E-Cigarettes by Other Names Lure Young and Worry Experts

Source: New York Times
Olivia Zacks, 17, recently took a drag of peach-flavored vapor from a device that most people would call an e-cigarette. But Ms. Zacks, a high school senior, does not call it that. In fact, she insists she has never even tried an e-cigarette. Like many teenagers, Ms. Zacks calls such products “hookah pens” or “e-hookahs” or “vape pipes.”
These devices are part of a subgenre of the fast-growing e-cigarette market and are being shrewdly marketed to avoid the stigma associated with cigarettes of any kind. The products, which are exploding in popularity, come in a rainbow of colors and candy-sweet flavors but, beneath the surface, they are often virtually identical to e-cigarettes, right down to their addictive nicotine and unregulated swirl of other chemicals.

Marketers of e-hookahs and hookah pens say they are not trying to reach young people. But they do say that they want to reach an audience that wants no part of e-cigarettes and that their customers prefer the association with traditional hookahs, or water pipes.

“The technology and hardware is the same,” said Adam Querbach, head of sales and marketing for Romman Inc. of Austin, Tex., which operates several websites that sell hookahs as well as e-cigarettes and e-hookahs. “A lot of the difference is branding.”
Public health authorities worry that people are being drawn to products that intentionally avoid the term “e-cigarette.” Of particular concern is use among teenagers, many of whom appear to view e-cigarettes and e-hookahs as entirely different products when, for all practical purposes, they are often indistinguishable.
Indeed, public health officials warn that they may be misjudging the use of such products — whatever they are called — partly because of semantics. A survey by the Centers for Disease Control and Prevention found that 10 percent of high school students nationwide said that they had tried e-cigarettes in 2012, double the year before. But the C.D.C. conceded it might have asked the wrong question: Many young people say they have not and will not use an e-cigarette but do say they have tried hookah pens, e-hookahs or vaping pens.
Health officials worry that such views will lead to increased nicotine use and, possibly, prompt some people to graduate to cigarettes. The Food and Drug Administration is preparing to issue regulations that would give the agency control over e-cigarettes, which have grown explosively virtually free of any federal oversight.
Sales of e-cigarettes more than doubled last year from 2012, to $1.7 billion, according to Wells Fargo Securities, and in the next decade, consumption of e-cigarettes could outstrip that of conventional cigarettes. The number of stores that sell them has quadrupled in just the last year, according to the Smoke Free Alternatives Trade Association, an e-cigarette industry trade group.
The emergence of hookah pens and other products and nicknames seems to suggest the market is growing well beyond smokers. Ms. Zacks was among more than 300 Bay Area high school students who attended a conference focused on health issues last month on the campus of the University of California, Berkeley. Many students talked about wide use of e-hookahs or vaping pens — saying as many as half of their classmates had tried one — but said that there was little use of e-cigarettes.

Ms. Zacks said the devices were popular at her high school here. “E-cigarettes are for people trying to quit smoking,” she said, explaining her understanding of the distinction. “Hookah pens are for people doing tricks, like blowing smoke rings.”

James Hennessey, a sophomore at Drake High School in San Anselmo, Calif., who has tried a hookah pen several times, said e-hookahs were less dangerous than e-cigarettes. He and several Drake students estimated that 60 percent of their classmates had tried the devices, that they could be purchased easily in local stores, and that they often were present at parties or when people were hanging out.
“E-cigarettes have nicotine and hookah pens just have water vapor and flavor,” said Andrew Hamilton, a senior from Drake. Actually, it is possible for e-cigarettes or e-hookah devices to vary in nicotine content, and even to have no nicotine. Mr. Querbach at Romman said that 75 percent of the demand initially was for liquids with no nicotine, but that makers of the liquids were expanding their nicotine offerings. Often, nicotine is precisely the point, along with flavor.
It is also possible to buy disposable versions, whether e-cigarettes or hookah pens, that vary in nicotine content and flavor. At King Kush, the Atmos ice lemonade-flavored disposable electronic portable hookah promises 0.6 percent nicotine and 600 puffs before it expires.

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