According to a survey from the Centers for Disease Control and Prevention, the percentage of smokers over 18 for January-September 2017 was 14.1%—the lowest it’s ever been.

In recent decades, smoking cigarettes has become less popular than alternatives like electronic cigarettes, which have increased their presence in the tobacco products market. Composed of a mouthpiece, e-liquid tank, microprocessor, heating element, and battery, e-cigarettes first arrived in the United States in 2007. Brushed off by many as a gimmick or fad, they began to gain a big following through the “modding” scene where owners could modify their e-cigarettes anywhere from adding lithium-ion batteries to differently shaped enclosures. Following this rise, there are now even annual competitions where participants blow out the best vape cloud—which is produced when e-cigarettes convert the liquid nicotine into vapor.

An example of someone vaping.
An example of someone vaping. http://vaping360.com/

Now, more than a decade since its introduction to the United States, vaping is ubiquitous. Users cite a range of reasons for vaping including recreational use, believing that vaping is healthier than smoking, and to help quit smoking. A “satisfying alternative to cigarettes” is where e-cigarette company JUUL bases its product. Marketed as a tool for current smokers to help reduce or end their consumption of cigarettes, the company has seen a steep rise in notoriety since its inception in 2015. As recently as August of this year, JUUL has seen a market share of more than 70% in the electronic cigarette sector with the closest competitor more than 60 percentage points behind.[1] While JUUL seems to be profiting very well from public consumption of their product, a problem has arisen: teenagers have started JUULing at very high rates.

Possibly an unforeseen consequence from marketing a product that so closely resembles a USB drive is that students can easily stash it away while in school. JUUL has also become very attractive to the younger generation because of its prominence on social media platforms such as Instagram and Twitter. They offer flavor pods ranging from mango to crème brûlée and cool cucumber.  High schools and universities have taken notice of the trend and are beginning to wonder about the future trajectory of e-cigarettes like JUUL. The company has fallen under the scrutiny of health organizations, including the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). These organizations have started to wonder about the health concerns of such products, especially with the increasing usage among teens.

JUUL starter kits at a gas station with other tobacco products.
JUUL starter kits at a gas station with other tobacco products. Photo credit: Ovidio Vasquez

Earlier this month the FDA announced that they issued 1,300 warning letters and civil money penalty complaints to retailers who illegally sold JUUL and other e-cigarette products to minors. These warnings came as a result of a blitz program to target these retailers because, as the FDA’s commissioner Scott Gottlieb, stated: “youth use of electronic cigarettes has reached an epidemic proportion”. In response to this epidemic, Gottlieb made it clear that the FDA plans to take an active approach through their Youth Tobacco Prevention Plan. One big step that implicates JUUL specifically is the request from the FDA for documentation from JUUL Labs (among other e-cigarette companies) to investigate “reportedly high rates of youth use and the particular youth appeal of their products”.

With the health effects of vaping still not fully understood, the rise of e-cigarette companies that appeal to the youth, like JUUL, could have unwarranted consequences on a new generation. Gottlieb also declared, “we cannot allow a whole new generation to become addicted to nicotine.” This seems to be the driving factor for the FDA’s direct response to e-cigarette use among minors.

With the health effects of vaping still not fully understood, the rise of e-cigarette companies that appeal to the youth, like JUUL, could have unwarranted consequences on a new generation.

Just last week the FDA revealed that it will be launching an anti-vaping ad campaign that will focus on teens. The ads will be delivered to teens through YouTube ads, social media ads, and even in school bathrooms and will highlight the negative effects of the toxins in e-cigarettes. Although there is still a need for more research on the effects of e-cigarettes, it is clear that the health implications of JUULing for teenagers is a high priority for the FDA and we can expect continued dialogue on this topic.

Anti-vaping advertisement that says "Vaping can put dangerous chemicals, like Diacetyl, into your lungs."
Anti-vaping advertisement. Courtesy of U.S. Food and Drug Administration

References:

1: Ramamurthi, D., Chau, C., & Jackler, R. K. (2018). JUUL and other stealth vaporisers: Hiding the habit from parents and teachers. Tobacco Control. doi:10.1136/tobaccocontrol-2018-054455

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