Popular smoking cessation medication Chantix has been linked to severe side effects, such as intense suicidal thoughts and violent outbursts. Still, it’s recommended by most medical and anti-smoking groups over electronic cigarettes.

The popular smoking-cessation drug, Chantix (known as Champix outside of the U.S.), has made headlines recently with news that using it can significantly increase suicidal thoughts.

Thomas J. Moore, a senior researcher at the Institute for Safe Medical Practices, found that Chantix is responsible for more adverse events than any other pharmaceutical drug on the market. Since 2010, the FDA has received reports of 544 suicides and 1,869 attempted suicides connected with taking Chantix.

Moore said patients have reported harmful side effects ranging from suicidal behavior to blurred vision, seizures, and blackouts. While studies report that smokers who are quitting are slightly more likely to experience suicidal ideation than the general population, it appears that Chantix increases these feelings disproportionately to other cessation methods.

Also troubling is the increased incidence of violence against others while using Chantix. A 2010 study conducted by Moore found that the violence tended to be unprovoked, directed at whoever was nearby, and was usually committed by users of Chantix who had no history of violence prior to taking the drug. Moore’s research led him to conclude that Chantix is eight times more likely to lead to suicidal ideation and behavior than other nicotine-replacement therapies such as gum or the patch.

Highest Warning

In 2009, the FDA put a black box warning on Chantix, though in 2011 it still disagreed with the findings of a study linking Chantix and suicidal behaviors. The black box warning is the FDA’s highest warning of danger associated with medication. Chantix’s label warns it “has been associated with reports of changes in behavior such as hostility, agitation, depressed mood, and suicidal thoughts or actions.”

Some believe this warning is still inadequate because it relies on physicians’ monitoring of patients for suicidal behavior. Dr. Michael Siegel, a professor at Boston University’s School of Public Health, explained to America Tonight:

In the case of Chantix, the black box warning is basically telling physicians, ‘Be careful because your patients might die taking this.’ What use is it to monitor patients for suicide? Once they commit suicide, it’s over.

Influential Donations?

Some believe the FDA is prone to being swayed by pharmaceutical contributions. Donald W. Light of the School of Public Health of the University of Medicine and Dentistry has this to say about the FDA’s standards:

[S]ince the industry started making large contributions to the FDA for reviewing its drugs, as it makes large contributions to Congressmen who have promoted this substitution for publicly funded regulations, the FDA has sped up the review process with the result that drugs approved are significantly more likely to cause serious harm, hospitalizations, and deaths.

E-cigarettes, on the other hand, appear to present a much safer alternative, not just to tobacco cigarettes, but apparently also to one of the leading FDA-approved smoking-cessation prescription medications.

Unrealistic Test Conditions

So far, there is no research conclusively showing that e-cigarettes are dangerous to mental or long-term physical health, and there is an abundance of research that suggests they are much safer than traditional tobacco cigarettes.

Despite the results of reputable research and scientific reviews that conclude that e-cigarette vapor contains many fewer harmful chemicals than traditional tobacco cigarettes, and that secondhand vapor is essentially harmless, unrealistic or implausible research conditions may result in misleading conclusions about e-cigarettes.

For example, a study published in The New England Journal of Medicine claimed to observe alarming levels of formaldehyde — a known carcinogen — in vapor produced at high temperatures. Sensationalized headlines from news outlets like the Washington Post and CBS read, “Lab tests imply formaldehyde risk in some e-cigarette vapor” and “E-cigarettes filled with cancer-causing chemicals.”

The problem is, significant amounts of formaldehyde are present only at temperatures higher than an e-cigarette can realistically reach without being damaged or that would produce an unpalatable vapor that no e-cigarette user would tolerate.

The study actually determined that at realistic, low-wattage levels, there was absolutely no presence of formaldehyde in e-cigarettes.

But, of course, that’s not what made headlines.

The New York Times’ Joe Nocera interviewed David Peyton, one of the study’s authors. He said:

When I read him the tweet from the New England Journal of Medicine — ‘Authors project higher cancer risk than smoking’ — he sounded horrified. ‘I didn’t see the tweet,’ he said. ‘I regret that. That is not my opinion.’

