Triangle schools, businesses deal with growing popularity of e-cigarettes

Angel Garcia vapes with his electronic cigarette in the vapor lounge at E-Cigs, an electronic cigarette store, Friday January 31, 2014 in Cary, N.C.
Angel Garcia vapes with his electronic cigarette in the vapor lounge at E-Cigs, an electronic cigarette store, Friday January 31, 2014 in Cary, N.C.

The Wake County school board is expected to vote Tuesday on whether to ban something that many parents probably already thought was against the rules: electronic cigarettes.

Duke University has barred them except in designated smoking areas, and the city of Raleigh and Durham County are considering similar rules for their buildings.

E-cigarettes, battery-powered devices that heat a usually nicotine-laced liquid into an inhalable steamlike vapor, have become popular so quickly – and are still such a mystery to many who don’t use them – that local governments, bars, restaurants and private employers across the Triangle have been caught off-guard.

Some are scrambling to enact restrictions even before there is solid science about the health effects. Others simply haven’t noticed anyone “vaping,” the term for using the devices.

They will.

U.S. retail sales of e-cigarettes more than tripled last year to a projected $1.7 billion. Sales are expected to continue soaring as major tobacco companies push aggressively into the market. Analyst Bonnie Herzog of Wells Fargo in New York has predicted the market could top $10 billion by 2017 and eventually eclipse traditional cigarettes.

As the popularity of electronic cigarettes grows, some are beginning to treat them like traditional smokes. The U.S. Food and Drug Administration is expected to propose new guidelines on things like the marketing of e-cigarettes in the next few weeks. New York City passed a ban on their use in most public places in December, and Chicago followed suit in January.

But in the Triangle, the suddenness of the boom, the lack of knowledge about e-cigarettes’ effects on health and the discreet nature of vaping have helped create a patternless patchwork of places where there are and aren’t rules. An informal N&O survey of about 20 businesses, local governments, university campuses and private companies in the Triangle found that only a few had rules about using e-cigarettes, and many hadn’t even considered the idea.

This means “vapers” are often left to guess where they can puff, while being as discrete as possible in case they’re wrong. And their fellow patrons in restaurants, malls, movie theaters and other venues – not knowing the rules, and unsure of any health risks from secondhand vapor – are left wondering whether to complain.

“It’s being regulated kind of Wild West style,” said Molly Brown, who works at a store in Cary called E-Cigs. “A lot of times, it just comes down to who’s perceptive and who’s not.”

E-Cigs customer Michelle Mankin said she puffs in her favorite bar, and even vaped while waiting for a plane at Raleigh-Durham International Airport recently, but mainly avoids it in places where she knows regular cigarettes are banned, or sneaks off to a bathroom stall. That’s easy, because they emit little smell, and the vapor vanishes quickly.

If it were more clear where vaping is allowed, she would likely do it more frequently in public places, but for now it’s usually not worth the risk of a dirty look or confrontation, she said

“Teenagers are bolder, and you’ll see them walking around with it at the mall or wherever, just not giving a hoot,” she said. “But I don’t like to be the center of attention.”

Among large private employers, SAS Institute in Cary bars e-cigarette use, but Red Hat in Raleigh and GlaxoSmithKline in Research Triangle Park have no specific rules about them.

The Triangle’s three major universities all have different approaches. Duke’s ban has been in place for more than a year, but N.C. State University has no policy on e-cigarettes. Nor does UNC-Chapel Hill, though it discourages their use in places where its policies prohibit smoking – inside and within 100 feet of buildings. But UNC allows individual facility managers to decide. For example, vaping isn’t allowed in the libraries or the Smith Center, and a ban is under consideration for Kenan Stadium.

Durham schools banned them in October, and the Chapel Hill-Carrboro school system also has a ban.

Increasing use in teens

School administrators, along with many public health experts, are concerned that the candylike flavors are luring teens into trying e-cigarettes. The percentage of U.S. high school students who had used e-cigarettes jumped to 10 percent in 2012 from 4.7 percent a year earlier, according to the U.S. Centers for Disease Control and Prevention. The percentage of middle school students who had tried them nearly doubled, to 2.7 percent.

This increase in use by children has created a concern that e-cigarettes promote nicotine use and are a gateway to smoking, said Dr. Adam Goldstein, director of the UNC School of Medicine’s Tobacco Prevention and Evaluation Program and its Nicotine Dependence Program.

