Recently, 14 teenagers were hospitalized due to breathing problems linked with e-cigarettes. This comes at a time when JUUL, the largest e-cigarette manufacturer, is under scrutiny for its role in the teen vaping health crisis. In recent years, e-cigarette use has exploded among teens and adolescents prompting concern about a potential public health crisis. Some members of Congress want to hold JUUL accountable for what they allege is unethical business practices that target young people and minors. Here is a broad overview of vaping, JUUL, and recent trends around teens and e-cigarette use.
Over 20% of high school students reported using e-cigarettes in 2018, which is a 78% increase from 2017. The sharp uptick of teenagers using these devices alarms health advocates and government agencies alike. Tobacco use is the leading cause of preventable disease and death in the United States, and youth who use e-cigarettes are more likely than non-users to try traditional cigarettes in the future. JUUL, the most pervasive e-cigarette product, faced scrutiny from Congress and concerned parents about the startling increase in popularity of e-cigarettes among teenagers in a July Congressional hearing. Though JUUL is not the only e-cigarette product used by teenagers, it is the most well known and well sold–its sales account for 75% of the entire U.S. e-cigarette market. The U.S. Surgeon General, the Director of the CDC, and the Secretary of the Department of Health and Human services have all declared that e-cigarette use among teenagers is an epidemic. In addition to the increase in e-cigarettes, overall tobacco product use among high school students has increased nearly 40% in the past year.
We have previously written about the dangers of e-cigarettes, and recently there is additional focus on the increased reports of nicotine addiction, seizures, and hospitalization due to lung damage associated with heavy use of e-cigarettes. According to the testimony of Dr. Winickoff from the American Academy of Pediatrics, many teenagers underestimate the level of nicotine they consume through e-cigarettes (and some believe that there is no nicotine at all!). A study showed that “adolescents who use pod-based e-cigarettes such as JUUL have higher concentrations of nicotine biomarkers in their body than adolescents who smoke cigarettes.” The high nicotine concentration in products like JUUL along with the increased ease of use compared to a cigarette leads to teenagers consuming more than if they only smoked cigarettes. Nicotine addiction can occur in only days and can lead to dependence, especially in the vulnerable developing brains of teenagers. According to the FDA, there were 35 reported cases of seizures linked with e-cigarettes between 2010 and 2019; the reported incidents did not have a singular common product, instead there were many different e-cigarette brands involved, showing that the problem exists across the industry. Seizures and convulsions are potential sides effects of nicotine toxicity. Experts are also concerned by the recent hospitalization of 14 teenagers and young adults due to breathing problems associated with the use of e-cigarettes. Medical staff were unclear on the cause and potential for long term effects; these patients had no known lung problems before their hospitalization.
Before the JUUL hearing, the FDA announced its first e-cigarette prevention ads as part of “The Real Cost” campaigns aimed at educating kids about the dangers of tobacco and tobacco-related products. Existing “The Real Cost” campaigns have prevented approximately 350,000 youth aged 11-18 from starting to smoke in the three year period of 2014-2016. The prevention messages will be distributed through TV ads and posters placed in high school bathrooms–a location that the FDA states many teens are using e-cigarettes or are faced with the peer pressure to do so.
The FDA is responsible for regulating products that claim to help people quit smoking. The FDA has approved products including nicotine patches, chewing gum, and lozenges (which are all forms of Nicotine Replacement Therapy) as well as two prescription products that act on sites in the brain affected by nicotine. No other product type has been approved by the FDA to help quit smoking, including any e-cigarette replacement for traditional cigarette smoking such as JUUL. E-cigarette companies often imply that they are a healthier alternative to traditional tobacco, but they have not been shown to help quit smoking. E-cigarette companies such as JUUL focus on converting tobacco customers to e-cigarette products rather than helping them quit the practice altogether. Along with the help of a doctor, FDA approved smoking cessation products are the most effective way to quit smoking.Tagged Public Health, teens, vaping