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32 RHODE ISLAND MONTHLY l
APRIL 2020
pain and diarrhea — that were linked to
liquid solutions containing tetrahydrocan-
nabinol (THC) and the additive Vitamin E
acetate. The outbreak, affecting mainly
young adults, led to 2,711 hospitalizations
and sixty deaths as of late January. Rhode
Island had six cases. Since a peak in Sep-
tember, the injuries and deaths have
declined.
The CDC regards the EVALI epidemic
as distinct from the upward trend of youth
vaping. But public health officials worry
because vaping is so new, no one knows
what the long-term health effects might be.
“E-cigarette aerosol generally contains
fewer toxic chemicals than the deadly
mix of 7,000 chemicals in the smoke
from regular cigarettes. However, safer is
not the same as safe,” Dr. Brian King,
deputy director for research translation
in CDC’s office on smoking and health,
writes in an email. “E-cigarette aerosol
can contain harmful and potentially
harmful substances, including nicotine,
heavy metals like lead, volatile organic
compounds and cancer-causing agents.
There is no safe tobacco product.”
Nonetheless, lifelong adult smokers
consider vaping a lifeline. E-cigarettes
not only helped Lou Del Sesto quit tradi-
tional cigarettes after a bout of smoking-
related pneumonia, they freed him from
his dependence on disability payments.
In 2013, Del Sesto opened the Ecig Shed
in Barrington, Rhode Island’s first brick-
and-mortar vape shop.
“In six months, all of a sudden, it ex-
ploded and the business did very, very
well,” he says. After the temporary flavored
e-cigarette ban went into effect “my sales
went down 70 percent. I just couldn’t
sustain it. I closed at the end of October
and, after around two months, I went
back to disability. I lost everything.”
So far, the biggest quitters the ban has
produced are people who sell vape prod-
ucts. Convenience stores are likely to
survive it; tobacco products represent a
third of inside sales — mostly traditional
cigarettes. But vape shops have been dev-
astated, and several have already closed.
Mike Runshe, CEO of Giant Vapes, has
seen proliferating state bans cut into
sales at his online shop, but revenue loss
is almost beside the point.
Like Del Sesto, Runshe entered the
business seven years ago as a convert. A
smoker for thirteen years, Runshe began
trying to quit in his late twenties but
nothing worked. On June 4, 2012, he
tried his first e-cigarette and never lit up
another American Spirit again. The fla-
vors were key: “That wet ashtray, musty,
moldy, nasty burnt cigarette smell —
that’s what tobacco vapes taste like,” he
says. “That’s why nobody uses them, and
that’s why they don’t help people to quit,
because they are disgusting.”
You can take away the products, but
the nicotine addicts remain, he says.
“We have a marketing problem,”
Runshe, a member of the state’s Vaping
Advisory Group says. “We need better
programming and education. There’s a
middle ground.”
Thoracic radiologist Terrance Healey,
who stares at lung X-rays for a living,
agrees that the conversation about how to
respond is just beginning. To be clear,
Healey doesn’t like cigarettes of any kind.
The human lung was designed to absorb
nothing but air. And science has not yet
validated the claims that flavored vape
products help people to quit, or that vap-
ing is safe. The odds are that vaping will
eventually produce serious lung injuries
such as emphysema and cancer, because
the aerosol allows more fine particles to
enter the lungs more deeply, and the vap-
ing oil stays in the tissues.
“There are two groups: chronic smok-
ers looking to a potentially safer product
to ease off traditional cigarettes with the
goal of quitting everything and young ado-
lescents who were never tobacco smokers,
and directly marketed to by big industry
to be addicted to nicotine through fla-
vored vaping products,” he says. “We have
to tailor our response, and I don’t think
there can be one message for everybody.”
South Kingstown State Representative
Teresa Tanzi, a former smoker, blames
the high stakes of today’s debate on yes-
terday’s political apathy. Seven years ago,
she began working on legislation to raise
the legal smoking age from eighteen to
twenty-one years old. Her bills never
made it past a hearing.
“Not only were we allowing the next
generation to become addicted to nicotine,
we were also allowing this industry to take
hold, only to be shut down abruptly,” she
says. “The leadership allowed this happen.
It was irresponsible on both ends.”