By Arlene Karidis, For The Baltimore Sun
It's lunch time, and William Brown has stepped away from his desk for a nicotine fix in the lobby of the building where he works. The city employee isn't allowed to smoke here, but he can vape.
He flips the switch on his sleek black electronic cigarette, with its digital readout to gauge the nicotine, and inhales. He sucks in on the plastic tip and blows out a big white cloud that dissipates fast. People pass by, but Brown says he rarely gets a reaction.
"E-cigarettes have gotten so popular that when you spew out vapor, people put one and one together," said Brown, who works for the Municipal Telephone Exchange. "Though a year ago, I got a lot of 'What the heck is that?' I would go through the spiel of how it works and how it helped me stop smoking."
Electronic cigarettes turn nicotine-laced juices into an inhalable vapor. The e-cigarette industry claims it's a safer way to take in nicotine, and they say e-cigarettes can help smokers quit. But skeptics aren't convinced. The U.S. Food and Drug Administration announced last week that it's seeking regulatory power over e-cigarettes, something it doesn't now have. Efforts to regulate vaping failed in the recently ended Maryland General Assembly session when a bill that would have treated e-cigarettes as traditional cigarettes died in committee. This week, the Baltimore City Council took up the issue when Councilman James B. Kraft, who represents Southeast Baltimore, introduced a similar bill that would ban e-cigarettes at all places where smoking is banned.
Kraft called e-cigarettes a "new threat" and said they "create an impression on the young that smoking is OK." It will likely be several months before the bill's fate is known.
For now, with no formal regulations about the practice, it's up to individual workplaces, restaurants and other businesses to determine whether vaping will be allowed on their premises.
"Legally, people can vape anywhere in Maryland. But policy is at the discretion of employers in the workplace, just as it is at the discretion of other public establishments," said Jeff Blumenfeld, who works at the Westminster corporate office of S.S. Vape, a chain that sells the devices and juices.
Blumenfeld likes to partake when he eats out. "I won't vape in family restaurants like Bob Evans or Chick-fil-A out of courtesy for people who are not comfortable with it. But I do it in every other restaurant I go to," he said, adding that if he gets a reaction, it is one of curiosity. He says he quit two packs a day of Newports, cold turkey, the day he bought his e-cigarette starter kit.
Gordon Harden, co-owner of Souris' Saloon in Towson, is happy to give vapers a place to partake of their e-cigarettes. "They are not breaking laws," he said. "It is not putting out an offensive odor or lingering smoke, and I have heard no complaints."
While some have no qualms, others are skeptical. "There is no conclusive evidence that nicotine heated in liquid is less harmful than nicotine burned in tobacco," warns Cynthia Hallett, executive director of the Americans for Nonsmokers' Rights Foundation. "It is not proven that secondhand exposure is not toxic. And because e-juices are not FDA-regulated, they have been shown to have varying degrees of nicotine and, sometimes, other chemicals."
And as e-cigarette use has risen, so have calls to poison control centers related to their nicotine—up from one call per month nationwide in September 2010 to 215 per month in February 2014, according to the Centers for Disease Control and Prevention. And just over half of those calls were for children under age 5.
"Use of these products is skyrocketing, and these poisonings will continue," CDC Director Tom Frieden said in a statement. "E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children."
With no federal or state guidelines to follow, some local employers and organizations are proceeding with caution.
Baltimore County employees were told in March that e-cigarette use at work is prohibited. Dr. Gregory Branch, the county health officer, advised, "Given the lack of scientific information regarding the safety of e-cigarettes, I believe it is prudent to treat them as we do regular cigarettes and tobacco products in the workplace."
The Johns Hopkins University has no organization-wide policy, but beginning this fall, vaping will be banned in student housing at the university's Homewood campus.
"The decision was made over concerns about nicotine, and in reaction to the fact that e-cigarettes... are now marketed to teenagers as an alternative to traditional cigarettes," said Dennis O'Shea, a spokesman for Hopkins Employees of LifeBridge Health cannot use e-cigarettes at any campus location. The practice is prohibited at all hospitals accredited by the Joint Commission, as mandated by that national organization.
