You may have heard of JUUL (pronounced jewel), a brand of electronic cigarettes, or device used for “vaping.” JUUL vaping recently has become popular among middle and high school students. A JUUL resembles a USB flash drive, and is easily used by students in class, hallways, restrooms and public places. E-cigarettes are battery-operated devices that heat a liquid into an aerosol that a person inhales. E-cigarettes typically contain nicotine, flavoring and other chemical additives. The nicotine in e-cigarettes, just like in regular cigarettes, is addictive. Their easy availability, alluring advertisements, desirable flavors (fruit, chocolate, mint, etc.), and the belief that they’re safer than cigarettes have all contributed to the increased appeal of e-cigarettes among middle and high school students. JUUL has more than two times the amount of nicotine concentrate than many other brands of e- cigarettes, and therefore has a higher risk of addiction, especially for youth users. One cartridge (pod) has about the same quantity of nicotine as a pack of cigarettes!
The U.S. Surgeon General released a report in 2016 stating that the use of Electronic Nicotine Delivery System (ENDS) products in young people is a public health concern and that exposure to nicotine during adolescence can cause addiction and harm the developing adolescent brain. It reported that youth use of e-cigarettes is associated with the use of other tobacco products,that youth use of nicotine in ANY form is unsafe, and that secondhand exposure to this aerosol contains nicotine and other harmful substances.
The nicotine in these devices is quickly absorbed from the lungs into the bloodstream when inhaled, which causes the release of the hormone adrenaline. Adrenaline stimulates the central nervous system (brain and spinal cord) and increases heart rate, blood pressure and breathing. Nicotine also activates the brain’s reward systems by increasing a substance in the brain called Dopamine, which causes some people to continue using nicotine, even if they know it is not good for them (addiction). The specific risks for youth involve the fact that the brain is still growing until about age 25, and each time something new is learned, there are stronger connections made between brain cells. These connections are made faster in young people’s brains; therefore they can become more easily addicted and potentially train the brain to make other drugs more desirable. Nicotine also affects the development of brain circuits that control attention and learning, and can cause mood disorders and permanent problems with impulse control, as these parts of the brain are still developing during adolescence.
The vapor that is exhaled with these devices is not harmless water vapor, as some people believe, but have been shown to contain cancer-causing chemicals. They can have ultra-fine particles that are inhaled deep into the lungs, heavy metals such as lead, and compounds like benzene which is found in car exhaust. There is still much unknown about the full effects of these aerosols on both those who are using them, and second hand exposure.
Yet another unique risk to e-cigarettes is the possibility of defective batteries that can lead to burns, fires and explosions. We have seen significant burns in some youth due to these unusual situations, although generally associated with vape pens rather than JUUL devices. In one instance the battery came in contact with coins in a pocket, and the coins caused second degree burns all the way down the leg after burning a hole in the pocket.
E-cigarettes have become a multi-billion dollar business in the U.S. Manufacturers spend millions of dollars marketing and advertising their products, using many deceptive tactics to make these devices attractive to young people and promoting their products through TV, radio and social media. We need to prevent kids from using these products, so that’s why education and spreading the word to parents and adolescents is so important. Next time you see an advertisement, an e-cigarette store or someone vaping, take the opportunity to talk to your kids about the dangers of e-cigarettes. Tell them about the dangers of nicotine in any form to their still developing brain, and that you and their doctors strongly recommend against using any tobacco products. Together with local and national tobacco control and prevention strategies to reduce initiation among youth by regulating manufacturing, distribution and marketing, we can help protect the health of our young people.