from smoking to vaping can be a challenge for some.

A number who made the change to quit smoking still regularly used traditional cigarettes because of a strong attachment to and nostalgia for the "real deal", the study found.

"For some people it was 'my vape device feels different in my hand', or 'it tastes different', or 'it's just not the same with a vape and a coffee as opposed to a cigarette and a coffee'."

For many, smoking was "a very ritualised thing". "People like the feel of the [cigarette] packet, and unwrapping it."

Smokers "had gone into their quit attempt thinking vaping would be that perfect match, and it wasn't".

"So I think the important thing is to help smokers understand that to better prepare them."

Vaping supplies at Vapo, Karangahape Road, Auckland. Photo / Michael Craig

Some younger participants in the study reported being influenced by negative portrayals of vaping in social media, Robertson says.

"These are social smokers — they'll only smoke cigarettes when they're drinking with friends. They actually, somewhat surprisingly and concerningly, saw smoking as more acceptable and they thought vaping was embarrassing or stigmatised.

"So when they were out socialising at weekends, they would choose to smoke a standard cigarette rather than take their vape out with them. They didn't want to be seen doing it in public."

Older participants, heavier and long-established smokers, didn't report any stigma associated with vaping, however.

"They were very, very proud — that they had either quit smoking completely or they'd significantly reduced the number of cigarettes they were smoking. They were quite happy to be vaping in public."

Robertson says there are not yet long-term studies on the effects of vaping. But "as far as we know, based on the evidence that's available now, vaping and e-cigarettes are considerably less harmful than smoking tobacco".

Getting good advice from well-trained retailers with specialist vaping knowledge would be useful in making the transition, Robertson says.

There have also been concerns that although vaping may solve the smoking problem for many, it could lead others into a new addiction.

Professor Janet Hoek, from Otago University's departments of public health and marketing, recently completed a presentation on vaping uptake among non-smokers.

Hoek stresses her survey, based on 18 people who vaped at least once a month and had never smoked regularly, is "not a population-level sample". But it showed young non-smoking Kiwis had taken up vaping.

"The first is that they're really curious about it — here are these unusual new devices, people puffing out large aerosol clouds of vapour.

"The flavours are also incredibly appealing. There's just an enormous array of flavours that people can choose from. Young people find these really quite tantalising."

There were also a smaller number "who saw smoking as a way of managing stress but didn't want to take up smoking".

Pryor first came across vaping when he was on an internship at an intellectual property firm in Europe, after completing an LLB and BSc in psychology at Otago University.

"I saw a dramatic uptake in vaping in countries where e-cigarettes were actually more expensive than smoking. This led me to realise that perhaps continual price increases were not the only answer to decreasing smoking in New Zealand."

"We find if our customers can vape for two weeks without smoking they find it difficult to even smell second-hand smoke. It's amazing how sensitive you get to cigarette smoke when you aren't inhaling it over 20 times a day."

The Government maintains changing the law is a balancing act. Salesa warns e-cigarettes' potential to improve public health depends on how much they can help New Zealand's 550,000 daily smokers out of smoking — without being a route to smoking for children and non-smokers.

"Expert opinion is that e-cigarettes are significantly less harmful than smoking tobacco but not completely harmless," Salesa says.

"A range of toxicants have been found in e-cigarette vapour, including some cancer-causing agents but in general, at levels much lower than found in cigarette smoke, or at levels that are unlikely to cause harm."

What is vaping?

• Electronic cigarettes are generally comprised of a tank with a built-in "atomiser" - a coil of wire wrapped around a wick - and a battery.
• The tank is filled with "e-liquid", which comes in a range of flavours. Some e-liquids contain nicotine.
• This is absorbed into the wick while the wire is heated by the battery. The heat then vaporises the liquid in the tank, which is then inhaled by the user who produces smoke-like vapour when they exhale.
• There are a vast array of vaping devices available, some looking like traditional tobacco cigarettes.