JUUL, E-Cigarettes, Teens, and Vaping: What You Need to Know

Vaping: What You Need to Know

Vaping has become a regular part of life for many Americans, particularly among teens.

Selling e-cigarettes to anyone under the age of 18 is illegal, however a 2018 federal survey showed that more than three million high school students in the United States had tried e-cigarettes in the month prior. That is a 78 percent increase from 2017.

This means that one out of every five high schoolers in our country uses e-cigarettes.

Did you know that, according to researchers:

  • One JUUL pod delivers more nicotine than a packet of cigarettes.
  • JUUL pods are specially formulated to deliver an otherwise intolerable amount of nicotine while maintaining a smooth flavor.
  • Most teens don't know that their vaping product contains nicotine.
  • JUUL pods contain potentially harmful toxic chemicals that can lead to serious health conditions like lung disease and cancer.

We want you to have as much information as possible amid what the Surgeon General has called an "e-cigarette epidemic among youth." This will allow you to make the best choices possible for you and your loved ones' well-being.

Below is what the experts have to say about teens, e-cigarettes, and what vaping can mean for your health.

E-Cigarettes Contain More Nicotine Than a Pack of Cigarettes

First things first: Nicotine is the addictive drug in traditional tobacco products like cigarettes and cigars. Researchers have found that just one JUUL pod contains the same amount of nicotine as 34 to 38.5 cigarettes—that's more than a pack and a half.

A study of 506 teens who exclusively use e-cigarettes found that they had higher levels of nicotine in their bodies than the levels found in adolescents who smoked traditional cigarettes.

In addition, researchers determined that the e-cigarette pods deliver the nicotine in a particularly potent way using nicotine salts. These salts mimic the natural structure of nicotine found in tobacco leaves, making the nicotine more absorbable and less harsh, allowing for increased inhalation and consumption.

The Surgeon General: Nicotine Can Harm Young Brains

Research has shown that young brains are particularly susceptible to the addictive effects of nicotine.
  • Nine out of 10 smokers begin by the age of 18.
  • Eighty percent of people who start smoking as teens will continue into adulthood.

The Surgeon General's Advisory on E-Cigarette Use Among Youth puts it simply: "Nicotine exposure during adolescence can harm the developing brain." The advisory warns that teens who consume nicotine can experience negative impacts on learning, memory, and attention. They are also at a higher risk of future addiction to other drugs.

Truth Initiative Study: Teens Don't Realize What They Are Inhaling

You might be surprised to know that despite the facts outlined above—that JUUL pods contain more nicotine than a pack of cigarettes and that their nicotine is designed to be easier to consume—most young people don't know their e-cigarettes contain nicotine.

  • According to an April 2018 Truth Initiative study, nearly two-thirds of JUUL users between the ages of 15 and 24 didn't know the pods always contain nicotine.
  • Most young e-cigarette users think they vape flavoring only.

If you know a teen who vapes, we encourage you to talk to them about what is in the products they use and the side effects those ingredients can have.

American Chemical Society, FDA: E-Cigarettes Contain Known Carcinogens

Teens and young people are vulnerable to nicotine addiction. Some e-cigarettes contain a highly addictive amount and type of nicotine. But you might wonder, aren't e-cigarettes "safer" than traditional tobacco products?

Here's what research says in response to that question:

While it's true that e-cigarettes can reduce exposure to some of the hazards found in tobacco, they contain other potentially harmful toxins.

Research presented at the 2018 annual meeting of the American Chemical Society found that vaping can damage DNA in a way that can cause cancer. According to the study, three DNA-damaging compounds were found in users' saliva after vaping: formaldehyde, acrolein, and methylglyoxal.

  • This echoes the findings of the Food and Drug Administration (FDA), which previously declared that e-cigarettes contain "known carcinogens and toxic chemicals."
  • The National Academies of Science, Engineering, & Medicine drew similar conclusions, saying that the majority of e-cigarette products contain "numerous" potentially toxic substances.

In addition to carcinogenic effects, some e-cigarette flavoring compounds can lead to inflammatory responses in the body. Chronic inflammation can lead to conditions like:

  • Bronchitis
  • Emphysema
  • Heart disease

A study based on survey responses of 66,795 e-cigarette users found that, compared to non-users, people who vape had a:

  • 71 percent higher risk of stroke
  • 59 percent higher risk of heart attack or angina
  • 40 percent higher risk of coronary heart disease

The highly addictive nature of the nicotine in e-cigarettes leads to dangerous chronic use of the products, increasing the chances that users develop these serious diseases.

Stanford University Researchers: JUUL's Marketing Targeted Youth

JUUL is the post popular e-cigarette in the United States, with a market share of over 70 percent.

A team of researchers at Stanford University examined JUUL's advertising from the time the company launched in 2015 through the fall of 2018. They examined thousands of Instagram posts, emails, and ads.

Despite the fact that selling e-cigarettes to minors is illegal, researchers came to the following conclusion about JUUL's marketing: It was "patently youth-oriented."

Among their findings:

  • The ads depicted behavior that more closely resembled that of teens than adults (for example, young models dancing, flirting, and socializing).
  • JUUL launch parties featured younger-leaning musical acts and unlimited free supplies.
  • The company ran ads in youth-oriented publications that aimed to convince young people who were not smokers to try e-cigarettes.
  • Not only did JUUL mimic the tobacco industry's well-documented advertising tactics to appeal to young users, it also took advantage of social media, finding teens where they spend the most time.