Unfortunately, the damage was already done.

Despite Hazards, Chantix Still Recommended

Most medical, public health, and anti-smoking groups continue to advocate the use of Chantix for quitting smoking, while not only rejecting e-cigarettes as a viable smoking cessation aid, but fervently discouraging their use among adult smokers.

Most major medical organizations are reluctant to recommend e-cigarettes, citing insufficient studies. Some, like the Tobacco Control Research Branch of the National Cancer Institute, insist there is no proof that e-cigarettes help with smoking cessation. Others say there is some possible proof that e-cigarettes help, but believe it is still inconclusive. Many organizations are reluctant to endorse a harm-reduction approach to quitting smoking that still involves nicotine delivery and an act that looks similar to smoking.

But what’s even more puzzling is that so many of these organizations — including the National Cancer Institute, the National Heart Association, and the Center for Disease Control, among others –- still endorse Chantix, which is known to have severe and even deadly side effects.

The Best Choice for Smokers

Smoking cessation is difficult for the average smoker. The goal should be to encourage smokers to quit smoking with methods proven to reduce morbidity and mortality, like e-cigarettes. Refusing to endorse e-cigarettes while endorsing a smoking-cessation method with proven harmful side effects seems counterintuitive. As Dr. Michael Siegel points out, this trend toward valuing complete abstinence over harm reduction is ultimately hurting smokers and their chances to quit.

This Wednesday, January 7th at 10am, NOLA City Council’s Community Development Committee is meeting on an ordinance that would ban smoking in all public workplaces in the city, but would also senselessly ban vaping everywhere “smoking” is banned. The ordinance would also exempt tobacco retailers from the “smoking” ban, but NOT specialty vape shops.

A similar ban was shot down in Westminster, MA in large part due to strong (but respectful) opposition at the city’s board of health meeting.

We’ll be heading to city hall on Wednesday, and we hope you’ll join us!

If you want to attend the meeting at city hall (1300 Perdido Street, 2nd Floor West), we are organizing free transportation from Crescent City Vape’s new Lower Garden District location at 9:15am on Wednesday:

Crescent City Vape
1224 St. Charles Ave, Suite B (at Erato Street)
New Orleans, LA 70130
(See the Facebook Event.)

Can’t make the meeting, but want to make your voice heard? Please send an email to our city council members voicing your thoughts on the proposed vamping ban! More info is available at the CASAA blog here.

Hope to see you bright and early on Wednesday!

Blowing clouds in my apartment.

How I Started Vaping

Like a lot of people, I got into vaping because I was a smoker and I wanted to quit. I smoked between a pack and a pack-and-a-half of Camel cigarettes a day. I never expected to be a smoker — in fact, during my teenage years I was aggressively against the idea of smoking. But few people develop an addiction on purpose.

An addiction to tobacco can sneak up on you. For me, a variety of things upped my cigarette usage. Getting into lawn care was a major factor. You’d think that after working a 16-hour day in the hot sun that the last thing you’d want is a smoke. But in fact, the difficulty of the job was the main thing that got me into smoking. Dealing with difficulty is why a lot of people turn to cigarettes.

But the statistics are brutally clear: If you keep smoking cigarettes for a long time, there is a pretty good chance they will kill you, or at least cause a serious and debilitating chronic illness. This was always on my mind while I was smoking. So after this past Mardi Gras, I did what a lot of people do in New Orleans, whether they are Catholic or not: I gave up something for Lent. I wasn’t going into this planning to quit smoking. I just wouldn’t smoke a single tobacco cigarette from Mardi Gras until April 17 — approximately 40 days — and after that I would see what happened. Setting this stubborn and precise line worked for me.

Why Vaping Has Helped Me Quit Smoking

I believe it wouldn’t have worked if I hadn’t decided to use vaping to curb the habit during Lent — I believe I would have slowly returned to tobacco. Instead, I began my vaping journey. I had no idea how far it would go.

