Youth Vaping Draws Questions to Whether E-cigarettes are Safer than Traditional Tobacco Products

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At one Midwest high school, a few freshmen gather $65 in the back of a locker room. This cash will soon be exchanged with an 18-year-old student for a JUUL and four JUUL pods. The friends are going in on a “JUUL share.” Because they split the price, they will rotate who keeps the JUUL each week, an anonymous freshman at the high school said.

In an attempt to end e-cigarette usage among youth like the ones in this Midwest school, the Food and Drug Administration pushed some e-cigarette creators to make changes to its flavors, marketing and selling of its products. Although many manufacturers like JUUL Labs chose to comply with the request, other e-cigarette product producers not in question exist, and there is a chance it is too late to end some young people’s appeal to these devices.

What Are E-cigarettes?

E-cigarettes come in a variety of forms, but typically involve the user having to inhale vapor through the mouth of a device that uses a temperature-controlled battery to heat up a liquid in the form of e-juice. The JUUL is one version of an e-cigarette, and it is the most popular form of vaping among youth.

Similar in shape and size of a USB device, the JUUL entered the marketplace in 2015 and has dominated e-cigarette sales since. According to a research study by the Centers for Disease Control and Prevention published in JAMA, in 2016, 2.2 million JUUL devices were sold. That number skyrocketed in 2017 to 16.2 million JUUL devices sold – a 621 percent increase.

Along with the JUUL device, disposable cartridges called JUUL pods, which contain flavored liquid, are inserted into the JUULs and allow users to vape. JUUL offers eight pod flavors: Virginia tobacco, classic tobacco, mint, menthol, fruit, mango, cucumber and crème.

JUUL’s website says the ingredients in these pods are glycerol, propylene glycol, natural oils, extracts, flavor, benzoic acid and nicotine. Each pod is supposed to last around 200 puffs and has about the same amount of nicotine as a pack of cigarettes.

Although there is no tobacco in e-cigarettes, an article published by Nicotine & Tobacco Research in June 2018 called “Are e-Cigarettes Tobacco Products?” says nicotine is extracted from tobacco. Also, the FDA classified e-cigarettes as tobacco products in 2014. However, Canada and most countries in Europe do not refer to them as such.

Is JUULing Harmful?

The nicotine in JUUL pods can be harmful to youth, but young people continue to vape despite side-effects. The Centers for Disease Control and Prevention reported last year that a little over 20 percent of high school students admitted to using tobacco products in 2016. As for e-cigarettes, 11.3 percent of high school students reported using them along with 4.3 percent of middle school students.

Dana Thomas, a substance abuse counselor at Ball State University, said she has seen an increase in e-cigarette use among college and high school students. She is alarmed by the myths she hears about vaping, such as it not being harmful or addictive like cigarettes.

“There are a lot of different chemicals in both cigarettes and e-cigarettes, but what makes them both addictive is the nicotine, so people can become addicted to either,” Thomas said.

According to the Surgeon General’s report on E-Cigarettes Among Youth and Young Adults, nicotine is even more harmful to those younger than 25, and it may alter the way a young vapor’s brain functions for life. Because the brain continues to develop up until this age, exposing it to nicotine makes a person vulnerable to nicotine addiction. Also, it may cause concentration problems along with reduced impulse control and mood disorders.

Although the risks may be more severe for youth, people can become subject to nicotine addiction at any age. Ron Washington, a 25-year-old in Muncie, Indiana, said he steered away from smoking cigarettes his whole life because he did not like the taste. However, after trying his roommate’s JUUL, he found himself at the Smoke Shop buying his own two weeks later. Now, he said he is addicted to “hitting it.” Occasionally, he smokes a pod or more in one day.

Even the Midwest high school student said the buzz one gets from just one hit off of a JUUL is what makes the device so appealing. This person said a mild hit feels like a 30 second high, but a strong one may even cause a nauseous feeling.

Because e-cigarettes have barely been on the market for more than a decade, The American Academy of Family Physicians website says the long-term side effects of vaping are still unknown. Its website did say some researchers are starting to find impacts on short-term effects including rapid deterioration of vascular function, increased heart rate and elevated diastolic blood pressure.

The National Academies of Science Engineering, and Medicine concludes that there is at least enough evidence to show that youth and young adult e-cigarette use increases the likelihood of one smoking non-electronic cigarettes.  

Restricting Access to Youth

A nationwide undercover brick-and mortar blitz found many retailers illegally selling JUUL and other e-cigarettes to youth. According to the FDA’s website, the organization issued letters to the top five e-cigarette companies in September 2018 asking manufacturers to submit a plan within 60 days that describes how its company will address the widespread youth access and use of its products.

