Science

Vaping Killed. Vapers Don’t Care.

Shrugging It Off

Horror stories of a man being killed by an exploding vape and a teen contracting ‘wet lung’ after only three weeks of vaping are unlikely to persuade vapers to quit, experts say.

180518-basu-vaping-hero_a5kqyk
Dan Kitwood/Getty

Vaping is having a rough couple of weeks.

There’s what appears to be the first death by vape, once considered the millennial response to cigarettes, the potential safe replacement to the oddly human oral fixation of sticking something that blazes fire on one end into one’s mouth.

Firefighters responding to a fire earlier this month found 38-year-old Tallmadge D’Elia with severe injuries to his face. Officials believe the lithium battery, used to generate heat for the smoke that’s emitted at the end of a vape, got so hot it exploded, causing the fire and killing D’Elia.

ADVERTISEMENT

Then there was the case of an 18-year-old hostess at a rural Pennsylvania restaurant who decided to try using e-cigarettes, according to a case study in Pediatrics. Within three weeks, the woman developed a rather nasty condition—“wet lung”—that included coughing, labored breathing, and stabbing pains in her chest, eventually sending her into respiratory failure.

While the woman made a full recovery, it took only three weeks for her lungs to collapse, a side effect that doctors blamed squarely on vaping.

Both reports come on the heels of the Food and Drug Administration announcing that it was going to crack down on e-cigarettes and vaping, sending warning letters to companies that sell e-liquids that look variously like juice boxes, cookies, and candies. “Companies selling these products have a responsibility to ensure they aren’t putting children in harm’s way or enticing youth use, and we’ll continue to take action against those who sell tobacco products to youth and market products in this egregious fashion,” Scott Gottlieb, the FDA commissioner, said in an accompanying statement.

But the sobering news stories will likely have little to no effect on vaping, often referred to as “Juuling,” for Juul, the brand name of the vape that leads the pack in both sales to adolescents looking to vape and social media influence.

Sherry Emery, the director of Health Media Collaboratory and a senior fellow in public health at NORC at the University of Chicago, has focused heavily on the vaping and smoking industries. She said upcoming research she’s done on vaping advertising and teen usage from social media shows that these teens will look at negative news and just shrug, pull out their Juul, and inhale.

Emery acknowledged that the news that an exploding vape pen actually killed a person might give teens pause, mostly because it’s the first death by vape explosion and carries with it violent imagery. There’s also the immediacy of death, something most users don’t associate with vaping, whose implicit “watered down smoking” branding—like smoking, but safer—makes it easy for users to believe vaping doesn’t cause disease or death.

“It’ll be really interesting to see what the reaction of the exploding vape pen is since it’s so shocking,” she told The Daily Beast. “It’s so dramatic that he blew himself up.”

But the news that the FDA is cracking down on vaping, or that serious conditions like wet lung could occur as a result of vaping, will probably not register with the majority of vape users. That’s because the jury on the science of vaping remains hazy, simply because vaping is so new and accurate scientific analyses of its health effects require years of data.

What doesn’t help is the social media marketing genius of companies like Juul. On Juul’s Instagram (@juulvapor, whose bio is “The satisfying alternative to cigarettes”), the company appeals directly to its millennial and Gen X base with minimalist lifestyle-y posts that present “juuling” as cool, chic, and artistic, often promoting vaping as a substitute or alternative to smoking. Posts carry disclaimers about the nicotine content of Juuls and explicitly state that they are intended for use by adults.

But what makes Juul’s social media marketing more surreptitious and potentially subversive is how its affiliate partners use Juul’s upscale branding to “carry the water for Juul,” Emery said.

😁

A post shared by Vape Pods (@pod_memes) on

That means Juul maintains a pristine legal front image of being only marketed for adults, but those who service Juul could reach out to teens and bring in that valuable demographic without sullying the brand’s reputation.

Emery says vaping seems bulletproof against negative news coverage because of the industry’s expert use of social media and take advantage of the as-yet-unknown verdict on the health front. “Their marketing is spectacular,” she said. “They’ve really found a way to reach teens.”