I started with Green Smoke. I had purchased a few Blu and Njoy e-cigs in the past, and they didn’t do much for me. The Green Smoke cig-alikes were miles ahead of those two brands for me: Green Smoke had more options, lasted longer, and was more customizable. Soon enough I wanted to see what else there was out there. I went to a brick-and-mortar e-cig shop and bought my first “device,” a mysterious (and in my mind, silly-looking) Evod tank on top of an eGo battery.

At first, I totally loved the vapor, flavor, and nicotine hit I got from this thing. But I was a little embarrassed to be walking around with a weird-looking device. Quickly, though, I fell all the way down the vaping rabbit hole. (I use that term lovingly).

Soon I wanted to try variable voltage, and I wanted a dual-coil compatible tank like a Nautilus or an Aerotank. I wanted smaller but still powerful tanks like the Mini Protank 2. I made the shift over to high-VG e-liquids because their flavors were nicer and subtler, the throat hit was softer, and they produced more vapor.

I had heard vapers insist that rebuilding your own coils was superior. I tried an Igo with a tiny single air hole, built a mediocre first coil, and while the vape was better, I didn’t see what the fuss was about. When I bought a Kayfun, I realized what people meant. Even later, when I bought a Stillare, built a better quality and lower resistance dual coil, I was blown away. Each new step in vaping was a new, fun experience.

I learned about Ohm’s Law, battery safety, safe sub-ohming, mech mods, and regulated box mods. My experience with that first Igo versus my experience with a Stillare is a great example of what’s amazing about vaping. You only know what you like if you try new things and explore. Vaping is a personalized, educational, and endlessly entertaining pastime.

A Hobby That Can Save Your Life

The single most important reason that vaping keeps me away from cigarettes is the hobby aspect of it. The quest for a better vape experience is one of the most fun, engaging, and technically interesting hobbies to come along for me in a while. I learn more about vaping every day. I make my own e-liquid now, and perfecting this alone could take a lifetime.

Importantly, even with all the buying for this hobby, I still am spending quite a bit less than the $6-10 a day I used to spend on cigarettes.

Vaping and the Public

In the eight months since I bought my first cig-alike, the vaping world has exploded. Many people know more about e-cigarettes and don’t find them as weird as they once did. But, there is a strange animosity toward it, to the point that I have encountered more protests and doubts from strangers while vaping than I did while smoking.

Some smokers who quit cold turkey feel that they have quit smoking more correctly. And without a doubt, it’s harder to do and shows more willpower. But everyone is different, genetically and conditionally. Smoking has a much stronger hold on some than on others.

Quitting smoking is not a competition, it’s a life-saving goal. I can’t see the problem with relying on an aid to help you through an addiction. However you move away from cigarettes, it’s better when you’re there.

I have also encountered plenty of people who are simply fascinated by vaping, want to learn more, and are grateful to see more people moving away from smoking.

Where I Am Now

As for me, each new vaping discovery is still a pleasure. Right now I switch between a Big Dripper clone, a Tobh clone, a Stillare clone with a Chuff Enuff, and an iStick with a Magma or Veritas on top.

The big not-so-secret secret for me is that there is no vaping end game, and there shouldn’t be. I foresee a future, perhaps a long time from now, when few people smoke tobacco anymore because e-cigarettes are just that good.

It saddens me that many wheels are in motion — like proposed federal regulation — that jeopardize this possibility. But, it gladdens me to think of all the people who will turn to vaping out of desperation and come out on the other side with an exciting new hobby. So, for now — vape on!

I hit the streets of NOLA to chat about e-cigarettes.
Image by David Ohmer on Flickr

Vaping is rapidly growing in popularity here in New Orleans, which makes sense for a city that has the 24th highest smoking rate in the nation. But while many New Orleanians are turning to e-cigarettes to reduce or quit their smoking habit, others are still wary of this phenomenon.

There are many misconceptions about vaping, from claims that they contain antifreeze to claims that they are even worse than tobacco cigarettes. Controversy is bound to arise with a product that promises delivery of nicotine without the major drawbacks.

