INTRODUCTION TO THE “DOC” by “Doc Jr” Ryan Matthew Thornton    Published in VAPUN MAGAZINE 9/2017

On June 13, 2014 Docs Vape e-Scape was born in a tiny 600 square foot space in the heart of Cookeville, Tennessee, home to Tennessee Tech University and located almost equidistant between Nashville and Knoxville on I40.  The name was a tribute to the “Doc”, Anthony P. Dalton, M.D., retired Orthopaedic Surgeon and the Cofounder and CEO of DocsVapeEscape along with his wife Karen and Ryan M. Thornton, COO, nicknamed “Doc Jr”, son and author of this tribute.  Unbeknownst to any of us, the “Doc” would pass away in May of 2016 and the name would become one of his legacies.

As a result of Dr. Dalton’s vocation as an orthopaedic surgeon, as well as to honor the oath he swore when he received his medical degree of “…but first do no harm!” he developed a penchant for perfection and demanded that DocsVapeEscape become a leader in the industry, not only for products and juices imported from liquid artists locally and nationally, but also to provide a shop where patrons of all ages and levels of vaping experience would be comfortable to shop, share information, and gain knowledge about the techniques and nuances of this new technology.  First and foremost he emphasized customer service, realizing that strict adherence to providing excellent customer service would result in success both in productivity and financially, but most importantly to ensure the customer remained dedicated to their decision to give up combustible tobacco products and continue vaping.  This is probably a good time to point out that the industry jargon “vaping” was bred out of the fact that when the user exhales the end product is “vapor” per Dr. Dalton’s playful quote in the blog about this issue:  “Water vapor is the product of vaping, and only adds water vapor to the clouds which make our farmers more successful.”

Despite the fact that there was no FDA monitoring of liquid quality or manufacturing, Doc and I (Doc Jr) were one of the first shop owners in the industry to ban liquids containing Diacetyl as it had been proven to be detrimental to lung and breathing function after long term use in other industries.  We began demanding written statements from various liquid laboratories indicating no Diacetyl was used in the production of the juice, and eliminated those liquids that did not provide this documentation. Doc became passionate about reading whatever research was available about vaping and began to publish articles on his blog which can be found at www.DocsVape.comfollow the link to the blog. The following are excerpts from Dr. Dalton’s blog regarding his findings in the research about nicotine which incidentally led to his increasing his nicotine preference from .3 mgs to .6 mgs.  In his own words:

I’m back with more vital information regarding the controversial effects of nicotine in smoking vs the unequivocal advantages of the nicotine content in e-liquids for vaping. For ease of assimilation to the reader, I will again construct my entries in enumerated facts, specifically by numbering, using AF for REFERENCED DATA and OS as an OPINION STATEMENT after appropriate entries:

  • Nicotine is named after the plant Nicoiana tabacum (with this genus and species can there be any doubt regarding the origin of Nicotine?). It was named after the French ambassador in Portugal, Jean Nicot de Tillemain, who, in 1560, sent seeds to Paris to promote their “medicinal use.” (AF)
  • Nicotine was first isolated and introduced by Wilhelm Heinrich Posselt and chemist Karl Ludwig Reimann of Germany in 1828, who “considered it a poison” which is not surprising because . 0.6 to 4% of the dry weight of tobacco and chemically isolated nicotine is efficiently absorbed through the skin and a lethal dose of Nicotine to humans is only 30 to 60 mgs. Perhaps the isolators became aware of this propensity for skin absorption only after one expired due to uneducated exposure!  Let this fact become well-assimilated as pure liquid nicotine is readily available in the market and can be spilled on the skin, or ingested by uniformed adults and, tragically, by children, as e-liquids containing  0 to 38 mg% are often contained in colorful, fantastical bottles, often quite appetizing in appearance to the uninformed.  YOU are no longer “uninformed.”  But more about these facts are forthcoming in this treatise.  (AF,OS)
  • The average cigarette contains one (one) mg of Nicotine. It is absorbed from lungs to brain in 10 to 20 seconds and has an elimination half-life of two hours.  However, its powerful metabolite, Cotinine, remains an active metabolite for up to 18 to 20 hours in the bloodstream. (AF)
  • Initially, cigarettes and other Nicotine products and foodstuffs comprised only about 4.4% of blood concentration. Insidiously, however, the dosage of Nicotine in cigarettes increased at 1.78% per year between the years 1998 and 2005, giving a heavy smoker an increased dose of nicotine. This amounts to an increase of about 14.4% in 8 years!  Is there any doubt that cigarette manufacturers could never be accused of safeguarding the public against the tar-nicotine combination which is carcinogenic?!   The lethal dose of Nicotine to humans is 30 to 60 mgs, so the 1 mg per cigarette morphed intentionally to 14.4 mg per cigarette.  How many people smoke over a pack of cigarettes per day?  The ONLY saving grace is the half-life of two hours in the bloodstream never reaches the LD50 numbers which could result in mortality.  But the morbidity of Cotinine of 18-20 hours could potentially cause innumerable health risks, which could explain why the Census Bureau estimates 440,000 deaths per year.  As an orthopaedic surgeon, I can voice unequivocally that over 80 to 90% of post-operative complications, including post-operative pulmonary atelectasis (and pneumonia), stroke, infection, deep vein thrombosis and pulmonary emboli, delayed wound healing and 50% longer recovery times were directly related to cigarette smoking!  (AF,OS)
  • Nicotine increase binds with neurotransmitters in the brain and increases their levels, specifically Dopamine which is carried to the “pleasure center” by acting as a “volume control”. It is for this reason that dopamine enters the reward circuits of the brain which contribute to the relaxation and euphoria felt to be the cause of nicotine addiction.  (AF)
  • Nicotine also acts on the sympathetic nervous system (in contrast with the parasympathetic nervous system) stimulating the increase in epinephrine which explains the increase in blood pressure, pulse, respiratory rate and increase in blood sugar level , simulating the “fight or flight” action of epinephrine when faced with danger. (AF)
  • Studies show that tobacco smoke increases the reward pathway sensitivity, the opposite of other addictive drugs such as heroin and cocaine, and actually DECREASES the brain reward sensitivity.  Make no mistake, however, Nicotine is an addictive substance as found in cigarette studies, not in vaping experiments as studies are not yet available for vaping.  Anecdotally, we have found that cessation of vaping seems much easier than with cigarettes having experience with over 500 clients. (AF,OS)
  • The risk of ulcerative colitis has been shown to be less frequent in smokers due to nicotine and is dose dependent (the number of cigarettes smoked) suggesting similar positive effects from vaping. (AF)
  • Studies show that nicotine reduces the risks of preeclampsia in pregnancy. (AF)
  • Nicotine seems to decrease the risks of disorders such as allergic asthma. (AF)
  • Although smoking has been shown to increase the risk of Alzheimer’s disease, pure nicotine has been shown to be effective in the prevention and treatment of Alzheimer’s disease. (AF)
  • Nicotine has been shown to delay the onset of Parkinson’s disease. (AF)
  • Studies show that nicotine is effective in treatment of adults with nocturnal frontal lobe epilepsy (nightly seizures.) (AF)
  • Nicotine in lower doses has been shown to be effective in the treatment of schizophrenia. (AF)
  • Studies at Duke University have shown that nicotine is beneficial in the treatment and prevention of depression. (AF)
  • The same Duke studies have shown Nicotine to improve ADHD (adult attention deficit disorder). (AF)
  • Low dose nicotine patches have been shown to be effective in the treatment of major depressive disorders in non-smokers. (AF)
  • Nicotine (used as chewing gum or transdermal patches) has been shown to be successful, even in refractory cases, in the treatment of OCD (Obsessive Compulsive Disorders.) (AF)
  • Nicotine has the paradoxical effect of being effective in the treatment of ulcerative colitis, a severely debilitating disease. (AF)
  • The drug Nicotine is UNIQUE in that it has both a stimulant and a sedative or relaxant effect.  Users report feelings of relaxation, sharpness, calmness and alertness. (AF) Research has shown that when smokers wish to achieve alertness or a stimulating effect, they take short, quick puffs, producing a low level of nicotine. Conversely, when smokers wish to achieve a sedative or calming effect, they take deep, long puffs. (AF,OS)
  • Nicotine at higher doses causes opiate effect producing calmness and a pain-killing effect. This uniqueness of Nicotine was a phenomenon described by Paul Nesbitt in his doctoral dissertation and has subsequently been referred to as “Nesbitt’s Paradox.” (AF)
  • The average cigarette, inhaled, has about 1-3 milligrams of nicotine, which causes Nicotine to reach the brain in about 7 seconds.  It is quite possible that smokers use cigarettes to self-medicate anxiety and/or depression, among the other aforementioned disease effects. Vapers may do the same in their decision of choice in the milligrams of Nicotine in their e-liquids. (OS)
    In summary, only 5% of the smoking population has switched to vaping, in part due to the fact that federal grants for research seems to be preponderantly awarded to those who wish to add to the “negative “bibliography of vaping and, egregiously vilify a good and enjoyable habit which, on balance, makes cigarette smoking a habit for fools and weak-kneed individuals who refuse to even consider a healthier change in theirs and their families’ and other citizen’s lives.

Final note from the author:  Vaping is an art, and if learned correctly it is a better, safer alternative than smoking the tar, carcinogens, and thousands of chemicals contained in cigarettes. Vaping is a hobby which allows the “hobbyist” the opportunity to “lead a whole new lifestyle!”  Vaping is not a quick fix, it is a learned skill, and when applied correctly the highest level of vaping is often referred to as the “art of vape” because it is a beautiful, positive activity that was designed to save lives!

For more information about the medical literature and Dr. Dalton’s extensive recording of the facts available prior to his passing in May of 2016, please go to our website and follow the link to the blog.

**Anthony P. Dalton, M.D. obtained his Medical Degree from Creighton University Medical School in Omaha, Nebraska in 1975 and was Board Certified with the American Academy of Orthopaedic Surgeons, Board Certified with the American Board of Arthroscopic Surgery as well as the Arthroscopic Board of North America.  In May of 2009 Dr. Dalton completed his Masters in Medical Management Degree from the University of Southern California’s Marshall School of Business, a degree offered to physicians exclusively, having been accepted to a Cohort of only 12 from a field of approximately 50 applicants.  His wife Karen and their son Ryan reside in Cookeville, Tennessee and continue to operate DocsVapeEscape, along with General Manager Bryan Austin Phifer (“Shazam”) and Dakota Cox, finance major at the local university, utilizing the rigorous standards as originally implemented by the “Doc.”  We are confident that Dr. Dalton’s brief participation in the world of vape and the insights and scientific evidence he presented on his blog will greatly influence the journey of the industry and perhaps assist those who endeavor to sway legislation accordingly.

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