According to the lead researcher, "The messaging is very subtle, very carefully crafted, but they target adolescents in the same way [as the tobacco industry]."

The researchers found that JUUL shifted its marketing strategy only after the media and the FDA took notice of the steep rise in e-cigarette use among youth. However, the damage had been done:

  • During the three years JUUL marketed on social media, there were more than 250,000 posts with the hashtag #juul.
  • The company eventually halted its social media campaigns, but in the eight months after the company stopped, user posts featuring #juul skyrocketed to over 500,000.

Researchers: JUUL's Products Appeal to Youth

In addition to the marketing campaigns, researchers and health experts also noted that the design and accessibility of e-cigarette products themselves appeal to a youthful audience. Even though it's illegal to sell e-cigarettes to minors, experts say that:

  • Many websites that sell e-cigarettes do not use adequate age verification for purchase.
  • Many brick-and-mortar stores don't verify customers' ages.
  • E-cigarette flavorings such as mango, cucumber, cotton candy, and crème brulee are youth-friendly. Data from the FDA found that over 70% of youth e-cigarette users said they use the products "because they come in flavors I like."

The government has said that it will ban flavored e-cigarettes in an attempt to curb youth e-cigarette use. JUUL has already stopped selling its flavored pods, including mint, and now only offers menthol and tobacco flavors.

Surgeon General: Everyone Can Take Action on the "Epidemic" of Youth E-Cigarette Use

The Surgeon General of the United States issued an advisory saying that e-cigarette use has become an "epidemic among our nation's young people" and recommends that parents, teachers, and healthcare providers take steps to counteract youth vaping trends. Here are some of the Surgeon General's recommendations:

  • Parents should talk to their child or teen about e-cigarettes and their risks. It's never too late the start the conversation. Here is the Surgeon General's Tip Sheet for Parents: https://e-cigarettes.surgeongeneral.gov/
  • Make sure you're informed about the different types of e-cigarettes available and the potential risks associated with each. You can find more information here: https://e-cigarettes.surgeongeneral.gov/
  • Set up an appointment with your child's health care provider to talk about the risks of e-cigarettes and tobacco products.
  • Take advantage of services that help users quit tobacco and nicotine use, such as:
    • Smokefree.gov
    • 1-800-QUIT-NOW

And, if you have any legal questions surrounding injuries and illnesses from e-cigarettes, we are available for free, no obligation consultations at 1-877-532-9516.

You can lean more about JUUL and e-cigarette lawsuits here.

Sources:

  • CDC, Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students – United States, 2011–2018, , Morbidity and Mortality Weekly Report ("MMWR") 67(45);1276–1277 (Nov. 16, 2018), https://www.cdc.gov/mmwr/volumes/67/wr/mm6745a5.htm?s_cid=mm6745a5_w.
  • FDA, Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA, FDA News & Events (July 22, 2009), https://www.scirp.org/(S(i43dyn45teexjx455qlt3d2q))/reference/ReferencesPapers.aspx?ReferenceI D=1560557.
  • Medical Express, E-cigarettes linked to higher risk of stroke, heart attack, diseased arteries (Jan. 30, 2019), https://medicalxpress.com/news/2019-01-e-cigarettes-linked-higher-heart-diseased.html.
  • National Academies of Sciences, Engineering, and Medicine, Public Health Consequences of E- Cigarettes (Jan. 23, 2018) at 198, http://nationalacademies.org/hmd/Reports/2018/public-health- consequences-of-e-cigarettes.aspx.; 49 Id. at 401.
  • National Cancer Institute, Vaping Pods Produce High Nicotine Levels in Young Users (Oct. 5. 2018), https://www.cancer.gov/news-events/cancer-currents-blog/2018/youth-vaping-high-nicotine-levels.
  • Surgeon General's Advisory on E-cigarette Use Among Youth (Dec. 18, 2018), https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf.
  • Chaykowski, K., The Disturbing Focus Of Juul's Early Marketing Campaigns, Forbes (Nov. 16, 2018), https://www.forbes.com/sites/kathleenchaykowski/2018/11/16/the-disturbing-focus-of-juuls- early-marketing-campaigns/#68f6831d14f9.
  • France de Bravo, B. et al., Is Vaping Safer than Smoking Cigarettes?, National Center for Health Research, http://www.center4research.org/vaping-safer-smoking-cigarettes-2/.
  • Jackler, R, Rapid Growth of JUUL Hashtags After the Company Ceased Social Media Promotion, Stanford Research into the Impact of Tobacco Advertising, July 22, 2019, tobacco.stanford.edu/hashtagjuulgrowth.
  • Keller, K., Ads for E-Cigarettes Today Hearken Back to the Banned Tricks of Big Tobacco, Smithsonian.com, April 11, 2018, https://www.smithsonianmag.com/history/electronic-cigarettes- millennial-appeal-ushers-next-generation-nicotine-addicts-180968747/.
  • Pulvers, et al, Tobacco Consumption and Toxicant Exposure of Cigarette Smokers Using Electronic Cigarettes, Nicotine & Tobacco Research, 2018, 206-214.