Cameron Christy, an instructor at Delgado Community College in New Orleans, said, “I dislike the idea of [e-cigarettes] and would never use them. I smoke cigarettes sometimes, and I like knowing that I am smoking a tobacco leaf and nothing else. I buy tobacco-only cigarettes. I guess I’m a purist in my bad habits. I have had a student light an e-cig in class to my complete shock.”

Catherine Spaulding, who works in the New Orleans Public Library system, said, tongue in cheek, “they look dumb — obviously the worst offense of all, right?” But she quickly got serious: “Smoke real cigarettes or quit. If you can’t quit cold turkey, slap on a patch and laugh at the pathetic huddled masses under awnings who aren’t as strong as you.”

Beneficial Alternative for Some

On the other hand, some New Orleanians consider electronic cigarettes a beneficial alternative. Isabelle Whitman, who doesn’t smoke or vape, is a graduate student in literature and a bartender on Bourbon Street. She prefers customers who use e-cigs instead of tobacco cigarettes: “There’s no cleaning disgusting cigarette butts that people have had in their mouths. They usually smell good, and that smell doesn’t stick to you like tobacco smoke.”

Mark Wayne, a New Orleans jazz musician and organizer, has found e-cigarettes to be a saving grace. “I consider myself a low-level activist for these things. As cigarette prices kept rising, I was angry. I felt like Big Tobacco had this control over me — tobacco buyers are specifically and aggressively targeted. So I switched to e-cigs and I love them.”

He stopped a two-pack-a-day habit, and the benefits were immediate and obvious. “My lungs cleared up. And my kids said ‘your voice sounds so much cleaner. I don’t hear you coughing anymore.’ ”

Smoking tobacco cigarettes is one of the most addicting habits in the world. It’s incredibly hard to quit, and Mark Wayne knows this from experience. “I lost my job and half my income and I went back to smoking tobacco. A stressful life has kept me on real cigarettes, though I also use my e-cigarette. It can still sometimes keep me off tobacco for a whole night.”

Liam Meilleur, a New Orleans native and an editor at the literary magazines Uncanny and Urban Fantasy, quit smoking altogether using e-cigarettes. He said, “When you can’t breathe, nothing else matters. Asthma and twenty years of smoking taught me that. So, what do I think of e-cigs? I no longer carry a rescue inhaler in my pocket, and I stopped filling my Advair prescription. I haven’t been to an emergency room for respiratory distress in over four years.”

Harm Mitigation

Anything that might mitigate the deadly consequences of tobacco smoking — responsible for more than 480,000 deaths in the U.S. annually — could be a major benefit to the public health of our city and the country. A 2006 study published in PubMed found that “Nonnicotine components [in tobacco cigarettes] provide many rewarding effects, often surpassing the direct effects of nicotine.”

This suggests that nicotine isn’t the only addictive component of a cigarette. The study’s authors found that the simple habit of holding a cigarette-like object and puffing on it could be an effective smoking cessation tool. This is a role e-cigarettes fill brilliantly: satisfying the nicotine craving, as well as the hand-to-mouth fixation and social element that many smokers enjoy. And while we don’t know whether e-cigarettes are 100% safe, the studies so far have shown that the vapor produced by e-cigarettes causes negligible harm to the user and bystanders.

Misinformation Sparks Alarmism

Despite the potential benefits, many New Orleanians have been quick to dismiss vaping. Meilleur said, “there’s so much misinformation and alarmist hand-wringing out there […] Almost every state has legislation under consideration that would ban e-cigs. These laws would force smokers to return to inhaling thousands of known carcinogenic and toxic chemicals — all in the name of protecting us from the possibility that e-cigs might not be 100% safe.”

New Orleans, a city balanced between great joy and great pain, is a little skeptical. However, many New Orleanians already feel their lives have been greatly improved, or saved, by e-cigarettes.