Emery and her colleagues will publish a study soon that shows the spike in Juul-related tweets in the past year. The number remains flat between February 2015 and December 2016, when tweets start to jump. There’s a minor bump in the summer of 2017, but between October 2017 and December 2017, Juul-related tweets go from about 20,000 per month to close to 160,000 tweets per month. (The study is not yet published, though it has been reviewed and accepted, which is why The Daily Beast can’t publish the graph in question.)

Juul’s initial arrival on social media was rather boring, which may explain the initial low numbers, says Emery. “When Juul came on our radar, there were daily fluctuations, but you didn’t see that dramatic rise till just then,” she said. But the affiliate accounts are expert teen talkers: They tap into meme culture. “They come up with these great memes that tie back to the devices and make them cool, make people want to try them,” she said.

It’s not a new technique, to be sure: Emery and other tobacco industry researchers have long pointed to the industry’s keen understanding of its demographic to market its products. Think of the Marlboro cowboy’s brash, stereotypical masculinity, or Virginia Slims, whose slimmer design played into many women’s desire to appear more elegant and chic while smoking. Vaping is doing the same thing with its shrewd understanding of demographics—except now it’s playing into a more vulnerable, younger audience.

To most vapers, Emery says, “wet lung” sounds gross and terrible, but also distant and something that might have happened to the woman just because of bad luck. It’s far away, vaping’s technically not been proved to be unhealthy, and the electronic puff not only looks cool but its fruity or candy-tinged flavor is pretty tasty, too.

It doesn’t help that vaping’s root word, vapor, conjures images of steam, something water-based and otherwise innocent. Cigarette smoke smells like tar, burns a visible filter, and tastes like eating smoke (with menthol, minty smoke). Vaping, on the other hand, is sleek, cool, gently foggy, with a light flavor that makes the smoking experience more pleasurable than bumming a light from whoever is on the corner.

So does that mean we’re stuck? That nothing can make vaping look uncool and potentially save hundreds of thousands—maybe millions—of lives?

Andy Tan is with the Dana-Farber Cancer Institute and the Harvard T. H. Chan School of Public Health. A new study he and his co-authors published in the journal Drug and Alcohol Dependence seems to suggest that PSAs might earn eyerolls, but they also could be effective—especially if they have a lot of smoke in their imagery.

Tan and his team thought portrayals of vaping might trigger stronger urges to smoke among adults who are smoking and vaping at the same time, perhaps using vaping as a potential substitute for smoking or a way to quit smoking. The thought process was that vivid vaping imagery with plumes of smoke might act as a trigger.

But that’s not what happened at all. The study used 171 smokers and 122 “dual users” between 21 and 30, showed them various PSAs, then asked about any change in habits that ensued. It turned out that smokers who were exposed to anti-vaping PSAs with vapors in the imagery versus the actual act of vaping were turned off from the practice and claimed a lowered intention to smoke and purchase cigarettes or vape in the next hour. Dual users also found the cloud of smoke off-putting.

Why that’s the case is still unclear to Tan and his team, though Tan did point to various iconic anti-smoking PSAs that feature clouds of smoke. Perhaps the smoke makes what one is really breathing in—cancerous fumes—more real, less sexy, and more immediate than carefully curated images of vapes on Instagram. Young people, Tan said, found the vapor, not the vape, off-putting, which means that so long as adolescents and those in their 20s see images of vapes being used with minimal or next to no smoke, there’s not much—not even bad news—that can make vaping look not attractive outside of billowing smoke.

Of course, Tan said this study has “huge” caveats: “It needs to be replicated,” he told The Daily Beast. “And we only had two sites, one in Boston and another in Lansing, Michigan, so we can’t say this is generalizable.” But he does agree with Emery that news of death by vape doesn’t matter to vapers: “Young people don’t really read the news,” he said. “It’s a very temporary negative slant on the product.”

“Frankly, I don’t think it will make a difference,” Emery said of the recent spate of negative news on vaping. Vapers gonna vape, it seems.

Watch_Cure_Hunters_Approved_ContentSlug_b3c7nm

Got a tip? Send it to The Daily Beast here.