Many employers are still contemplating policies, said Christine V. Walters, director of the Maryland Society of Human Resource Management.
"Some employers don't want to be the first to [formally approve vaping at work]. They feel like they don't have enough information, and they worry about people objecting to vaping," she said.
At the same time, she said, some managers are considering the possible benefits of allowing vaping, especially those who have workers who often take smoke breaks.
"A few ask themselves, why would they want to ban this if it does not violate the law, and if it could increase productivity by reducing time away from the job?" Walters said.
While Walters knows of no employers with a policy allowing e-cigarettes at work, there are people who can vape on the job. Among them is Shawn O'Connell, an employee of Coldwell Banker Residential Brokerage in Timonium.
"I vape at my desk. But I am discreet," he said. "I'm back in a corner, so there is little foot traffic, other than from the folks in the row of nearby cubicles.
All six of the full-time workers at Astral Roofing vape in their shop and on their clients' outdoor properties.
"We have had no complaints from clients, not even schools," said the Baltimore-based company's owner, Michael Allen, who is an ex-smoker of 43-years and an e-cigarette convert himself.
"My workers saw me vaping, and one by one they switched from tobacco to e-cigarettes," he said.
But e-cigarettes, in flavors from banana nut bread to Frappuccino, can be more than just an alternative to traditional smoking. Some, like Blumenfeld, found a hobby in vaping.
"People buy, sell and trade the mods, which are the battery compartments," he said, noting that he has spent about $10,000 on this pastime.
"But I am a high-end collector," he said. "I get the rare, serialized mods from around the world. I like the variety and am especially a fan of brass."
While it's socially acceptable to vape in social circles like Blumenfeld's, there are still unanswered etiquette questions—especially where there is no clearly stated policy.
Carol Haislip, director of the International School of Protocol in Towson, has advice for vapers and nonvapers.
"I would treat [vaping] as I would smoking traditional cigarettes for now," she said. "If you use them when you are in public, ask if there is a policy. If you are unsure, I would not do it. If you do not [vape], and have concerns, I would also check with an authority to find out if there is a policy. If e-cigarettes are allowed, ask to be moved if you are uncomfortable."
Baltimore Sun reporter Luke Broadwater contributed to this article.
Quick facts about e-cigarettes
How do electronic cigarettes work?
A typical device includes a battery, a cartridge that holds the "e-juice," and a heater that vaporizes the nicotine in the juice. The vapor enters a chamber, is drawn out of the e-cigarette, and inhaled into the lungs.
What's in the juices?
Most e-juices have four basic ingredients: vegetable glycol, propylene glycerin, food flavoring and nicotine. However, the products are not regulated by the FDA, so they can contain ingredients that are not on the label. Ingredients can vary from brand to brand and even within brands. The American E-liquid Manufacturing Standards Association does offer guidelines for its members with regard to nicotine level, purity of nicotine and other ingredients, and restricted additives.
Is it safe to use e-cigarettes?
The e-cigarette industry and some research suggest vaping is safer than smoking tobacco because the vapor does not typically contain the same chemicals that are in tobacco smoke. But their safety has not been extensively tested, including whether heating some flavorings creates potentially dangerous new chemicals and byproducts. And there is no evidence that nicotine does not have the same effects in e-juice as in traditional cigarettes.
According to the FDA: "Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products." Scientists are investigating potential long-term health effects on users and bystanders.
Do e-cigarettes work as a smoking-cessation tool?
Many people claim they have quit smoking with long-term success by switching from conventional cigarettes to e-cigarettes. Study findings vary. The Lancet reported in September 2013 that e-cigarettes were "modestly effective" in helping smokers quit tobacco products, with results similar to nicotine patches.
BMC Public Health reported in 2011 that e-cigarettes aided in "substantially decreasing cigarette consumption."
JAMA International Medicine (March 2014) reported e-cigarette users did not have greater success quitting than those who did not use them.
Currently, no e-cigarettes have FDA approval as a therapeutic device for smoking cessation.