Louisville Medicine Volume 62, Issue 6 | Page 39

SPEAK YOUR MIND If you would like to respond to an article in this issue, please submit an article or letter to the editor. Contributions may be sent to [email protected] or may be submitted online at www.glms.org. The GLMS Editorial Board reserves the right to choose what will be published. Please note that the views expressed in Doctors’ Lounge or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine. HYPOCRISY Mary G. Barry, MD Louisville Medicine Editor [email protected] I am surrounded by priests who repeat incessantly that their kingdom is not of this world, and yet they lay hands on everything they can get. - Napoleon, 1814 C urrently Big Tobacco is licking its chops over the prospect of controlling the electronic cigarette market as totally as it controls all other tobacco product sales. As of this spring e-cig and “vaping” mods sales in the US had already surpassed $1.5 billion, and that was with smaller producers pushing their wares onto the shelves. Special vaping parlors have sprung up all over the country, where lovers of nicotine can try, for instance, Chocolate Martini flavored liquid nicotine, and commune with others of their ilk. As of this month there are an estimated 35,000 of these independent nicotine retailers, and their customers are devoted to them – if they can survive the impending FDA regulation, and all of its attendant costs. Fake cigarettes like the mass marketed Blu as originally devised are battery powered. Each cartridge is single use only, and flavor choices are limited (experts say that the traditional tobacco industry has planned ahead for regulation, and if the 2009 provisions hold up, many kinds of flavorings won’t be allowed). The vaping devices are very different. They feature an “open system” or cartridge that holds liquid capsules of myriad flavors and strengths of inhalable tobacco. The Chinese dominate the liquid capsule market. A whole culture has sprung up around them, with vaping houses, gear and accessory sales, and thousands of online merchants – there are pages of choices on Amazon.com alone. My patients who have switched to e –cigs from real cigarettes sneer at certain devices and extol others, but tell me that they like to try new ones too, just in case. They like how portable they are, the lack of odor, the sweet or spicy taste, and the virtuous feeling they get from having given up their Camels. At least half of the 40 million U.S. smokers have at least tried e-cigarettes once, according to industry estimates. Many smokers of course use both real and e-cigs, depending on their surroundings, and when trying to quit the real ones. Huge sums of money are potentially involved. The World Health Organization says as of August there are 446 e-cig types on the market and that global spending for them reached $3 billion in 2013. A Wells Fargo analyst has estimated a market of $10 billion by 2017. Lorillard bought the Blu e-cig brand for $135 million and now has pushed it to over 80,000 retail outlets (though CVS recently bowed out of that market). R. J. Reynolds has launched the Vuse “Digital Vapor Cigarette,” trumpeting its “smart techn