by Derek Kreider
Editor’s note: On Sept. 3, Summit County Public Health issued a news release warning people to stop vaping. “The immediate dangers of vaping are becoming increasingly evident and alarming in Ohio and across the nation,” the release said, citing a recent spike in cases of severe respiratory illnesses among teens and young adults who vape. Their symptoms include coughing, fatigue, dizziness, headache, chest pain and difficulty breathing. If you have a history of vaping and experience breathing problems, SCPH encourages you to seek medical care.
Wadsworth-based Awesome Sauce Vapor is a cog in a much larger cultural machine.
As a vape shop, it represents the next step in a long and arduous battle with the tobacco industry. It also represents, for some adults, a way to wean themselves off traditional cigarettes as they attempt to reduce the harm done by their nicotine addiction.
At the same time, there are now people who start vaping with no prior history of nicotine usage. In 2013, 13.5% of Summit County high schoolers reported smoking a cigarette in the last 30 days, according to the county-wide Youth Risk Behavior Survey. In 2019, that number was down to less than 6% — but 25% of high schoolers had used an e-cigarette in the last 30 days.
Yelp lists some two dozen vape shops in the Akron area. Convenience stores, gas stations and plenty of other retailers carry vaping products too. These shops face twin pressures from state and federal regulators, who seek to limit sales to young buyers, and from a tobacco industry that wants a piece of the action.
And all the while, experts say, nobody knows for sure what the health impacts of vaping are going to be. But the Ohio Department of Health has asked healthcare providers to make reports whenever a patient who vapes develops a serious pulmonary illness.
‘When they’re happy, they’re going to… quit smoking,’ shop owners say
Bill and Shemara Samaco, the affable duo who own Awesome Sauce Vapor, firmly believe that the products they sell can help people kick smoking habits. Bill, an ex-smoker whose addiction lasted 33 years, was unable to beat his habit until he discovered the world of electronic nicotine delivery systems, or ENDs for short.
Even after discovering a method of nicotine delivery that could have eliminated traditional cigarettes from his daily routine — specifically “cigalikes,” which are cartomizer e-cigarettes that look as much like traditional cigarettes as possible — Bill struggled to find a product that was right for his needs.
At first, he was unable to find a product that properly simulated the aspects of smoking he was attached to, like the harshness of the smoke hitting the back of the throat. He soon went back to cigarettes. It wasn’t until vaporizers became more prevalent that he was able to find something that worked for him.
And even then, it took time to get it right. “Back then, a starter kit was a hundred bucks. I’m two or three starter kits in before they give me what actually will help me,” Bill says. But he found a device that helped and never looked back.
Anytime a new customer comes to one of Awesome Sauce’s five locations, they can expect to be asked about their smoking habits and their goals for vaping. “[The staff] excel at matching the person with the product right out of the gate,” Shemara says.
“We’re not going to sell somebody who smokes three packs a day a starter kit pen that’s $40,” Bill adds. “When you can get someone [paired with] something that you know they’re going to do well with, it’s really cool, because they’re happy. When they’re happy, they’re going to keep using it and quit smoking.”
No one at Awesome Sauce is claiming that e-cigarettes are healthier than cigarettes. Neither Bill nor Shemara make any claims relating to the effects their products have on a user’s health or their effectiveness as cessation tools. They speak only for their experiences, the couple says.
The showroom in Northwest Akron is ringed with several long display cases with crystal-clear glass that house tanks, kits, coils and accessories. Behind the gleaming display cases is an astounding array of e-liquids, the substance through which nicotine is delivered.
The sheer amount of product and the constellation of colors on the shelves made these e-liquids seem more complicated than they are. There are only four ingredients in an e-liquid: Propylene glycol, vegetable glycerin, pharmaceutical grade nicotine, and food-grade flavorings. It’s the ratios of the ingredients that create the differentiation in product.
The goal at Awesome Sauce is to help people kick the habit, its owners say — even if that means losing them as regulars because they’ve left behind their nicotine addiction. (This isn’t a new concept within the tobacco industry. For decades, tobacco companies have expected certain percentages of their patrons to die from using their products each year.)
When running a business that supplies an addictive substance, it seems counterproductive to encourage someone to quit using that substance. Still, Bill says, “That’s the whole goal behind this… Even if we know that they’re not going to quit, we do everything we can to get them on the lowest possible nicotine we can.”
If something were to happen to the vape industry, Bill’s hope is that they’ve gotten customers onto a product with a low enough nicotine content that they won’t head to the gas station to buy a pack of cigarettes out of desperation.
E-cigarettes facing increasing regulation
That’s more of a concern now than it was when Awesome Sauce opened four years ago. Since then, the FDA and public health agencies have pushed for more stringent regulations on the products that make up the vaping industry.
And they’ve gotten it.
In May 2016, e-cigarettes, hookahs and cigars became subject to the same rules as cigarettes and smokeless tobacco. With the passing of this rule, intended to enact the full strength of the Family Smoking Prevention and Tobacco Control Act, the whole of the tobacco industry — including the burgeoning e-cigarette market — fell under the purview of the federal government.
How can an e-cigarette be a tobacco product when it contains no tobacco? The FDA addressed this by noting that nicotine is obtained via the tobacco plant and that e-cigarettes deliver nicotine to the user, therefore they’re technically tobacco products.
