Most vape shops, such as Stone City Vapors in Bedford, sell a variety of flavors. Some fun flavors, such as Cotton Candy, appeal particularly to younger users, said Troi Stith, Lawrence County’s tobacco prevention and cessation coordinator at Hoosier Uplands. (Christine Stephenson / Times-Mail)
Most vape shops, such as Stone City Vapors in Bedford, sell a variety of flavors. Some fun flavors, such as Cotton Candy, appeal particularly to younger users, said Troi Stith, Lawrence County’s tobacco prevention and cessation coordinator at Hoosier Uplands. (Christine Stephenson / Times-Mail)
Christine Stephenson Times-Mail

BEDFORD — Dakota Caraway uses his vape throughout the day every day until he goes to bed.

Caraway, who now works at Stone City Vapors in Bedford, started vaping the day he turned 18 to kick his tobacco chewing habit. And it’s helped, he said.

“I haven’t chewed in two and half years,” the 20 year old said. “I feel a lot better ... I’m more active and I can breathe easier.”

Caraway is among tens of thousands of adult Hoosiers who vape. Recent self-reported data from the Centers for Disease Control and Prevention revealed Indiana has the third highest adult vaping rate in the country, according to a recent QuoteWizard analysis.

But it’s not just adults — 3.6 million U.S. middle- and high-schoolers reported using them, as well.

E-cigarettes, or vapes, don’t contain tobacco, so most health professionals agree they aren’t as damaging as cigarettes.

But not everyone agrees that they are helpful tools, especially when it comes to teenagers using them.

“A lot of people think e-cigarette vapor isn’t harmful … it most certainly is,” said Troi Stith, Lawrence County’s tobacco cessation and prevention coordinator at Hoosier Uplands. “We have a huge issue in high schools, middle schools and even some elementary schools with Juuls and e-cigarettes in general.”

Regardless of why they started or whether they are better off or not, a significant number of Hoosiers are using vapes. And soon, they might be penalized for it.

Lurking costs

Under the Affordable Care Act, many health insurers include an extra fee for those who identify as smokers. The fee, called the Tobacco Use Surcharge, forces self-reported smokers in states such as Indiana to pay premiums up to a maximum of 50 percent.

E-cigarettes were classified as tobacco products by the U.S. Food and Drug Administration a few years ago, but most health insurers are still stuck on what to do.

Adam Johnson, the QuoteWizard analyst who conducted the vaping study, said the increased prevalence of teenagers using e-cigarettes could push insurers to add a vaping surcharge, as well.

Although insurers may not have a definite plan in the works, Johnson said, he believes e-cigarette surcharges will become more likely as today’s teens get older and need their own health insurance plans.

“It’s only going to increase as these middle- and high-schoolers become of age,” he said. “It’s certainly something worth monitoring.”

‘It gets tricky’

For some experts, the potential e-cigarette surcharge isn’t the biggest concern right now. It’s how the smokers and vapers are going to be helped.

Jon Macy is an associate professor at Indiana University Bloomington who specializes in public health policy and tobacco use, cessation and prevention.

He said he thinks the rise in health care costs for e-cigarette users may or may not happen. But if it does, there is going to be an even greater need for efficient tobacco cessation programs.

Throughout his years of research, he said he has noticed states with the highest smoking and vaping rates — such as Indiana — are also the states with the poorest public health funding.

“The place where it gets tricky is when you penalize people for having an addiction and then don’t help them to quit,” Macy said. “We know it costs a ton to take care of smokers … but you need to accompany it with counseling, nicotine replacement therapy …”

Whether it’s lifelong smokers who are using e-cigarettes to quit or those that just got caught up in the trend of vaping, Macy said no one should be left alone to kick addiction. And it’s going to take more than individual health care providers or the smokers themselves to fix it.

“The state legislature has eroded most of the funding for tobacco cessation over the years,” he said. “It all comes down to what the state and what its elected officials value.”

Still good kids

Traditionally, e-cigarettes were marketed to adult smokers looking to cut back or quit. But a few years ago, companies such as Juul started marketing their vapes toward younger people, most of whom had never even smoked a cigarette before, according to Truth Initiative, America’s biggest public health nonprofit to focus on tobacco cessation.

Stith often visits schools to teach students about the dangers of vaping and said most of the time the kids — and adults — don’t know how just harmful it is.

And it’s not really their fault, she said. Vapes haven’t been around long enough to have reliable data about long-term effects, and they’re usually marketed as relatively harmless.

But this isn’t true, Stith said. Some vape cartridges can still contain enough nicotine to roughly equal a pack of cigarettes.

Not all of the students who vape use those with nicotine in them, Stith clarified. But most do.

“You’d be very, very hard pressed to find those that don’t have nicotine in them,” she said.

Some vapes can cause even more harm than cigarettes, Stith said. A chemical called diacetyl, which is found in many e-cigarette flavors, can lead to lung scarring and narrowed airways if inhaled. It’s more commonly referred to as “popcorn lung.”

Even when Stith tells the students about health effects like this, it still sometimes doesn’t reach them. The thing that works most often, she said, is when she explains how secondary smoke can affect their families, especially younger siblings and pets.

Because they want the best for their loved ones, she said. It’s not that they’re bad kids. It’s more complicated than that.

© 2019 TMNews.com, Bedford, IN.