It also was one reason that N.C. Attorney General Roy Cooper joined 39 other state attorney generals last year in writing a letter to the FDA urging it to regulate the advertising and ingredients of e-cigarettes, and to treat them as tobacco products.

“Many of these products are misleading people, especially minors, into thinking they are a safe alternative to smoking cigarettes,” Cooper said in a statement then.

The state legislature barred the sale of e-cigarettes to minors last year, but it also classified them as “vapor products” rather than tobacco products, something critics say could make it tougher to tax or regulate them in the same way.

Aid to quit smoking

Users say that research or not, e-cigarettes clearly make it easier to stop smoking, and that restrictions on using them can make it harder to kick the habit.

Mankin, who is the co-owner of a Meineke Car Care Center in Morrisville, said all nine people who work there, including herself and her husband, eventually stopped smoking conventional cigarettes after one worker came in with an e-cigarette last spring.

“First one guy started doing it, then another would ask him questions and try it, then a couple more,” she said.

She and her husband now allow their workers to vape on the job. That has increased productivity by eliminating smoke breaks, she said. And there’s no more risk of smoke-steeped mechanics transferring cigarette smell to the interiors of customers’ cars.

Mankin smoked for 28 years and had tried prescription drugs, nicotine patches and gum, even hypnosis in an effort to quit. With e-cigarettes she was able to quit smoking in June. Now she’s dialing down the amount of nicotine in the “juice” she buys. She started at a powerful level, 2.4 percent, and now is down to 0.3 percent and sometimes uses varieties with no nicotine, just flavoring.

Vaping may not be perfectly safe, but it’s surely safer than smoking, and that’s a clearly a good thing for society, said Alex Makam, co-owner of two E-Cigs stores, in Cary and Apex.

“What I started to realize when we opened the stores was that we’re in the business of quitting smoking,” he said.

Makam, who uses a vapor device built into his iPhone case, said it helped him kick the habit six months ago after smoking for 20 years. It’s because e-cigarettes offer such a similar experience to smoking – unlike prescription drugs, patches or nicotine gum – that they help smokers stop, he said.

But public health experts say more research is needed on the health effects of e-cigarettes and whether they truly are effective in helping smokers kick the habit.

Need for policy?

Goldstein said that among his patients who smoke, most have tried e-cigarettes. Some said it didn’t help and stopped using them. Others transitioned completely to e-cigarettes, but none of those have stopped vaping.

For breaking the habit, he said, the most effective methods include multiple measures such as prescription drugs to help fight addiction and nicotine patches along with behavioral counseling, something that people who switch to e-cigarettes on their own don’t get.

And the temporary dearth of solid science on e-cigarettes is no reason not to bar their use in public places, Goldstein said.

“There’s nothing wrong with enacting it and saying, OK, we can look at this in a year and change it if doing so makes sense,” he said. “That’s good public health policy.”

Back in 2010, restaurants and bars were ground zero in North Carolina for the war on second-hand smoke when they became the subject of a state-wide smoking ban.

With e-cigaretttes, though, there appear to be few problems. A spokeswoman for the N.C. Restaurant and Lodging Association said she hadn’t heard of any, and the topic had never come up in discussions with members.

In some places, vapers fly under the radar. Frank Heath, owner of the iconic Chapel Hill nightclub Cat’s Cradle, said e-cigarette users there have been so low-key that he hasn’t had any problems.

Chapel Hill Restaurant Group had not received a single report of someone trying to smoke an e-cigarette in any of its six eating establishments in Chapel Hill, Durham and Raleigh, said one of the owners, Greg Overbeck.

The company made its restaurants completely smoke free about two decades ago, before the state ban, but Overbeck said the idea of banning e-cigarettes simply hadn’t come up with his partners or restaurant managers.

He said that even without consulting his partners he could predict where they would come down on e-cigarettes.

“I feel pretty sure our policy would be that until there is more research showing absolutely no harm from the second-hand smoke, that we would not allow them,” he said.

Brown, who works at the Cary E-Cigs store, said her regular customers include cooks, tech workers and a lot of construction workers and painters.

She counsels customers to avoid devices with red lights, which make vaping look more like smoking, and are more likely to draw comments or ugly looks.

For the foreseeable future, vaping will take that kind of discretion and guesswork, said her boss, Makam.

“You can do it in more places than you can’t,” he said. “And the only way you can find out I guess is someone tells you.”