Meghan Snatchko started smoking at age 15 and was smoking regularly at 18. She quit while pregnant and didn't smoke from 2005 to 2009. But moments of stress and nicotine addiction kept enticing her.
Last January, the 31-year-old Coraopolis woman decided yet again to quit smoking to get into shape for the new year by running. She vowed to smoke but three cigarettes a week, but it edged up to four, then five, and eventually back to regular smoking.
"By June, my smoking started getting more out of hand, and I realized how stupid it was to run to get into shape while I was still smoking," Ms. Snatchko said. "It affects lung capacity, but I still wanted nicotine."
That inspired her to experiment with electronic cigarettes. It took time, but once she found the right flavor -- Snake Oil, which mixes pear and coconut cream -- with the right nicotine potency to suit her, she was able to quit smoking cigarettes.
"It's been extremely successful," she said. "I've tried cigarettes with friends to see what I'm missing. It's disgusting."
While most researchers say e-cigarettes seem to be safer than combustible ones, they're quick to add that research on the health impact of inhaling nicotine mixed with food-grade vapors is not yet known.
The key ingredients in the atomized vapors -- propylene glycol and vegetable glycerin -- are generally considered safe in food, but research is lacking on whether they are safe to inhale for the long haul.
The sale of e-cigarettes and the so-called flavorful "e-juices" containing nicotine are legal in the United States. Canada allows the sale of e-cigarettes, but bans the sale of e-juices containing nicotine.
The recent U.S. Surgeon General's report on smoking notes a need to regulate e-cigarettes just as cigarettes are, explaining that "the percentage of U.S. middle and high school students who use electronic cigarettes more than doubled between 2011 and 2012."
A major concern is that the sweet flavorings will draw teenagers into the nicotine habit that could lead to smoking.
The U.S. Food and Drug Administration currently hasn't approved any e-cigarette for smoking-cessation therapy as it has for nicotine patches, gums and other alternative ways for people to ingest nicotine without smoking.
E-cigarettes currently are not regulated as tobacco products. But the FDA is moving ahead with proposed regulations for e-cigarettes as tobacco products because they contain "highly addictive" nicotine.
In that sense, regulations would focus on product safety for users and nonusers alike, FDA spokeswoman Jennifer Haliski said.
Because they are not proven methods to help people to quit smoking, e-cigarettes are being marketed to current smokers as an efficient means to get a jolt of nicotine, even when smoking is prohibited. That's led to dual use, raising the concern that e-cigarettes are making it easier for people to continue smoking.
"The FDA is moving to release for public comment a proposed rule to regulate additional categories of tobacco products," likely including e-cigarettes, Ms. Haliski said. "The FDA cannot comment on the contents of the proposed rule."
"Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products," according to an FDA statement, which encourages users to report any adverse effects they experience with e-cigarettes.
The health of vaping
Roberta Ferrence, a University of Toronto expert on tobacco use, said there are two ways to look at e-cigarettes: "Look at the individual perspective. If a person is a smoker of regular cigarettes, would it be better for the person to use e-cigarettes? Based on our limited knowledge, it probably is, but we still don't know for sure."
And should people be inhaling the food additive, propylene glycol?
"It's used in food, but we don't inhale food usually. This is different, and it is a known irritant and so we don't know at this point" if it has other health effects, said the professor at Toronto's Dalla Lana School of Public Health and a scientist with the Centre for Addiction and Mental Health.
Nicotine in vapors versus combustible tobacco is another uncertainty. In vapor form, she said, the nicotine can produce a more immediate impact on the cardiovascular system, blood pressure, blood sugars and the heart. Nicotine in gums and patches, used to help people quit smoking, enter the body at a slower rate with far less dramatic effects.
Another major concern is the sweet vapor flavors e-cigarettes offer, which can entice kids, teens and young adults to try them and become addicted. The total cost of using e-cigarettes also is a third to a fifth of the price of cigarettes, adding to the appeal to younger people. The uncertainty is whether e-cigarettes will allow fewer people to break their smoking habit or entice more people to become nicotine addicts.
"We can't just focus on the individual," Ms. Ferrence said. "We need to look at the benefit to society. It could have a net benefit to some individuals but cause greater harm to the total population."
Assistant manager at Smoker Friendly and Cigar Express at 906 Fifth Ave., Uptown, Stephanie Cerniglia, 27, of McKees Rocks, said the store had only one or two people a day buying e-cigarettes or supplies a year ago but now e-cigarettes represent 30 percent of the store's business.
What's emerging is a growing culture of e-cigarettes, with various types of e-cigarette brands,
Disposable e-cigarettes, she said, cost as little as $4. But others are stainless steel, some with gems and electronic bells and whistles can up the price to $500 and even higher, other local e-cigarette retailers say. More expensive e-cigarettes feature puff counters; filters; and temperature, battery-charge, and remaining-supply gauges.
There's also interest in the ever-expanding choice of e-juice flavors. Flavors include fruits, mints, vanilla, foods such as pizza, desserts such as cheesecake, and chocolate, which Ms. Cerniglia said is her favorite, with mixtures thereof. There even are flavors, she said, that attempt to mimic the flavors of popular cigarette brands such as Marlboro and Camel.
Another factor is the percentage mix of vaporizing agents. Propylene glycol vapors cause a sensation in the throat and chest similar to cigarettes, while vegetable glycerin has no sensation, Ms. Cerniglia said. Most e-juices offer a 50-50 mix.
Ms. Cerniglia even said e-cigarette devices now include one the size of a police flashlight, filled with e-juice and higher battery power.
The love of vape
When she took to e-cigarettes, Ms. Snatchko started at an 18-milligram level of nicotine in the vapor, which is a moderately high amount. Some are 24 mg and even higher. But she's dropped to 6 mg with thoughts of reducing to 3 mg and even getting to the point of using e-juice with no nicotine.
Her e-cigarette is customized to include a Pyrex tank to hold the e-juice, a rechargeable battery to run the atomizer that turns the liquid into vapor, all organized in a black container that may only vaguely resemble a cigarette shape but which Ms. Snatchko describes as "a sonic screwdriver or big fancy ballpoint pen."
She said she feels her health is benefiting by vaping e-cigs rather than smoking regular cigarettes.
"I would feel anxiety before that I shouldn't be smoking and feeling guilty about it. It was a double-sided thing, to feel guilty, then get anxious about it when the next one was coming. Now I don't feel that at all. It's taking the anxiety and the guilt out of my life. I don't have it anymore, It's awesome."
Her own mother died at age 51, albeit not from smoking. Now a mother, Ms. Snatchko said, she wants to remain healthy for her son. Her lung capacity has improved by using e-cigarettes and she said she feels much healthier.
"I will be alive longer. I won't be gone because of cigarettes," she said. "It is something that can be prevented."
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