More importantly, the FDA deemed them just as addictive as cigarettes or other methods of nicotine intake.
“Some doctors say they’ll prefer their patients — if they’re going to smoke — I’ve heard some doctors publicly state that they’d prefer their patients smoke an e-cigarette over a traditional cigarette… but there really isn’t a long-term data really anywhere for us to know what the long-term effects are going to be from e-cigarettes,” says Cory Kendrick, Policy and Legislative Affairs Manager for Summit County Public Health. “It took decades for us to discover how impactful traditional cigarettes are to someone’s health. Unfortunately for people who are the first generation and second generation of [vape users]… there could be some dire long-term consequences from using e-cigarettes as well.”
Although the long-term effects won’t be well understood for decades, Cory says the body absorbs nicotine from e-cigarettes more easily than it can from traditional cigarettes, meaning the body gets a stronger dose of the chemical. Also, it’s easy to smoke e-cigarettes more frequently than traditional cigarettes. For those reasons, “They’re way more addictive than traditional tobacco products,” he says.
Awesome Sauce Vapor doesn’t make its own e-liquid, so it isn’t subject to some of the FDA’s new rules. But their suppliers are.
It remains to be seen just how e-liquid manufacturers will cope under the new FDA guidelines. Bill worries that the increased regulation will lead to a resurgence of black market e-liquids. E-liquids need to be made in a clean-room environment in order to ensure that the ingredients in the liquid don’t become compromised by outside contaminants. If an e-liquid is manufactured and sold with the wrong ingredients at the wrong ratios, it could lead to serious, unintended consequences, such as a nicotine overdose.
In 2016, the FDA estimated that the entire process required to test market readiness would take 17,000 hours of labor and cost $1 million. That’s why Bill fears that heavy regulation and taxation will phase out smaller, independent stores like theirs.
A quarter of Summit County high school students now vape regularly
It’s true that Awesome Sauce is providing people with a way to continue their nicotine addictions. They’re also providing a service that works, at least for some, as a means for smoking cessation.
But as the industry grows, so does the number of underage people who are using e-cigarettes and vaporizers. In July, Ohio Gov. Mike DeWine signed a bill into law that makes it illegal to sell cigarettes and e-cigarettes to anyone under age 21, up from 18.
In the 2019 Youth Risk Behavior Survey conducted by Summit County Public Health, 42% of high school students reported having ever tried e-cigarettes. In the last 30 days, 25% of students had used e-cigarettes. And about 11% had tried them at age 12 or younger.
“When the Juul came on the scene, that’s really when it started getting popular,” Kendrick says. “It almost started off with a lot of social media buzz. Kids taking photos of doing it in class and that sort of thing. It just kind of caught on in the last couple years as more socially acceptable for young people to do it, and the smaller, sleeker products made it easier for it to be hidden.”
Among Summit County teens today, “Vaping is almost double what our smoking rate was five years ago overall,” Kendrick says.
For years, it’s been common knowledge that nicotine isn’t healthy. According to a 2012 study conducted by the U.S. Department of Health and Human Services, “Nicotine exposure during adolescence can disrupt normal brain development and may have long-lasting effects, such as increased impulsivity and mood disorders.”
The public health officials backing greater regulation of vaping, including this summer’s push to raise the legal age of tobacco purchase to 21, say they’re looking out for young people who may not have ever started smoking cigarettes, but who now use nicotine regularly.
But their primary concern isn’t vape shops, Kendrick says — it’s gas stations and corner stores.
In 2013, Kendrick says, survey data showed that “37% of kids could just walk into a store and purchase [vapes], that’s how they were getting them… Truthfully, it’s not really these vape shops that the kids are going into. Most corner stores and retailers sell Juuls now. If you go to any gas station, you’ll see a sign for a Juul starter pack for X dollars posted outside Circle K, Dollar General — any of those stores sell them now. I’d imagine that’s where most people are getting their stuff.”
For adult smokers, however, e-cigarettes may offer an opportunity for harm reduction. The National Academies of Science, Engineering and Medicine published a report in 2018 titled “The Public Health Consequences of E-Cigarettes.” The report’s authors wrote, “There is substantial evidence that — except for nicotine — exposure to potentially toxic substances from e-cigarettes is significantly lower compared with combustible cigarettes.”
While that report offers support to anecdotal reports like Bill’s, the FDA is quick to point out that there is not yet enough evidence to support those claims, and that more research is required to accurately evaluate how risky or beneficial an e-cigarette is to the adult smoker.
Bill and Shemara, for their part, say they’re trying to do some good for their community. And they worry that the legislative rush of recent years could make it difficult for independent retailers like them to survive.
“We know there are people who started vaping having never previously smoked analog cigarettes,” Shemara said. “However, we are not a company to ever market these products as a hobby to that demographic. Our goal is to give the communities we serve the tools and knowledge to quit a habit that is medically proven to be harmful.”
But vaping may prove medically harmful, too.
“There’s not enough research in the U.S. supporting that [vaping] is a safe alternative to smoking. There’s not enough research that shows that it actually leads to quitting smoking long-term,” Kendrick says. “There’s a lot of studies that show you’re trading one addiction for another.”
Derek Kreider is a freelance writer and a sort-of musician hailing from parts unknown.