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VEGAS INC AS MORE YOUNG PEOPLE LIGHT UP, HEALTH OFFICIALS' CONCERNS RISE e-cigarettes, From page 1 campaigns against smoking. E-cigarettes are battery-operated devices that vaporize liquid nicotine into an aerosol mist that can be inhaled, or "vaped." Proponents claim e-cigarettes are a healthier alternative to smoking, one that can help tobacco smokers quit. They argue e-cigarettes use more "natural" ingredients than traditional cigarettes, which contain dozens of harmful chemicals, including tar. Public health officials, however, say e-cigarette health claims cannot be substantiated because there isn't enough research yet on this relatively new device. The federal Food and Drug Administration doesn't consider e-cigarettes to be a sanctioned smokingcessation device, however. Despite the relative lack of information about the effects of e-cigarettes, their use has surged among American youths. A national survey released in September by the Centers for Disease Control and Prevention found that 1.8 million high school and middle school students had tried e-cigarettes in 2012 — double the number of student users in 2011. Clark County officials say they haven't noticed e-cigarettes being a problem, but health officials are concerned e-cigarettes can serve as a gateway for young adults and teenagers to try conventional cigarettes. Maria Azzarelli, the tobacco-control program coordinator for the Southern Nevada Health District, believes e-cigarettes are threatening decades of anti-smoking campaigns that have changed social norms and perceptions about smoking. In 1965, 42 percent of American adults were smokers. Today, it's less than half that figure, at 19 percent. Azzarelli fears e-cigarettes could reverse the public's views about smoking. After decades of anti-smoking commercials featuring emphysema patients breathing out of air tubes and poison signs on cigarette packs, e-cigarettes just might make smoking nicotine cool and glamorous again. "People who may have never used a tobacco product are now using e-cigarettes," Azzarelli said. "We're very concerned that what's becoming passe — 16 20131104_VI01_F.indd 16 PHOTOS BY PAUL TAKAHASHI UP IN SMOKE: Planet Hollywood employee Bronson Espinueva, 27, "vapes" an e-cigarette at the Vapery, a vapor shop at 8060 S. Rainbow Road, Las Vegas. To meet the growing demand for e-cigarettes, vapor shops have cropped up across the valley. The Vapery is one of more than 70 smoke and vapor shops that sell e-cigarettes locally. smoking — is now coming back." ••• E-cigarettes were invented in the mid2000s in China, but they have become popular in the United States only over the past couple of years. E-cigarettes range in size from a traditional tobacco cigarette to a small metal pipe — called a "mod" — that resembles the tip of a hookah pipe. These devices can cost between $30 for a starter kit, which includes an e-cigarette and battery, to more than $200 for a stainless steel "mod" used by vapor enthusiasts. E-cigarettes are manufactured around the world, predominantly in China and the Philippines. E-cigarette users purchase vials of "juice," which contain from 6 milligrams to 32 milligrams of liquid nicotine costing between $6 and $20 a pop. Vapor shops sell non-nicotine versions, but all juices come in various flavors, from cherry, watermelon and peach to chocolate and bubble gum. The vials generally contain propylene glycol, a preservative used in food and tobacco. E-cigarettes have been found to contain diethylene glycol, an ingredient used in antifreeze, as well as traces of toxic chemicals, heavy metals and carcinogens, according to early studies. However, it's still unclear how prevalent these chemicals are. Regardless, nicotine — e-cigarettes' chief ingredient — is an addictive vasoconstrictor that tightens and hardens blood vessels, which could lead to cardiovascular disease. "At the end of the day, we want people not to get addicted to nicotine," Azzarelli said. "No one can say right now whether e-cigarettes are a healthier alternative to cigarettes or hookah." ••• At first, e-cigarettes were expensive novelties, sold only at mall kiosks. However, with their price falling and popularity rising, e-cigarettes have become more commonplace. Users can be found "vaping" at concerts, restaurants and on college campuses. E-cigarettes are seen as a recreational and social activity for users, who sometimes hold friendly competitions to see who can produce the biggest vapor cloud. "A lot of people on (CSN's) campus vape," Gibbs said. "It's all the hype right now." The popularity of e-cigarettes among youths doesn't come as a surprise to Susan VanBeuge, a nurse practitioner and assistant professor at UNLV. E-cigarettes are flavored, their taste a stark contrast to the harsh tobacco taste of regular cigarettes. E-cigarettes give off a sweet smell, and leave no yellowed fingernails, teeth or stained clothes — telltale signs that could tip a parent off to a smoking habit. The "mods" and pipes also are customizable with different colors and accessories, like putting flashy rims on a car. Such modifications accentuate e-cigarette users' personalities, unlike a pack of Parliaments. For a generation that grew up with the Internet and experienced the rise of smartphones, e-cigarettes are the digital counterpart to the analog cigarettes. "It's popular because it's cool and new and electronic," VanBeuge said. "Everyone's fascinated by their iPhones | 4 NOVEMBER 2013 | 10/31/13 1:52:35 PM