They're small, virtually odorless, and they cost a fifth of the price of a pack of cigarettes.

And they're invading South Dakota.

Last month, Rapid City welcomed its first retailer of electronic cigarettes — a more than $1 billion industry that is growing rapidly across the country.

Electronic cigarettes, commonly known as e-cigarettes, are battery-powered devices that simulate traditional cigarettes. But rather than burning tobacco, the devices vaporize a nicotine liquid that the user inhales and exhales.

They're a device that supporters say offer a world of promise: not only do they lack the pungent smell of tobacco smoke, they pose few health risks.

But physicians and public officials in South Dakota are less convinced. They fear that not only does the proliferation of e-cigarettes bring a new set of health risks, they're worried that the industry is operating without any federal regulation, including any ban on selling the devices to children.

"That really concerns me," Mayor Sam Kooiker said. "Because that really becomes a way for tobacco companies to lure children to smoke the real thing."

New business in town

Robyn Bondeson, 43, is a convert to e-cigarettes.

It's Wednesday and the blond-haired Oklahoman is still making adjustments to the decor of her store — the Talulah Vaporium — at 2050 Main Street.

Bondeson's store is the first e-cigarette retailer in Rapid City and possibly the second in the state. Another store, Vape Conexxion in Sioux Falls, opened in late August, according to its Facebook page. The store didn't respond to a request from the Journal for comment.

Business has been slow since Bondeson opened her doors on Oct. 28, but she's expecting it to pick up significantly. In Oklahoma City, her hometown, there's already more than 100 e-cigarette retailers.

Bondeson said she was compelled to open her store not only because she saw an untapped market, but because she believes in her product.

"I think it solves the problem of how to promote public health and at the same time to honor individual liberty and freedom," she said.

Three years ago, Bondeson was a traditional smoker. She smoked a pack of Marlboro Reds each day. She loved it. But she didn't love the smell, the cost or the health effects.

"Probably from the time I was 33, I was having to use an inhaler," she said. "And I was sick a couple of times a year."

Bondeson said e-cigarettes left her lungs untainted and were significantly cheaper.

At her store, an e-cigarette device costs about $50 but the cost of refillable e-cigarette liquid — typically a solution of nicotine, propylene glycol, and concentrated flavor — is a $1 a day for a person who would normally smoke a pack a day.

Because the user is mostly consuming just nicotine, rather than the large number of chemicals and carcinogens in burnt tobacco, Bondeson and other industry supporters maintain it doesn't have the long-term health impact of traditional cigarettes.

"Even over the long-term, nicotine has not been shown to cause death," she said.

Health concerns raised

But the Center for Disease Control and Prevention has concerns about some of industry's claims.

Dr. Tim McAfee, director of CDC’s Office on Smoking and Health, said that enough research has been done to confirm that if a traditional smoker was to fully convert to e-cigarettes, they would do significantly less harm to their body.

However, he said, e-cigarettes still pose an array of public health risks.

McAfee said one of the biggest problems is that e-cigarettes remain unregulated. While the U.S. Food and Drug Administration intends to create new rules about e-cigarettes, which may place them under the same regulations as traditional tobacco, they still reside in a legal gray area.

That means there are no quality control standards for the manufacture of e-cigarettes, which in turn means there is no guarantee about what a user is inhaling each time they use a device.

“There are over 200 e-cigarette manufacturers and the ingredients in their products could change from day to day,” he said. “There are no standards.”

In addition, there are no federal restrictions against selling e-cigarettes or e-cigarette liquid to minors.

McAfee said that creates a major risk that children may be lured to try e-cigarettes, become addicted to nicotine, and eventually smoke conventional cigarettes.

In addition, while e-cigarette supporters may say the product is as benign as nicotine gum or nicotine patches, he said nicotine consumption still poses a health risk.

“For adolescents and women of child-bearing age, nicotine is not only an addictive substance, it’s also a dangerous substance for the developing adolescent brain and the fetus,” he said.

McAfee added that second-hand vapor from e-cigarettes may also have adverse health effects.

"While exposure to e-cigarette vapor will likely be much lower than secondhand smoke from traditional combustible tobacco products, the comparison should be between clean air and air with e-cigarette vapor."

A call for state regulation

It's the unregulated federal environment that has influenced many states to take it upon themselves to place some restrictions on the use of e-cigarettes or to cover them under law in the same way as traditional cigarettes.

According to the CDC, about half of the states have laws that prevent them from being sold to minors. Some states, including Utah, North Dakota and New Jersey, don't allow them to be used in bars or restaurants, just like smoking tobacco. Other states, like Arkansas, have banned their use on school property.

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At present, South Dakota has no state law prohibiting the sale of e-cigarettes to minors. However, it does ban their use in correctional facilities, according to a state-by-state comparison of e-cigarette laws from the American Nonsmokers' Rights Foundation

Kooiker believes that's something the Legislature needs to address. While he would need to check with the city attorney yet, he said it's unlikely that South Dakota cities have the power to regulate the use of e-cigarettes.

Kooiker said the state may also need to examine whether e-cigarettes should be included in the state's ban on indoor smoking.

"If there are dangers from the second-hand smoke, or vapor as you call it, then yes, it's definitely something that the Legislature needs to address," he said.

Dr. Daniel Heinemann, the president of the South Dakota State Medical Association, echoed many of those concerns.

In addition, Heinemann said the Legislature may need to consider applying the same excise tax that is placed on traditional cigarettes to e-cigarettes. 

"That's another reason there would be some concern," he said. "Because it's so much cheaper, it would be easier for children and young adults to afford this and then they get into a nicotine habit."

Some public entities are already taking matters into their own hands. Spearfish School District chose to ban the devices in the spring.

"Just from our perspective as a school system, it was not something we wanted to have an issue with," Superintendent Dave Peters said. "So we made a rule against it." 

Industry ready for regulation

While the e-cigarette industry doesn't agree with the degree of risk attributed to e-cigarettes by the Center for Disease Control and Prevention, it says it does welcome regulation.

Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, a group that represents about 70 e-cigarette retailers globally, said his group has a set of standards it requires from its members.

That includes requirements that e-cigarettes are not sold to those under 18 and that devices are labeled with warnings that they shouldn't be used by pregnant women.

Kiklas said that the group welcomes federal regulations that would ban the sale of e-cigarettes to minors and state regulations that would classify them under indoor smoking bans — although, he said, the industry believes second-hand vapor is virtually harmless.

However, he strongly rejected the idea that e-cigarettes should face the same excise taxes as traditional cigarettes.

Bondeson, who by Friday said she was starting to see repeat customers, also said she would like to see e-cigarette regulation in South Dakota. Her store policy is not to sell the devices to minors, but she had already set up an appointment with a state lawmaker to push that as a rule that applied to all retailers.

For an industry that has already doubled in size this year, Bondeson said she won't be the last e-cigarette retailer knocking at Rapid City's door.

"I will have competition before long," she said. "So I will have to brace for that."

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