She has watched Omahans who scratch and claw and climb their way toward zero, only to slide back down the mountain the second they smell a Marlboro.
She has studied the various gums and patches, the pills and potions, some of which can help you quit smoking, and many of which come with huge price tags, horrible side effects and questionable results.
So excuse Tammy Burns, manager of cardiology and tobacco programs at Creighton University's Cardiac Center, if she seems dubious as she watches the e-cigarette craze blowing through Omaha.
Excuse her if she looks at e-cigarettes — the whispered promise that they are safer, healthier, a shortcut to quitting — and worries that we might be inhaling a whole load of hot air.
“People want it to be that magic bullet,” she said. “My gut feeling? Most people who use e-cigarettes alone won't quit.”
For the uninitiated, an e-cigarette isn't a cigarette at all. It's a metal device that heats liquid into vapor and gives its users a nicotine fix without the smoke, the stench or the tar found in a Marlboro.
And for those of you who don't read every single world I type — so, everyone except Mom — earlier this year I wrote about a new business named Plumes, which is the epicenter of Omaha's e-cigarette craze.
And it is a craze. Dozens upon dozens of customers, many of them brand new, show up at Plumes to try the various e-cigarette flavors, known as juices, every day. They “vape” — that's what the cool kids call using an e-cigarette — and believe that what they are inhaling is far cleaner than cigarette smoke.
Which may be true, Burns says. And it could be far more complicated than that.
“This hasn't been studied,” she says. “Not at all.”
Creighton is doing just that. The university has received funding and started a two-year study that will eventually enroll 240 participants.
The goal is to answer the following question: When people use an e-cigarette as part of a smoking cessation plan, how successful are they?
“We are keeping an open mind,” Burns says. “We want to look at this in a scientific way, so we have good data when people ask us, 'Should I try one of these?' ”
As the study gathers that data, Burns hopes that we all take a half-step back from e-cigarettes and consider their larger implications, both to personal health and public health.
For example: Smoking an e-cigarette may be healthier than smoking a real cigarette. That's certainly the gut reaction (the lung reaction?) I had when I briefly vaped a non-nicotine version of an e-cigarette at Plumes.
I'm an ex-smoker, and the e-cigarette simply tasted cleaner. There's no tar, after all, and none of the various other poisons found in cigarettes.
But the e-cigarette is mostly about the delivery of nicotine, the addictive substance in all forms of tobacco and one that carries health risks, Burns says.
The scant research that has been done on e-cigarettes also suggests that e-cigarette users may be inhaling more than just nicotine-fueled water vapor. Researchers have detected silver, iron, aluminum, tin, chromium and nickel, many of which can contribute to respiratory disease. They have also found small levels of diethylene glycol, a chemical also found in antifreeze.
Even if e-cigarettes prove to be safer than cigarettes — and Burns' gut tells her they are — they won't be as safe as quitting altogether.
|Columnists Michael Kelly, Erin Grace and Matthew Hansen write about people, places and events around Omaha. Read more of their work here.|
How many people will use the e-cigarette to get around those pesky smoking regulations? After all, one of the underlying public health benefits of indoor smoking bans is that smokers tend to smoke less when they can't smoke in break rooms, restaurants or bars.
And how many teenagers who wouldn't have otherwise smoked will decide to try an e-cigarette? After all, the sweet flavors are similar to the flavored cigarettes now banned in the United States because they were so attractive to teenagers. And mom can't smell heated vapor like she can smell smoke on your clothes.
Twenty percent of Americans still smoke despite the fact that everyone knows that smoking is really, really bad for you. And while that percentage is way down from the 1960s, when nearly half of all Americans regularly smoked, it's stubbornly stuck at about 20 percent for the past few years.
Why? Because teenagers continue to take up smoking. Burns doesn't want them to take up vaping instead.
She knows how hard it is for them to kick a nicotine addiction.
The Creighton smoking cessation classes are led by experts and use research-based techniques proven to be more effective than quitting on your own or quitting cold turkey. Most of the participants are longtime smokers. During the program, many of them use nicotine gum or prescription medicine shown to help make quitting easier.
And yet, for every 100 people who enter one of these programs, only about 45 are still not smoking three months later.
That number goes down to 25 when you include the participants who dropped out during the 8-week smoking cessation program.
“We all want it to be easy,” Burns says. “It isn't.”