I miss owning a vape shop. It was gratifying to help people stop smoking. Some wonderful people walked through my door, in a small town in Minnesota, and I was honored that they chose me to help change their lives.
It was in July 2019 that one older man came in. I’ll never forget him. Even as he approached the counter, it was clear that he was struggling to breathe. As he reached for his phone, he pulled two inhalers out of his pocket.
We began chatting, and he told me that it was an act of desperation to go to a vape shop. He was a veteran with COPD, he explained, and had minimal funds to work with. When I called him “Sir,” he told me to call him “Bob”—a nickname he’d been given during the Vietnam War.
I was determined he wasn’t leaving without a vape, no matter how little he had to spend. I had to help him quit smoking.
The doctors at the Veteran Affairs medical center had been telling him to quit for years, he related, but nothing they suggested helped him to succeed in that. By coming to my shop, Bob was going against the advice of the VA doctors. He said they’d told him that vaping was as bad for you as smoking.
Regardless, he walked out with a refillable pod device, a spare box of pods and some strawberry-flavored e-liquid, ready to give it a try.
Over the next two weeks, Bob brought in nine of his fellow vets to get my help to quit smoking. They called their vapes “puffing machines.”
When he came back the next day, bursting with pride because he hadn’t smoked since the night before, my eyes filled with tears.
But it got better. Because this time, Bob brought with him a fellow veteran, who saw him “puffing on that thing” and had to try it. His friend wanted the same vape setup and decided he’d quit smoking, too.
Over the next two weeks, Bob brought in nine of his fellow vets to get my help to quit smoking. They called their vapes “puffing machines.” They’d thought they were too old to benefit from quitting smoking, but as the VA rightly told them, it is never too late. They were surprised to find themselves feeling better once they quit.
The most frustrating thing about trying to help them was hearing exactly the same story from each of them.
They had been to the VA, but none of the methods prescribed worked for them, and the VA doctors urged them not to take up vaping. These deserving men had been let down. They had not been told the truth about the relative safety and efficacy of vaping as a smoking cessation method, nor given support to access the full range of options.
I was heartbroken to see some of my vets believe the inaccurate reports and return to smoking.
That fall, the news was flooded with misinformation about vaping, and vaping nicotine was falsely associated with “EVALI,” an illness caused by vitamin E acetate in illicitly manufactured THC cartridges.
I was heartbroken to see some of my vets believe the inaccurate reports and return to smoking.
Once again, they deserved better, and I wasn’t about to have them die from smoking on my watch. It took printing volumes of data, hunting them down at their favorite coffee spots, and a lot of talking. But eventually, they all returned to vaping and were free from smoking once again.
As I got to know them better, they made clear that their stories were not unique, and that nationwide, the VA discourages the use of vapes for veterans who can’t or won’t stop smoking. When I heard this, I felt sure the VA would have developed better advice for smoking veterans in recent years. My research left me disappointed.
The 96-page My Tobacco Cessation Workbook provided to veterans by the VA contains just one discouraging paragraph about vapes. The 2023 Survey of Veteran Enrollees’ Health and Use of Health Care Findings Report, meanwhile, is rife with the kind of misleading information that may prevent people who smoke from switching to safer alternatives—including warnings about “cancer-causing chemicals” without the context that the dose makes the poison, and an apparent endorsement of the myth of “popcorn lung” caused by vaping.
“Ignoring established science and refusing to adopt technological advances that could save veterans’ lives is a failure in our commitment to those who served,” Dr. Timothy Vermillion, a service-disabled veteran, recently wrote for Filter. “It’s time for the Veterans Administration to embrace innovation and get this right.”
If the VA endorsed and recommended options like vapes, pouches and heated tobacco products, it could transform prospects for this population.
The VA has taken big steps forward in encouraging harm reduction for people who use state-banned drugs—developing one initiative, for example, with input from veterans with lived experience of drug use. Over 900,000 people receiving VA care who currently smoke cigarettes are owed the same.
The VA should listen to veterans who have made the switch to safer alternatives to smoking. They deserve to have a voice. Their stories can change minds and show how helpful these products can be. Considering all that veterans have been through, I don’t think that’s asking too much.
Fewer veterans smoke now compared to previous decades, which is excellent news. But too many who do smoke have been unable to stop—even with increased efforts by the VA, including newer resources such as quit-smoking apps.
If the VA endorsed and recommended options like vapes, pouches and heated tobacco products—all associated with large-scale smoking cessation at a population level—it could transform prospects for this population.
Of all of those veterans I worked with, Bob was my favorite. He was a gruff old guy whom most people thought of as a crab-ass, but he had the kindest, most caring heart. You just had to wiggle your way in before he let you see it.
I closed my vape shop at the end of 2021. The flood of misinformation was non-stop, as were the resulting bureaucratic hurdles imposed on small businesses in the vape industry. It just became impossible to continue.
Bob had many health issues due to decades of smoking and the things he was exposed to in Vietnam. Without my continued support at the vape shop and my constant debunking of the misinformation, Bob went back to smoking in the spring of 2022. He died from pneumonia that summer.
In September 2022, shortly after Bob passed away, I was on a panel in Washington, DC. Our topic was “Forgotten Smokers,” and I planned to use my speaking time to share stories of people I helped on their quit-smoking journeys.
One of those people would be Bob. Before leaving for DC, I showed my presentation to my group of veterans. I saw their eyes get misty when I told them Bob was one of the bravest people I’d ever known, and I vowed to conquer my fears by getting on stage and telling the stories of people like Bob, my hero.
The guys were thrilled that veterans were included in my talk. I had told them I would be meeting with other tobacco harm reduction advocates for drinks in DC, and before I left, they gave me a small envelope. They told me not to open it until I went out for that beer. They’re jokesters, and I was sure it was a gag gift. But when I opened it in the bar, money fell out. I had to ask a friend to read the note because I was too emotional.
The VA must recognize that a one-size-fits-all approach to smoking cessation is insufficient. We owe it to veterans to provide them with a comprehensive suite of resources, including tobacco harm reduction. We owe it to them to cater to their specific needs, tell them the truth, and support the choices they make for themselves.
By embracing tobacco harm reduction, the VA can help more veterans like Bob. Fear-mongering pushed him back to smoking. He deserved so much better.
Photograph (cropped) of hat at the Moving Wall Vietnam Veterans Memorial in Eugene, Oregon, by Rick Obst via Flickr/Creative Commons 2.0
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