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JUUL® E-Cigarettes and Teens and Young Adults

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Exhale of vapor from an e-cigarette.

E-cigarette use among teens and young adults has been rising rapidly in recent years. According to the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), there were over 3.6 million youth users of e-cigarettes in 2018, a number that continues to rise. From 2017 to 2018, the rate of e-cigarette use amongst high school and middle school students rose 78 percent.

Evidence suggests that some young people have been lured into e-cigarette use with:

  • Tempting flavors, which are now largely banned
  • Sleek, modern product design
  • Ease of use
  • Ease of hiding use, even indoors, due to lack of smell and e-cig’s sleek, easy-to-hide design
  • Marketing at rock concerts and in social media
  • Lack of emphasis on the fact that e-cigarettes contain nicotine—a fact that some teens have claimed they were not aware of
  • No apparent mention or emphasis on the dangers of vaping or, more importantly, the dangers and addictiveness of nicotine
  • Claims that e-cigarettes are safe
Exhale of vapor from an e-cigarette.

E-Cigarettes’ Dangers for Children, Adolescents, and Young Adults

E-cigarettes pose particular dangers for children, adolescents, and young adults. Along with the health risks e-cigarettes post to all users, including association with severe lung issues and seizures, prompting many to file e-cigarette lawsuits, the use of e-cigarettes and exposure to nicotine poses particular risks for children and teens. Youth and teen vaping:

  • Correlates to later beginning to smoke cigarettes, even among youth who claimed to never intend to start smoking.
  • Can harm adolescent brain development, affecting memory and attention.
  • May predispose the adolescent brain to addiction to other drugs.

JUUL’s Marketing of E-Cigarettes Deemed Aimed at Youth

Electronic cigarette companies had always claimed their products were a safer alternative to traditional cigarettes and could be used by adult smokers to stop smoking cigarettes. But their marketing campaigns were identified in 2018 as seeming to be “kid friendly,” including packaging resembling kid friendly cereal and candy products and the fact that they sponsored music festivals and engaged in aggressive social media campaigns. JUUL marketed in its early tenure (2015 to early 2016) on kid-friendly platforms such as Cartoon Network, Nickelodeon, and Seventeen magazine. JUUL was so popular with teens and young adults that many called vaping “Juuling.”

The FDA and the Federal Trade Commission, in response to these marketing tactics they deemed aimed at youth, issued warning letters to the companies they found engaging in these practices. Many e-cigarette companies then removed the products cited, and some e-cigarette manufacturers produced plans to lessen underage e-cigarette use. But in early 2019, the FDA accused those manufacturers of not following their plans, and now e-cigarette flavors have been banned in premade pods, except nicotine and menthol flavor. Flavors are still not banned, as of early 2020, in disposable e-cigarettes.

State and Federal Government Tactics to Curb or Prevent Teen Vaping

Even before the U.S. banned flavors, some states banned flavored e-cigarettes, which are considered more attractive to youth than unflavored e-cigarettes. And the FDA has launched e-cigarette prevention ads, aimed at educating teens about the dangers of vaping and e-cigarettes.

“The troubling epidemic of youth vaping threatens to erase the years of progress we’ve made combatting tobacco use among kids, and it’s imperative that our work to tackle this immensely concerning trend continue to include efforts to educate our nation’s youth about the dangers of these products. The new ads as part of our youth prevention campaign highlight one of the many alarming aspects of youth e-cigarette use ‒ that, according to emerging science, teens who vape are more likely to start smoking cigarettes, putting them at risk of a lifetime of addiction to smoking and related disease. As our new ads state: ‘it’s not magic, it’s statistics,’ and the potential for kids to become traditional cigarette smokers because of e-cigarettes gives me great pause,” said Acting FDA Commissioner Ned Sharpless, M.D. “We cannot allow the next generation of young people to become addicted to nicotine. We will continue to work to keep e-cigarettes out of the hands of America’s kids through policies to limit youth access to, and appeal of, e-cigarette products, take vigorous compliance and enforcement actions to hold manufacturers and retailers accountable when they illegally market or sell these products to minors, and continue to spearhead highly successful public education efforts to warn youth about the dangers of all tobacco products, including e-cigarettes.”

Teen Hospitalizations With Severe Lung Damage Due to Vaping

The news has been abundant with disturbing stories of young people hospitalized due to severe breathing and lung issues. Here are two examples.

One Pennsylvania 19-year-old, Anthony, was admitted to the intensive care unit at the hospital when doctors discovered that his lungs were heavily congested and his oxygen levels depleted. The young man’s father recounts a conversation with the doctor:

“I had to ask the doc how this happened. He said, ‘Imagine cooking bacon on the stove. It smells delicious. It tastes wonderful. When you’re done cooking, eventually you have to clean up. Well when you decide to clean up, there is white bacon grease all over. Places besides the stove.’”

“‘Well, this flavored oil in vapes is your bacon grease. The lungs are your kitchen,’” Anthony’s father recounted. “‘Unfortunately, you can’t just go in and wipe everything down. It builds up until (like my son) it chokes off the airflow.’”

Another teen—18-year-old Adam from Illinois, who was a student athlete—now has the lungs of a 70-year-old, according to his doctors. Adam started vaping at 16 because it “tasted good” and he believed vaping was safer than smoking. His mother reports he went through about a pod and a half every other day or day and a half. He was hospitalized after days of experiencing nausea and vomiting. Once there, the doctors discovered his lung damage:

“It was severe lung disease, especially for a young person. He was short of breath, he was breathing heavily,” said Dr. Stephen Amesbury, a pulmonologist and critical care physician at Advocate Condell Medical Center. “If his mom had not brought him to the hospital within the next two to three days, his breathing could have worsened to the point that he could have died if he didn’t seek medical care.”

Adam now has severe lung damage such that he even has trouble walking up stairs. “If I had known what it was doing to my body, I would have never even touched it, but I didn’t know,” Adam said.

Those are just two of the far too many stories of teens who vaped and damaged their lungs. Not all lung issues caused by e-cigarettes are as dramatic as these.

And in terms of vaping and young people, there are also many stories of teens who are now hopelessly hooked on nicotine. And there are teens who have experienced seizures and other serious health issues. All these young people vaped, and many thought it was “safe” or harmless.

Many parents were blindsided both by the prevalence and dangers of Juuling and by the fact that their child might be engaged in the behavior. There are tools and advice for parents who suspect their child is vaping.



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