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SALT LAKE CITY — The day Braxton Katis decided to quit smoking, he had just finished giving his 4-month-old daughter a bath when he noticed that she still smelled — like cigarettes.
"She started coughing," Katis said. "And not just like a normal cough — like a smoker's cough."
That scared him so much that Katis, now 27, hasn’t touched a cigarette in two years. Katis attributes his success to e-cigarettes, a product as controversial as it is popular.
A report from the Royal College of Physicians released Thursday adds new fuel to the debate. Over nearly 200 pages, the respected British medical organization summarized 10 years of data on e-cigarettes and tobacco and concluded that smokers should be urged to switch to e-cigarettes.
E-cigarettes, which deliver nicotine through water vapor rather than cancer-causing tar, are "an opportunity to improve the lives of millions of people," the report said. "It is an opportunity that, with care, we should take."
The organization's stance puts it at odds with many U.S. medical organizations, including the Centers for Disease Control and Prevention, which told the New York Times on Thursday that there is "no conclusive scientific evidence supporting the use of e-cigarettes as a safe and effective cessation tool at the population level."
Denitza Blagev, a pulmonologist at Intermountain Medical Center in Murray, said there are no definitive studies that show whether the potential benefits of e-cigarettes outweigh the risks. The uncertainty, she said, has inflamed debate among physicians internationally.
"Some people said, 'Look, it's really hard to quit. We should be promoting this to help people quit,'" Blagev said. "And other people said, 'It's not marketed as a tobacco cessation aid. We're just playing into the hands of the tobacco companies.'"
In Utah, lawmakers introduced two bills in the 2016 legislative session that would have taxed e-cigarette products at 86.5 percent.
Aaron Frazier, the executive director of Utah Smoke-Free Association, said the taxes would raise tobacco smoking rates, not decrease them.
"You double the price of a product … the customers are going elsewhere or it's going to push them back to smoking traditional cigarettes," said Frazier, who quit smoking more than five years ago with the help of e-cigarettes.
But Rep. Raymond Ward, R-Bountiful, one of the bill's sponsors, said the tax is intended to protect youths from getting addicted to nicotine, which has been shown to increase a brain's propensity for addiction if exposed often and early.
“I would be so happy to run a bill that says the tax goes completely away if the teenage use goes back down to its previous levels,” Ward said. "But every teenager you start … that is a hook in their nose for the rest of their life to try and get unaddicted to their nicotine."
Blagev said few experts disagree that e-cigarettes are probably safer than traditional cigarettes because e-cigarettes deliver nicotine without the accompanying tar and smoke.
But doctors and health officials are concerned that e-cigarettes are a gateway back into traditional cigarettes, with the potential to reverse decades of work combating a habit responsible for more than 480,000 deaths a year in the U.S. — about 1,300 deaths a day.
Some early studies indicate there could be a link between teen use of e-cigarettes and traditional tobacco products, but the evidence is still unclear, Blagev said.
Indeed, the vaping industry has often struggled to be seen as both a popular consumer product and a legitimate medical device.
The ads are splashy, glamorous and filled with celebrity endorsements. The flavors of e-liquid range from cereal milk to strawberry.
And youth usage rates are skyrocketing. In Utah, the percentage of students reporting that they use e-cigarettes have tripled since 2011.
"If (e-cigarettes) were marketed as a cessation aid, then it would be much easier for health care workers and public health advocates to say, 'Yes, you should try it,'" Blagev said. "But you look at the packaging and you feel like, 'I don't need to be endorsing this as a quote-unquote 'healthy alternative.'"
The Utah Department of Health neither supported nor opposed the tax bills, according to Brittany Karzen with the department's tobacco prevention and control program.
But the department did work with vaping industry representatives to craft a new set of regulations that go into effect July 1 that could improve the safety of e-cigarettes.
Among other things, Utah vape shops and manufacturers must now have child-proof caps on all e-liquids, print the batch number and manufacturer name on each bottle, and are banned from enhancing e-liquids with coloring or additives.
As someone who watched his father go through quadruple bypass heart surgery due to complications from smoking, Katis says anything that helps legitimize the e-cigarette industry is a good thing.
He's now trying to help his mom — also a smoker — switch to e-cigarettes.
The industry is "taking off like a storm," Katis said.
"And one of the highlights," he added, "is my daughter's eventually going to be raised in a world without cigarettes."
Email: dchen@deseretnews.com Twitter: DaphneChen_
