Quitting smoking is likely one of the best things you can do for your health as traditional cigarettes cause damage to nearly every organ in your body. Vaping, or using e-cigarettes, is sometimes marketed as a way for adults to quit smoking, but there’s not enough evidence to demonstrate it helps.1
If you’re trying to quit smoking, the American Heart Association2 endorses using established methods. They suggest you don’t try vaping because you think it’s “cool” or “safe.” There is a perceived assurance e-cigs are safe and harmless. The vapor is often the odorless, making it difficult to detect once the device has been put away.
In a 2016 report,3 “E-Cigarette Use Among Youth and Young Adults,” the U.S. Surgeon General called the products unsafe and documented an alarming increase in use by young adults. The report also showed e-cigarettes are associated with the use of other tobacco products as well as challenges with brain development affecting the health and mental health of young adults.
In July 2018 the Verge reported4 on the difference between Juul salts using freebase nicotine and other e-cigarettes. The combination of freebase nicotine with benzoic acid creates a chemical reaction designed to be as easy to inhale as cigarettes. A company spokesperson, Victoria Davis, called fighting underage vaping a “top priority.” She said:5
“Juul is intended for adult smokers only who want to switch from combustible cigarettes. We cannot be more emphatic on this point: No young person or non-nicotine user should ever try Juul.”
Juul spends thousands in schools and camps
Davis’ commentary in 2018 does not line up with information presented to the House Oversight Subcommittee on Economic and Consumer Policy, which viewed documents as part of an investigation into the role the company played in the vaping epidemic.6
Documents show “Juul spent hundreds of thousands of dollars to fund” programs, which an employee characterized as7 “our new understanding of how much our efforts seem to duplicate those of big tobacco.” In the same email thread, another employee expressed concerns about pulling out of the health fair as they would certainly lose the school as part of the pilot program.8
In a memo from the Subcommittee,9 an examination of the role Juul has played in teenage nicotine addiction was outlined. The memo stated Juul had deployed “a sophisticated program to enter schools” and direct its message at teenage children; it also targeted teenagers in summer camps and public out of school programs.
Internally,10 Juul maintained a division aimed at recruiting schools to present a program to students. In testimony about one presentation, a representative from Parents Against Vaping E-cigarettes said no parents or teachers were allowed in the room and the message from the company was the product was safe. During the presentation, the presenter did a demonstration of how to use the product.
The program paid the school system $10,000 to access the students in class, in summer school or at a Saturday school program.11 Additionally, they targeted teenagers by purchasing access to teens in a public out of school program,12 in one instance paying the Richmond, California, Police Activities League $89,000 to offer the Juul program.
At another time, the company paid $134,000 for access to children attending a five-week summer camp, recruiting those in grades 3 through 12 and providing them with a “holistic health education program.”13
Juul also engaged social media influencers
Over the past decade, there has been a shift from celebrities to social media influencers behind the drive to purchase new beauty products, cars and clothing and to get involved in nonprofit organizations. Whereas before spokespeople have been recognizable celebrities, marketing companies now understand the power that social media influencers wield on personal brand recognition.14
Audiences appear to be more receptive to social media influencers who often are the first to try products and services.15 In one survey 70% of brand marketing agencies said they either “agreed” or “strongly agreed” their 2018 budgets aimed at social media influencers would increase; 89% thought this form of marketing could impact how people felt about their product.16
Juul was no exception. They put into place a sophisticated program used to promote their product online to young people.17 Documents obtained by the subcommittee show Juul hired the Grit Creative Group to find 280 influencers in the Los Angeles and New York area18 “to seed Juul product to over the course of three months.”
In a second contract with the same company, Juul sought to secure social media influencers who held a following of at least 30,000 to attend launch events and engage their efforts to establish a network to leverage their influence for the company. Just four months later, the company’s marketing update stated:19
“The Container Tour will get JUUL into the hands of over 12,500 influencers, subsequently introducing JUUL to over 1.5 million people.”
The subcommittee was given further evidence of the program designed by Juul with planning documentation, in an email showing an employee held the title “Influencer Manager” and another email indicating there may be an entire department devoted to addressing social media influencers within Juul.20
Company pushes addictive nicotine but tells teens it’s safe
The subcommittee met in late July 2019,21 hearing testimony from research experts, parents and Juul Labs. In addition, the subcommittee heard testimony from two teenagers who told Congress a Juul representative had repeatedly told their ninth-grade classroom the e-cigarette was totally safe and then went on to show the students the device. All the students were underage.22
One of the teens, 17-year-old Caleb Mintz, told Congress the representative was there as part of a mental health seminar during which teachers were not present. At just 17, Mintz cut to the chase on Juul’s marketing tactics when he said:23
“I believe the presenter was sending mixed messages by saying Juul was ‘totally safe’ and following up every totally safe statement with ‘but we don’t want you as customers.’ I believe that the presenter was playing on the rebellious side of teens, where when teens are told not to do something, they are more likely to do it.”