E-juice, also known as “e-liquid” or “juice,” is the liquid used in an electronic cigarette to create vapor and flavor. At Crescent City Vape, we believe it’s crucial for consumers to be informed about the health implications of electronic cigarettes – and, as the primary ingredient, that starts with e-juice. We hope this guide will provide some clarity on the contents and safety concerns associated with e-liquid.

What Exactly Is in My E-juice?

The most common ingredients in e-juice are vegetable glycerin, propylene glycol, nicotine liquid, and flavorings. Here’s a detailed breakdown of e-juice ingredients.

Vegetable Glycerin (VG)

• What is glycerin? Glycerin is an organic compound of carbon, hydrogen, and oxygen that is derived from oils and fats. It is used in a huge variety of pharmaceutical applications, including soap, botanical extracts, skin products, and cough mixtures. There is no chemical difference between vegetable glycerin and any other form of glycerin — the “vegetable” part means the glycerin was derived from plant oils.
• How is VG used in e-juice? In the world of e-cigarettes, VG is mostly used as a dilutive, which means it dilutes the other main components of nicotine and flavoring. It also is a carrier, spreading the flavor evenly throughout. Flavors in VG tend to deepen as the liquid is aged.
• How does VG affect my vaping experience? Having a juice with a high VG content produces a softer, smoother throat hit when inhaled than one made with propylene glycol. VG produces noticeably more vapor than PG. VG also has a slight sweetness to it, so that having a higher VG content can increase the sweetness of the inhale. At the same time, VG can reduce or slightly mute the specific flavor of a juice. For example, you may taste a less pronounced strawberry flavor with a higher-VG juice. For many vapers, this flavor-reduction effect is negligible, and is worth the benefits of using higher VG. Among vapers who drip their juices and use more advanced rebuildable atomizers, there is generally a preference for the subtler flavor and higher vapor production of aged, high-VG juices.

Propylene Glycol (PG)

• What is propylene glycol? PG is another common main ingredient in e-juice. It is a diol (or double alcohol compound), which is most commonly used in binding with polymers to aid in the production of plastics. While used in plastic production, PG itself is rated as food-safe by the FDA.
• How does PG affect my vape?  PG is more watery and less oily than VG. PG is a great carrier liquid in e-juice, bringing out more of the specific flavor. An e-liquid with higher propylene glycol content will be harsher on the throat and will also produce less vapor than one with higher VG.
• What is PG allergy?  Some people have negative reactions to higher-PG juices. This is commonly called PG allergy. It can cause a range of symptoms, including sore throat, sinus problems, headaches, or nausea. Note that some of the same symptoms can be caused by the withdrawal from quitting smoking, so if you are having these issues, it’s worth experimenting to find out if switching to higher-VG juice is better for you, or if the symptoms go away on their own as you reduce your tobacco smoking. 

Nicotine Liquid

• Where does nicotine liquid come from? Nicotine liquid is extracted from tobacco and can either be pure and flavorless — a simple nicotine additive — or can be made to taste like the tobacco leaves from which it was extracted.
• How does nicotine affect my vaping? A higher nicotine content increases the nicotine buzz and also increases a juice’s throat hit. When vendors talk about the amount of nicotine in an e-juice, they refer to the number of milligrams per milliliter, meaning that if you get “18 nic” or “18mg,” there are 18 milligrams of nicotine in every milliliter of e-juice. The nicotine level in e-juice can range from none (0mg) up to 36mg/ml, usually in increments of 3mg/ml. It is commonly said that 18mg/ml provides nicotine equivalent to that of a standard tobacco cigarette.