As a result, brands may be required to remove some or even all of their flavored products because some believe these cookie and candy flavored names contribute to the rise in youth using e-cigarette products.

In a JUUL Labs’ press release published in September 2018, its Chief Executive Officer Kevin Burns responded to FDA’s request by saying JUUL Labs will work proactively with FDA to be part of the solution in preventing underage use of e-cigarettes. “By working together, we believe we can help adult smokers while preventing access to minors,” he said.

Up until that point, JUUL Labs launched the “What Parents Need to Know About JUUL” campaign announced in a June 2018 press release, which was said to be part of JUUL Labs’ ongoing $30 million initiative to stop underage use. The press release said JUUL Labs worked with parents and educational professionals to determine content of the multi-pronged educational advertisement campaign meant to provide parents with information about its product and make people aware of JUUL, vaping and nicotine facts.

Because of the popularity of social media among youth, the company also decided to shut down its Instagram page along with other JUULing pages such as @JUULNation, @Doit4JUUL, and @JUULCentral. JUULS’ June 2018 press release said an internal team has partnered with several social media companies to focus on removing posts, pages, and unauthorized offers to sell product targeted at underage users. Burns said in the press release that JUUL Labs will remove all social media posts featuring models. In the future, social media posts will share adult smokers’ stories who have switched from cigarettes to JUUL instead.

Will the Problem Evaporate?

There is a loophole in the system, though. Just ask the Midwest high school student who said neither he nor his classmates are fazed by JUUL Labs’ new restrictions. A quick YouTube search and anyone can learn how to refill used JUUL pods with e-cigarette juice, which not only comes in more, but also “better” flavors, the high school student said. And e-cigarette juice is still legally accessible for any 18-year-old buyer.

Jamie Brown, a sales associate at White Dragon Vapor Lounge, said although White Dragon does not carry JUUL brand products, the lounge has seen changes in some of its other products. For example, the e-juice brand Drip More is popular for its flavors such as Candy King Batch, which is supposed to taste like Sour Patch Kids and uses similar colors as the popular candy on its e-juice package. A lot of these brands are changing their products names to be less resembling of desserts and candies. But, Brown does not think the name of a flavor or the coloring of the package matters when it comes to vaping, at least for those over 18.

Brown said he started smoking cigarettes when he was 14-years-old and was up to smoking two packs of cigarettes a day before quitting and switching to vaping in 2016. Although he believes nicotine is not supposed to be inhaled by people and can be more dangerous for youth, he does not feel vaping is as harmful as it is made out to be.

A couple weeks after quitting traditional cigarettes and switching to vaping, Brown said he coughed up brown stuff because the vapor was cleaning out his lungs. His breathing improved, and he stopped getting consistent ­­­­­headaches. He sticks to the belief of what Royal College of Physicians published in 2016: E-cigarettes are 95 percent safer than smoking.  

“Kids are going to do what they want to do,” Brown said. “I do not think vaping is the worst form of rebellion they could be participating in.”

Although the Midwest freshman enjoys JUULing with his friends now, he said he does think it is an epidemic, nor does he see himself JUULing for life.

References

Ron Washington– JUUL Pod Owner
Anonymous Freshman

Dana Thomas– Substance Abuse Counselor at Ball State University,

Jamie Brown– Sales Associate at White Dragon Vapor Lounge

https://www.rcplondon.ac.uk/news/promote-e-cigarettes-widely-substitute-smoking-says-new-rcp-report
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm620184.htm
https://jamanetwork.com/journals/jama/article-abstract/2705175
https://www.aafp.org/patient-care/public-health/tobacco-nicotine/e-cigs.html#effects
https://www.cdc.gov/mmwr/volumes/66/wr/mm6623a1.htm?s_cid=mm6623a1_w
https://newsroom.juul.com/2018/07/12/juul-labs-will-make-3-nicotine-pods-widely-available/
https://newsroom.juul.com/2018/06/06/advertising-campaign-combating-underage-use/
https://newsroom.juul.com/2018/06/14/juul-labs-implements-new-social-media-policy/
https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/nty130/5041976
https://www.juul.com/shop/devices/basic-kit
https://support.juul.com/home/learn/faqs/juulpod-basics
https://truthinitiative.org/news/understanding-electronic-nicotine-delivery-systems
https://truthinitiative.org/news/understanding-electronic-nicotine-delivery-systems
https://www.cnn.com/2018/11/15/health/fda-vaping-ecigarette-regulation/index.html
https://motherboard.vice.com/en_us/article/yw4gvx/the-fda-declares-teen-juuling-an-epidemic
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