What Should Be Done About Juuling?

The use of e-cigarettes (e-cigs), commonly referred to as Juuling or vaping, has taken hold across the nation’s schools – 1 out of 4 high school seniors vaped within the past month, as did 1 out of 5 college students. Critics have argued that these devices targeted teenage users with fruit-themed flavors and downplayed the fact that they were still nicotine devices. Proponents, on the other hand, have touted the use of e-cigarettes as an alternative to smoking and a potential tool for people looking to reduce their tobacco use. What nobody envisioned was the sudden media attention vaping would receive in September, when the State of Michigan became the first state to take legislative action and ban the sale of flavored e-cigarettes, setting off a firestorm of states following suit and exploring the role e-cigs may have played in the deaths of several dozen individuals. This also prompted the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) to launch reviews of the products and explore tampering of the devices to deliver THC. Even after India banned e-cigs and China restricted Juul’s products from being sold on some its largest e-commerce sites, the FDA, who has an international office in China, told Fourth View that it was “not able to comment on any specific interactions with foreign regulatory authorities.” On Wall Street, commentators speculated that the sudden scrutiny played a critical role in merger talks between Phillip Morris and Altria (which owns 35% of Juul) being called off. Are teenagers the primary target market for e-cigarettes, and are the bans on flavored e-cigarettes the best way of protecting the health of underage users?

Filmmaker and father Judd Apatow tweeted, “JUUL is some evil shit…keep your kids away from it. It’s a scam to get you addicted.” Time magazine reports on the crisis with an 8-page spread, ‘The New American Addiction: How JUUL Hooked Kids and Ignited A Public Health Crisis’ that details the effects that JUUL, vaping and e-cigarettes have had on America’s kids.

Federal statistics recently released support the concern expressed by Apatow and Time. Nearly 1,300 people in 49 states have fallen sick with mysterious vaping-related lung injuries and 26 deaths have been confirmed in 21 states. 

From 2017-18, the National Youth Tobacco Survey reported that e-cig use (defined by use on at least one day in the past 30 days) by high school students increased 78% from 11.7 to 20.8%. This accounts for a troubling 3.6 million kids using e-cigs in 2018. E-cig use among middle school students jumped 48% (from 2017-18). Today, a total of 4.9 percent of middle school students—or 570,000 kids—are current e-cig users. 

The 2019 Monitoring the Future Survey underscores that the youth e-cigarette epidemic is getting worse.  More than 1 in 9 high school seniors reported vaping nicotine on a near-daily basis, signaling a growing youth addiction crisis. 1 in 4 high school students have used a tobacco product. Concerningly, kids as young as 12 years old have reported vaping.

JUUL’s 2015 launch was aimed at youth and created a cult-like following. Wells Fargo Analyst Bonnie Herzog estimates that with about 75% market share, “JUUL is clearly the leader.” Truth Initiative (TI) reports JUUL’S high nicotine content is driving an overall increase among e-cig users. That makes sense, as TI reports 15-17 year old kids are 16 times more likely to use JUUL than an older group. It’s a fact that 1 JUULPod equals at least the same amount of nicotine as a pack of 20 cigarettes. Vape pods can also include chemicals, metals, carcinogens, toxins, oils and potentially lethal ingredients; due to the industry’s history of lax legislation and regulation.

Today, there are more than 10,000 vaping flavors and it is these flavors that hook kids; making the tobacco-taste tolerable. In 2018, 68% of high schoolers used flavored e-cigs (compared to 61% in 2017) and menthol use increased (from 42.3% to 51.2%) among all current e-cig users.

The FDA needs to do their job and protect America’s kids from dangerous and now deadly vaping products. We need legislation, regulation and enforcement at the national, state and local level. The priority should be to remove flavors from the marketplace and out of the hands of kids.

In light of recent news reports on vaping-related deaths, the Trump Administration has proposed banning electronic cigarettes. These headlines are misleading and need context before jumping to a widespread ban on vaping.

After a thorough review of these deaths on a case-by-case basis, one would notice that there is a consistent factor that is associated with these tragedies – THC (a main ingredient in cannabis and the source of the ‘high’ feeling users experience rather than the ‘numb’ feeling of CBD) has been found in the majority of electronic cigarettes that have caused these recent deaths. On October 1st, the CDC itself acknowledged that “the latest national and regional findings suggest that products containing THC play a role in the outbreak.”

Consumers of vaping products often buy manipulated cartridges from the black market that contain THC. These appear to be causing deaths or severe illnesses, not the e-cigarettes themselves. The CDC made a point of telling adults who switched to e-cigarettes, as a step to quit smoking, not to return to traditional cigarettes. THC is not a standard ingredient used by legal and reputable vaping products. Therefore, resting the blame solely on companies such as JUUL, and banning their flavored products for occurrences beyond their control, is not a reasonable policy.

Instead, we should be focusing our energy on people who are combining THC with e-cigarettes and marketing them. In Wisconsin and Illinois, state investigators looked at 86 patients with vaping-related lung illnesses. Two-thirds reported using ‘Dank Vapes,’ a counterfeit brand and packaging scheme in which black market suppliers print packaging from the internet in order to create the appearance of a standard and legitimate brand. This is what should be drawing our attention and outrage.

But even with an identifiable brand, shutting down one label isn’t enough to stop this crisis. In the same investigation, Wisconsin and Illinois officials discovered that the 86 patients had actually used 234 different products. Similar to counterfeit pharmaceutical products, policing the vaping industry is going to require targeted and ongoing action, not a knee-jerk reaction.

To stop these deaths, the conversation needs to shift to the unregulated practices of the black market that manipulate cartridges that go beyond their intended use.