Flavorings

• What’s a flavoring? Flavorings are the natural or artificial flavors in a carrier liquid used to give an e-liquid its flavor and scent. Some flavors are naturally extracted from the source, whereas others use esters and other ingredients to replicate flavors like “peanut butter cup” or “jolly rancher.” PG and ethyl alcohol are the two most common carrier liquids used in flavorings. All of these components are GRAS, or generally recognized as safe by the FDA.
• Some other ingredients occasionally used in flavorings are:
  • Triacetin, a food-grade flavor carrier, is occasionally used in e-liquids. It has been found to be safe for inhalation by animals.
  • Acetyl propionyl and acetoin are used to create creaminess in flavors like custard or peanut butter. Diacetyl was once used in place of these components for the same purpose, but it has been removed from most vendor’s e-liquids because it has been shown to cause bronchiolitis obliterans, or “popcorn lung.” Acetyl propionyl and acetoin are virtually always diacetyl-free, except for tiny amounts in some rare scenarios.
  • Caffeine is sometimes included in e-liquids, with claims that it replicates the results of consuming caffeine in coffee. Though this is not proven either way, it has been argued that given the amount of caffeine that can proportionally be included in an e-liquid, the amount of caffeine actually consumed via inhalation is not enough to produce a noticeable effect. Besides this, nicotine has been shown to deplete caffeine more rapidly in the body, essentially cutting the caffeine’s effects in half while nicotine is also being consumed.

  Is E-Liquid Safe? Examining the Health Effects of E-Juice

  A common phrase in any discussion of vaping these days is that “we just don’t know yet” about the health effects of e-juice vapor. This is not entirely accurate — many studies have been conducted showing some of the elements we are inhaling when vaping an e-cigarette. Below are some of the common e-juice health concerns and some quick discussions of them.

  Formaldehyde and Acrolein

  • What are formaldehyde and acrolein? These are potentially carcinogenic (cancer-causing) chemicals that are present in a great variety of day-to-day applications. Your body produces formaldehyde naturally, although this alone does not indicate that it’s safe to inhale additional amounts of the chemical. There is a natural amount of formaldehyde produced by the methane gas in the earth’s atmosphere, but human activities have increased these amounts. Formaldehyde is thought to be produced by the heating of VG in e-liquids. Acrolein is another chemical that is natural, but increased by human environmental activity. Acrolein in vapor probably comes from the heating of the propylene part of PG.
  • Are they unsafe in e-cigarettes? In short, no, they almost certainly are not. For one thing, many of the studies only found these chemicals in e-cig vapor when running e-cigarettes at such a high heat that the liquid generally could not wick fast enough, causing a “dry burn.” More importantly, the formaldehyde and acrolein contents have been shown to be significantly less than the amount that is officially considered safe for frequent exposure in a workplace environment.

  Heavy Metals

  • What are they? The relevant heavy metals include tin, lead, and aluminum. An article published in the scientific journal PLOS ONE found a presence of these metals in the vapor produced by an e-cigarette.
  • Is this something to worry about? Again, no. The amounts these metals were found to be in safe levels for frequent workplace exposure.

  Nicotine

  • Is it harmful? Because nicotine is the chemical most often associated with cigarettes, many people think that it causes cancer or is otherwise harmful. In fact, nicotine itself, while physically addictive, is not considered a carcinogen.
  • Can you overdose? It would be extraordinarily difficult to overdose on nicotine by vaping. A human would need to consume around 500mg of nicotine or more to overdose, and this would essentially require consumption by drinking, or spilling nicotine liquid on your skin without washing it off. On that note, while e-liquid has nicotine in greatly reduced amounts, it’s important to be extremely careful about handling your e-liquid and keeping it away from pets and children.
  • What about dehydration? There are some indications that nicotine can cause dehydration, although as an extremely rare and possibly unrelated symptom. Still, anecdotal reports from vapers imply that vaping itself can cause dehydration. So, when vaping, be sure to drink plenty of water — which is something you should be doing anyway.

  These studies do indicate that vaping is not a perfectly safe habit. But cigarettes are definitively proven to include more than 70 carcinogens in toxic levels. At this point in time, all studies show that the potentially harmful elements found in e-cigarette vapor are not present in harmful levels. The bottom line is that so far, it appears likely that vaping e-juice is much safer than smoking tobacco. There you have it: That’s what scientists currently know about what’s in your e-juice and how it may affect you. Now that we’ve got that covered, there are over 150 flavors of e-juice waiting at Crescent City Vape — surely one of them is your all-day vape. Come and find it!