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After smoking for 30 years, Tammy Hosfield quit in May 2014. She had been smoking two packs a day — two to three cigarettes an hour.
“I tried the patch, nicotine gum, Chantix. I even called the Quit Line,” she said. “Nothing worked for me.”
Hosfield finally quit smoking after family members bought her a vaporizer — a refillable, non-disposable e-cigarette.
“After using the vape, I never touched a cigarette again,” she said. “It was just easy for me. It had the hand-to-mouth feel that the gum and patches just didn’t have.”
Over the past 18 months, Hosfield has cut her nicotine consumption in half. She has plans to quit vaping entirely.
Like Hosfield, many smokers have turned to vaping as either a mechanism for quitting smoking or because they believe it’s healthier than cigarettes. Yet others are concerned that vapes are marketed to teens and need to be regulated.
Meanwhile, their popularity is growing.
The Montana Department of Health and Human Services reports that e-cigarette use doubled among middle and high school students from 2011 to 2012 and quadrupled among U.S. adults from 2009 to 2010.
A DPHHS survey of Montanans found that 2 percent of respondents were currently using e-cigarettes, and 11 percent reported having used e-cigarettes in the past. The survey also found that 56 percent of respondents who used e-cigarettes used them to quit or reduce cigarette use. The other commonly reported reason was “to try something new.”
A Chinese pharmacist named Hon Lik first developed e-cigarettes in 2003 as a healthier alternative to smoking tobacco. He came up with the e-cigarette after his father, a heavy smoker, died of lung cancer. They’ve been on the U.S. market since 2007.
Vaporizers like Hosfield’s work by using a battery to heat a liquid called e-juice that can, but does not always, contain nicotine. The liquid evaporates, and the user inhales the vapor. The battery is usually controlled by a button that the user pushes while inhaling. Non-refillable, disposable e-cigarettes, often referred to as “cigalites,” more closely resemble cigarettes and are commonly sold in gas stations and tobacco shops, while vaporizers are typically sold online or in specialty shops.
Ron and Deanna Marshall of Bozeman opened their two local vape shops, Freedom Vapes, after they both successfully quit smoking using vaporizers two years ago. The couple runs their Bozeman location, and their son manages the Belgrade shop.
“Probably 95 percent of the people who come into our shops are looking for a way to quit smoking,” Ron said.
Despite some smokers having success quitting using vaporizers, Dr. Greg Holzman, state medical officer, said e-cigarettes have not yet been sufficiently evaluated to determine their effectiveness as a stop-smoking tool.
“Let’s get e-cigarettes approved by the FDA, and then we’ll have this conversation,” Holzman said.
Rather than using e-cigarettes, DPHHS suggests calling the Montana Tobacco Quit Line for free or reduced-cost access to FDA-approved quitting aids, such as nicotine gum, patches or lozenges.
Dominic Palazollo, professor of physiology at Lincoln Memorial University in Tennessee, studies e-cigarettes and e-liquids. He believes they are just as effective as any FDA-approved smoking cessation aid.
Smokers, he said, are more apt to vape because it doesn’t require a prescription, unlike many FDA approved aids. Plus, he said, and vaping is more cost-effective for people who do not have access to resources like the Quit Line.
E-juice is cheap because it is not regulated by the federal government and currently isn’t taxed as a tobacco product — though some state and local governments have begun regulating vapor products.
“The same amount of nicotine that you might purchase in a bottle of e-liquid that cost you $20 might cost you hundreds of dollars with FDA-approved methods of nicotine replacement,” Palazollo said.
The feds don’t regulate e-cigarette marketing or e-juice flavors. They don’t regulate the use of e-cigarettes inside buildings or prevent minors from buying vaping products. The only statewide e-cigarette law prohibits minors from using or buying vaping products.
Despite the state law, DPHHS worries that e-cigarettes are under-regulated, and this may encourage minors and young people to begin vaping. In particular, the department hopes to see Montana regulate the flavors used in e-liquids.
“If you’re marketing gummy bear and fruit punch, I don’t think that’s marketed to a 45-year-old man,” said Stacy Campbell, the department’s healthy lifestyles supervisor.
But the owners of Freedom Vapes beg to differ.