Following Mintz’s testimony, his 16-year-old friend Philip Fuhrman testified. CNN reported Fuhrman told Congress the Juul representative told him the24
“FDA was about to come out and say that Juul was 99% safer than cigarettes, and he said that that would happen very soon, and that it was in FDA approval while the talk was going on.”
In June 2018, Juul Labs was valued at $15 billion.25 While selling tobacco and nicotine to those addicted has been a good business model, Juul innovated the e-cigarette to a product delivering more nicotine than a cigarette and with a sensation similar to smoking. This is all thanks to nicotine salts, a chemical base used to deliver nicotine.26
Each puff from a Juul delivers more nicotine than other e-cigarettes while reducing throat discomfort at higher concentrations. And, because nicotine salts work well in smaller devices, there’s no need to opt for a larger, bulkier e-cigarette product. Using new technology, Juul salts in one cartridge delivers roughly the amount of nicotine as found in a pack of cigarettes.27
The vaping community acknowledges nicotine salts are potentially more addictive since they lead to higher blood levels of nicotine over a short amount of time.28 Juul sponsored a study demonstrating their29 “tobacco-flavored nicotine salt-based ENDS were well tolerated and provided similar nicotine exposure and perceptual satisfaction compared to tobacco-flavored combusted cigarettes.”
Reactions in vape juice form airway irritating compounds
The long-term effects of heating e-cigarette juice have not been determined, but researchers have now found these liquids are reacting on the shelf and forming chemicals called acetyls. In a study published in Nicotine and Tobacco Research,30 data show the liquids may form new chemicals as they are sitting on the shelf with unexpected toxicological effects.
The researchers recommended a rigorous process to monitor the changes in chemical composition and continue to analyze the situation in order to identify the potential health hazards to users. In other words, chemical reactions that occur once the liquid is placed in the delivery device and before heating, may increase the potential risk for those using e-cigarettes.31
The chemicals in question are from flavorings for vanilla, cherry, citrus and cinnamon. Sven-Eric Jordt, Ph.D., from Duke University, and senior author of the study commented on the results, saying:32
“These individual ingredients are combining to form more complex chemicals that are not disclosed to the user. When inhaled, these compounds will persist in the body for some time, activating irritant pathways. Over time, this mild irritation could cause an inflammatory response.”
Clusters of seizures and pulmonary infections
Doctors and hospitals have found vaping is associated with a cluster of neurological conditions.33 The FDA has received reports of 127 people who have experienced seizures or other neurological symptoms potentially related to the use of e-cigarettes. Although experts have not yet established a link, they are investigating if the nicotine in e-cigarettes are causing neurological disturbances.
NPR reports34 there have been 15 cases of severe respiratory injury in Wisconsin and 15 more are suspected. Six other cases were reported in Illinois and four in Minnesota, prompting the Centers for Disease Control and Prevention to work with health departments to determine the cause.
The problem was first found by Children’s Hospital of Wisconsin after eight healthy teenagers were hospitalized with rapid onsets of coughing, weight loss and breathing difficulties. Some were admitted to the Intensive Care Unit for treatment. At this point, Dr. Thomas Haupt from the Wisconsin Department of Health Services says the only common denominator has been vaping.35
Vaping companies sue over regulations to protect kids
In 2009, the law gave the FDA power over combustible cigarettes but not e-cigarettes. In 2016 the agency expanded those regulations but have repeatedly delayed the timeline to review the products that have come to market. Recently, an e-cigarette industry group sued to delay the review arguing the deadline of May 2020 could wipe out many smaller companies.36
Unfortunately, while manufacturers and regulators argue over legalities, children and teens are being caught in the middle. Exposure at a young age to nicotine affects the reward center in the brain and increases their risk of engaging in addictive behavior as they grow into adulthood.
Additionally, addiction at a young age leaves these teens with no good treatment options for the addiction to a product designed specifically to increase the users risk of becoming addicted. In other words, children as young as 11 are becoming addicted to a product for which medical science has yet to come up with a treatment option safe at their age.
If you are addicted to cigarettes or e-cigarettes and would like to take control of your health and quit the habit, I suggest my previous article, “Quitting Smoking Starts in the Brain,” to learn a free technique that may make the process easier. Take the profit out of the tobacco industry’s pocket and put it back in yours.