College-age students in Tucson and the U.S. are turning to e-cigarettes as an alternative to cigarettes, often unaware there are health risks.

Electronic cigarettes are not new devices, as they joined the U.S. market in 2007; however, sales continue to climb in 2017.

New research in the American Journal of Preventative Medicine shows sales of e-cigarettes increased in the U.S. between 2011 and 2015. Traditional cigarette sales still far exceed e-cigarettes, but the electronic devices have seen growing popularity.

The long-term health effects remain unclear, but there are already established short-term health risks of e-cigarette use, including throat and mouth irritation, coughing and nausea. And the chemicals in the “e-juice” often used in e-cigarettes can cause respiratory irritation, eye irritation, and problems with the central nervous system.

E-cigarettes are not regulated by the FDA, explained Alicia Allen, who is an assistant professor of family and community medicine at the University of Arizona. Even though e-cigarette products are available that say “no nicotine” on the label, no one is checking to see whether that claim is accurate, she said.

Allen said 18- to 24-year-olds have the highest rates of e-cigarette use in the U.S. And the devices and accessories are readily available to that age group in Tucson.

There are 13 smoke shops where electronic cigarettes, “e-juices,” and accessories can be purchased within a 3-mile radius of the UA. In the same radius, by contrast, there are eight Starbucks locations.

“A lot of the e-cigarettes contain nicotine, and when your brain is exposed to that you can become addicted to it, so that could be in terms of being addicted to e-cigarettes or traditional cigarettes,” Allen said. “If you don’t want to be a dependent cigarette smoker later in life, it might be wise to avoid e-cigarettes when you are younger.”

E-cigarette users should not assume the electronic devices are without health risks, echoed Judith Gordon, a UA professor of nursing.

There’s not enough evidence for health officials to say they’re harmless, she said. Some chemicals in e-cigarette liquids have been shown to cause cancer and other kinds of very serious illnesses in animal models, Gordon said.

Gordon helped develop an educational program called Click City: Tobacco, which is an online program used in Oregon public schools that’s designed to teach fifth- and sixth-grade students about the risks of tobacco use.

Gordon and Judy A. Andrew of the Oregon Research Institute are now updating the online program’s curriculum to address the hazards of Electronic Nicotine Delivery Devices (ENDS), better known as e-cigarettes.

Buzzwrapz

The UA enacted a tobacco-free campus policy in August 2014, and in April 2016 that ban was expanded to include e-cigarettes. But it hasn’t stopped some UA students from using them off campus.

Responding to the popularity of e-cigarettes among his peers, Erik Jacobsson, 20, a UA junior studying mining engineering, started an e-cigarette-related business with two fellow students in early March. He now uses e-cigarettes, too.

Jacobsson said he did not start using e-cigarettes until the Buzzwrapz LLC business started designing its product in mid-February, and he did not smoke traditional cigarettes previously. The business makes decorative wraps for JUUL e-cigarette devices.

Jacobsson acknowledged he doesn’t know anything about the health risks of using e-cigarettes compared with the health risks of smoking traditional cigarettes.

“I smoke them because they’re fun and a good buzz,” said his business partner, 21-year-old UA business management senior Jesse Lee. “I know it is kind of unhealthy but probably better than cigarettes.”

Lee also said he smokes e-cigarettes now but did not smoke traditional cigarettes before.

One of the most popular e-cigarette models among youth and young adults is the JUUL device. JUULpod juices contain nicotine, benzoic acid, glycerol, propylene glycerol, natural oils, extracts and flavor.

Lee, the chief financial officer for Buzzwrapz, said the company sold 210 Buzzwrapz to people across the country for their JUUL devices in the first week and half they were on the market.

They have a patent pending on their design. Lee said sales happen primarily online, but Buzzwrapz can be found now at the Metro Wildcat gas station on the corner of North Park Avenue and East Sixth Street.

The wraps are easy-to-apply vinyl stickers cut into a shape that will fit the e-cigarette. Lee said they got the business idea from a close friend who wanted a way to customize their JUUL device.

“This is just a trendy product and it might be over when JUUL changes their design,” Lee said. “The whole thing is just a joke and we’re making a ton of money.”

Lee said the Buzzwrapz students believe that if they don’t sell the products, someone else will.

E-juice

There are many brands and models of electronic cigarettes and vaporizers. Generally, the parts of an e-cigarette include the battery, the atomizer, cartomizer or clearomizer, and the drip tip or mouthpiece. A user will purchase a cartridge or a bottle of e-juice to put into their device to get flavored vapor when they inhale.

Allen said that although there is no real evidence to back it up, e-cigarettes are probably safer than traditional cigarettes, but they are not a completely safe choice.

“The main ingredients of the e-cigarette juice is propylene glycol and glycerin and both of those items have detrimental health effects when inhaled,” Allen said. “These chemicals are unique to the e-juice.”

Allen said makers of the e-juice products usually have a disclaimer on their website alerting people that propylene glycol should not be inhaled.

“The research that’s been done looking at what’s actually in the e-juice says there’s a lot of misreporting going on on the labels,” Allen said. “It’s really hard to be sure actually in the e-juice that’s being bought without it being regulated.”

Help quitting

Alec Bird, 19, a University of Arizona freshman studying pre-business, said he started using an e-cigarette two years ago.

“My mom was trying to get me to quit smoking cigarettes so she bought me an e-cigarette to quit,” Bird said.

Bird said he uses an e-cigarette more frequently than he used to smoke traditional cigarettes because he can use it in more locations. He said one time he used his e-cigarette in an airport and nobody batted an eye.

Bird said he knows there are two main chemical components of the e-juice that may not be good for you.

“I know that’s not an aspect you get from normal cigarettes, but I assume that it is not as bad as smoking traditional cigarettes. That’s why I started doing it,” Bird said. “Because I felt like it was better for me.”

Allen said many people have the misconception that smoking electronic cigarettes will help them quit smoking, or avoid smoking in the future.

“It might be fun to just try it and taste it while you are out with friends and stuff like that,” Allen said.

“I think it is kind of replacing traditional cigarettes. I think a lot of young people don’t like the taste and smell of traditional cigarettes, so e-cigarettes are a more attractive option.”

But e-cigarette users may be endangering others with second-hand vapor, just like second-hand smoke from traditional cigarette use.

“You can be inhaling all of the same chemicals that they are inhaling,” Gordon said.

“That’s part of what went into the inclusion of e-cigarettes in the tobacco ban on campus. This is why the task force recommended that e-cigarettes be banned on campus, because they don’t want to expose other people to somebody’s vapor.”

Another health issue related to e-cigarettes is that people can be injured by the batteries in the devices.

Also, flavored e-cigarette liquids are very appealing to little children and to pets, and ingesting the liquid could lead to poisonings because nicotine is poisonous if taken in large quantities.

“It’s used actually as a pesticide, so if a small child or a dog drinks a bottle of e-liquid, they could die,” Gordon said.

The message public health officials have for e-cigarette users? Proceed with caution, Gordon said.

“We haven’t learned enough, they haven’t been used enough for us to say they’re harmless.”

Brandi Walker is a University of Arizona journalism student who is an apprentice at the Star.