“Let’s have this conversation in the aisle of our local liquor store,” Ron Marshall said. “They have raspberry, blueberry, chocolate, all kinds of flavored alcohol drinks. Why? Because adults like sweet stuff too.”
The Marshalls testified in Helena on behalf of the Montana vaping industry in January and succeeded in preventing vapor products from being labeled as tobacco products. They intend to visit the Legislature again in 2017 to defend their right to use flavoring in their e-juice products.
Bozeman High School resource officer Mark Van Slyke said vaping is more popular than smoking.
“We do see e-cigarettes a lot, but from last year to this year, overall, smoking has gone down,” he said.
Van Slyke said he hasn’t issued a single minor in possession ticket for cigarettes this year, which is highly unusual. He said there have been a few vaporizers confiscated by the school, as they are not allowed on school grounds, but no tickets have been issued for minors in possession of vaping products.
“I’d like to think people are just quitting altogether,” Van Slyke said, but he suspects students may be leaving their vaporizers at home because the equipment can be expensive, and they wouldn’t want it confiscated.
Professor Palazollo said many teens who are attracted to vapor products are the same teens who would have otherwise begun smoking cigarettes.
“I’d be willing to bet that their parents smoke. And they’re thinking it’s less harmful than cigarettes, so they vape instead. And they’re right because vaping is less harmful than cigarettes,” Palazollo said.
Most scientists agree with Palazollo that vaping is less harmful than cigarettes. The British Department of Health released a report in August that urged smokers to switch to e-cigarettes, claiming that they are 95 percent less harmful than smoking tobacco. The report also supported the claim that e-cigarettes are useful stop-smoking tools.
Palazollo said the conversation among scientists is no longer about whether e-cigarettes are less harmful than tobacco cigarettes. The majority of e-cigarette research is focused on the harm e-cigarettes can cause and whether they can help people quit smoking, he said.
The four ingredients in most e-juices are propylene glycol, glycerin, nicotine and flavoring. Ron Marshall of Freedom Vapes said all ingredients used in the store’s e-juices are FDA-approved. With the exception of nicotine, the FDA labels all the ingredients as “generally recognized as safe.”
“I hate big tobacco as much as anyone. But we’re not selling tobacco. We’re trying to help people quit smoking,” he said. “If vaping would have been around 40 or 50 years ago, how many parents and grandparents would still be with us?”
The Marshalls are disappointed to see pushback from health officials because the couple believes e-cigarettes will play a major role in helping smokers quit and improving public health.
“Montana Quit Line is our biggest enemy right now. And it’s so sad that they are fighting us like this because I’ve seen so many people quit smoking with the vape,” said Deanna. “The reason I love this job so much is because someone will come in here, and they’re so frustrated because they’ve tried everything to quit smoking, and nothing’s worked. They never think that vaping is going to work either. We set them up with a starter kit, and they never touch a cigarette again. Rarely do you get someone who still smokes.”
Twenty-nine-year-old Nate Stansfield is one smoker who continuously struggles with quitting, even with the use of a vaporizer. Like many smokers, he tried nicotine gum and lozenges before ever trying e-cigarettes.
Stansfield was able to quit smoking for periods of time using vaping, but he believes he hasn’t quit smoking completely because vaping products were not totally safe or reliable when he started using them in 2011 to cut down his 14-year, pack-a-day smoking habit.
“Until last year, vaping equipment was laborious and unreliable,” Stansfield said. “Now days, anyone who wants to quit smoking can go into a vape shop, buy a starter kit for around $60, and have everything they need to vape reliably and safely.”
Because of improvements in vaping equipment, Stansfield plans to quit smoking with vape in the near future. He said he knows dozens of people who have quit smoking using the new, improved vaping technology.
“I only know a handful of people like myself who have not been able to quit smoking cigarettes entirely using a vape,” Stansfield said. “My highest hope for quitting smoking is vaping. It’s just the easiest thing for me to transition to.”
In the past, he has quit for up to six months with the aid of a vape. He is confident in his ability to quit smoking with a vape now that the technology has improved, he said.
“The biggest thing that vaping has proved to me is that I can get through the day without a cigarette,” Stansfield said. “I want to make sure that the option to vape is around to help people quit smoking. I don’t want to see local vape shops taxed out of business because of e-cigarette regulation.”