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VEGAS INC What are e-cigarettes? and Androids." ••• E-cigarettes once were manufactured and promoted by startup companies that peddled their wares at specialty shops. However, lured by potential lucrative profits from the youth market, major tobacco players are getting into the e-cigarette business, which is projected to approach $1.7 billion this year: • Philip Morris, the maker of Marlboro and the nation's largest tobacco company, has the "MarkTen" e-cigarette. • R.J. Reynolds, the maker of Camel and the country's second-largest tobacco company, has the "Vuse" e-cigarette. • And Lorillard, the maker of Newport and America's third-largest tobacco firm, acquired "Blu" e-cigarettes, which make up a third of all e-cigarettes sold in U.S. convenience stores. Unfettered by marketing, age and flavor restrictions that hamper traditional cigarettes, tobacco giants have been able to promote e-cigarettes freely. Companies are spending millions of dollars on celebrity endorsements and sports sponsorships, harkening back to Big Tobacco's heyday 50 years ago. "The tobacco industry is taking everything out of their playbook and recycling it because it works," Azzarelli said. "After lying for decades about carcinogens in cigarettes, are we going to trust the tobacco industry when they say e-cigarettes are safe?" Much of the advertising around e-cigarettes seems to target youths, VanBeuge added. Young adults, ages 18 to 25, historically have been the ideal market for tobacco companies, she said. "If you can get kids addicted and hooked between 18 and 21, you've got a user for life," VanBeuge said. "That's well demonstrated in the literature on smoking addiction." ••• To meet the growing demand for e-cigarettes, vapor shops have cropped up across the valley, seemingly overnight. The Vapery, which opened in July, is one of more than 70 smoke and vapor shops selling e-cigarettes in Las Vegas, according to Yelp.com. Three Filipino brothers who saw a business potential in e-cigarettes and a calling to help tobacco smokers started the Vapery. Elmer John Yumul, the middle brother, said he used to smoke up to two packs of cigarettes a day for decades. In February, Yumul, 45, began using e-cigarettes at the urging of his younger brother. Yumul incrementally stepped down from 24 milligrams of nicotine, the equivalent of one pack of Camel cigarettes, to 6 milligrams of nicotine every two weeks. Now, Yumul says he's on the verge of | 4 NOVEMBER 2013 20131104_VI01_F.indd 17 | RISING TREND: E-cigarettes on display at the Vapery. The rise in e-cigarette use by young adults and teens is a growing concern among health officials, who have long waged a public health campaign against smoking. kicking his tobacco habit. "This is heaven's gift for smokers," Yumul said. "There are a lot of advantages. My food tastes better, I don't have shortness of breath and my closet smells good." Although it has a steep upfront cost with batteries, pipes and coils, e-cigarettes are cheaper than purchasing $4 cigarette packs daily, Yumul said. A 6-milligram vial of nicotine, which costs about $6, lasts about two weeks for Yumul, who acknowledges that mileage varies from user to user. Since opening a few months ago, the Vapery has seen more than 1,000 customers, many of them first-time e-cigarette users, Yumul said. About a third of them are younger than 25, although increasingly vaping has become popular among adults and seniors, he said. The Vapery demonstrates to customers how to maintain their "mods" and introduces them to new "juices," which they say are made from high-quality, food-grade substances. In the coming months, Yumul plans for the Vapery to distill juices on its own in a laboratory-grade facility in the shop's backroom. ••• Like many smoke and vapor shops, the Vapery treats e-cigarettes the same as regular cigarettes: The shop doesn't sell them to minors. However, that's only at Yumul's discretion. There are no regulations to compel Yumul and other vapor shops to card and turn away minors, who by law cannot purchase tobacco cigarettes. Nevada law does not mention e-cigarettes or vaping, only the "smoking of tobacco." The Silver State also does not prohibit minors from possessing or using cigarettes or e-cigarettes. Nevada Attorney General Catherine Cortez Masto joined 38 other attorneys general in urging the FDA to place regulations on the advertising and ingredients of e-cigarettes, and prohibit their sale to minors. States also are considering adding e-cigarettes to their public smoking bans. Currently, e-cigarettes skirt Nevada's ban on indoor smoking in most public places. In 2006, Nevada passed the Clean Indoor Air Act, which prohibited smoking in airports, supermarkets, stores and restaurants — even those with slot machines. The law doesn't apply to casinos, both downtown and on the Strip, however. The law was seen as a major victory for Nevada's anti-smoking advocates, who worked for years to ban smoking in public places to combat the negative effects of secondhand smoke. However, e-cigarettes technically are not tobacco, and so users can vape anywhere property owners allow it. Increased e-cigarette use in public locations has prompted numerous calls to the Southern Nevada Health District. Residents are concerned about the health effects of e-cigarettes, Azzarelli said. Five years ago, the health district received no calls about e-cigarettes. Now, the district receives calls several times a week, Azzarelli said. Consequently, the health district has started to compile fact sheets and train schoolteachers on ways to educate Clark County high school and college students about e-cigarettes. "Right now, there needs to be more research," Azzarelli said. "We need legitimate studies on these things to see if they have fewer chemicals and carcinogens than cigarettes. We need to know more." In the meantime, students like Gibbs will continue to experiment with e-cigarettes. Gibbs, a nonsmoker, plans to use only the non-nicotine vials. She hopes to introduce vaping to her brother and father, who are both smokers. "I want people close to me to stop smoking," Gibbs said. "That, and it makes my car smell good. It's the bomb." E-cigarettes are battery-operated devices that vaporize liquid nicotine into an aerosol mist that can be inhaled, or "vaped." These devices, many of which are manufactured in Asia, range in size from a traditional tobacco cigarette to a small metal pipe — called a "mod" — that resembles the tip of a hookah pipe. The metal pipe has a button connected usually to a digital display, which controls how much nicotine is released when a user "vapes." Vials of liquid nicotine, which comes in 6- to 32-milligram increments, are heated through a coil and vaporized into a fine vapor mist, which is inhaled. A "mod," short for modification, can be customized with different tips, colors, accessories and nicotine-delivery methods. Some e-cigarettes and mods come with a colorful light, which mimics the orange glow of a lit tobacco cigarette. What substances are in e-cigarettes? Only a handful of clinical studies have been completed so far on e-cigarettes. Although most researchers acknowledge e-cigarettes may be safer than tobacco cigarettes, e-cigarettes were found to contain carcinogens and traces of toxic chemicals and heavy metals. E-cigarettes have been found to contain diethylene glycol, an ingredient used in antifreeze, according to the Food and Drug Administration. The nicotine in e-cigarettes is addictive and a vasoconstrictor, which means it can constrict and harden blood vessels, leading to cardiovascular disease. What do e-cigarettes cost? A starter kit, which includes an e-cigarette and battery, can cost around $30. A stainless steel "mod" used by vapor enthusiasts can cost upwards of $200. E-cigarette users purchase vials of "juice," in various flavors, from cherry, watermelon and peach to chocolate and bubble gum. Vials cost between $6 and $20. 17 10/31/13 1:52:43 PM