In 2003, the first commercially successful electronic cigarette debuted in China. Today, millions of consumers regularly use “electronic nicotine delivery systems” (ENDS), especially electronic cigarettes (also called e-cigarettes). Juul e-cigarettes, apparently created to help adult smokers quit smoking more easily, are now the most popular “vaping device” among teens and young adults.
While the vast majority of adults can’t identify a Juul and report never trying one, the same can’t be said about most teens. Studies suggest that Juul devices and “vaping” can lead to problems with brain development, lung damage, increased risk for high blood pressure and increased risk for nicotine/smoking addiction.
In November 2018, the U.S. Food and Drug Administration (FDA) announced its plans to ban the sale of flavored e-cigarettes, including Juuls, as early as late 2018. The FDA’s decision will be based on whether or not several e-cigarette manufacturers can prove that they are capable of keeping their products away from minors.
The FDA’s move comes on the heels of some startling new statistics: e-cigarette use among high-school and middle-school kids rose from 77 percent and 50 percent, respectively, from 2017 to 2018. The estimates show that more than 3.5 million minors vaped at least once in 2018. (1) If the ban goes through, convenience stores and gas stations will no longer be able to legally sell flavored e-cigarettes in the U.S. The hope is that buying the products online will become much more difficult, too.
What Is a Juul?
If you don’t yet know much about e-cigarettes, you’re probably wondering, “What is a Juul vape, and what does Juuling mean?”
A Juul is a type of e-cigarette (short for electronic cigarette). According to the National Cancer Institute, it’s “a device that has the shape of a cigarette, cigar or pen and does not contain tobacco. It uses a battery and contains a solution of nicotine, flavorings, and other chemicals, some of which may be harmful.” (2)
Juuling is a type of vaping, another way to describe the use of e-cigarettes that causes a nicotine solution to turn into an inhalable mist. E-cigarettes like Juuls contain heated nicotine extracted from tobacco, but they don’t contain tobacco itself.
A 2017 survey conducted by the Schroeder Institute at Truth Initiative found that 25 percent of teens aged 15 to 17 and 29 percent of young adults aged 18 to 24 recognized a Juul device. Between 10 and 12 percent reported both recognizing and having ever used a JUUL, and 8 to 10 percent reported recognition and past 30-day use. Overall, the survey found that young adults aged 18 to 24, especially males, were most likely to recognize and use Juuls regularly. (3)
Juul Labs first released Juuls in 2015, stating that the company’s mission was to “eliminate cigarettes and help the more than one billion smokers worldwide switch to a better alternative.” (4) But while Juuls may be intended to serve as part of a “harm reduction strategy” — a public health strategy that intends to reduce the negative effects of addictive substances, including nicotine/tobacco — there’s evidence that Juuls may be doing more harm than good.
Experts on the dangers of nicotine tell us: “It is not yet known whether electronic cigarettes are safe or if they can be used to help smokers quit smoking.” There’s still debate over whether Juul devices and other similar products offer more benefits to smokers than they cause harm. What we do know is that evidence suggests they aren’t totally harmless, especially when used by teens or young adults or for long periods of time.
Juuling vs. Vaping
How much nicotine does a Juul contain, and how does this compare to other e-cigarettes? The amount of nicotine in e-cigarettes can vary. Juul devices come with a preset five percent nicotine content, similar to the amount found in cigarettes. Each nicotine cartridge inserted into the Juul (called a pod) gives about 200 puffs, providing about as much nicotine as a pack of cigarettes, according to the product’s website.
Juuls might not contain tobacco, but they deliver nicotine as efficiently as a combustible product (for instance, a cigarette). They cause nicotine to reach the lungs, affect the brain and can potentially increase the risk for nicotine addiction. (5)
Is there a difference between vaping and Juuling?
- Juuling is a type of vaping. Juuling is said to provide a higher and faster dose of nicotine compared to other vaping products.
- Juuls contain a unique chemical composition compared to other vaping devices. Most vaping products on the market use propylene glycol and glycerin as the solvents that deliver nicotine, but Juuls contain organic nicotine salts, a combination of a nicotine and an organic acid.
- Nicotine salts allow for absorption of nicotine. PAX Labs claims that Juul products provide a nicotine concentration that is comparable with a traditional cigarette, plus they can deliver nicotine 1.25 to 2.7 times faster than competing vaping products.
- The look and ease of use of Juuls is also part of what makes them appealing. They feature a small, slim, high-tech design and use nicotine cartridges, or “Juul pods,” that come in a variety of flavors.
- A Juul looks just like a USB stick and is small enough to hide from parents and teachers. Juuls do not omit vapor into the air, so they are easy to use in public without anyone knowing,
- Some report that the nicotine delivered from Juuls feels “less harsh” on the throat and in the lungs compared to the nicotine from cigarettes, making the experience more pleasant, including among sensitive or new users.
Why Juuling Is Surging in Popularity
Juul is now considered a leader in the e-cigarette market, with roughly 45.7 percent of e-cigarette market unit shares, according to a 2018 Wells Fargo Equity report. Since 2017, two years after first release, sales of Juul kits increased 680 percent; sales of refills increased 710 percent.
- They’re convenient, easy to obtain and pleasant to use. Juuls are relatively inexpensive (about $29 to $49 for a starter kit, plus more money to keep replenishing pods), easy to obtain and have a “high tech” look. (Basically like a long thumb drive that can be recharged using a computer USB drive). They are also easy to conceal and use discreetly, since they don’t produce smoke, vapor or generate much smell. Plus, Juules come in appealing flavors like mint, mango, fruit and creme. (6)
- Their use is encouraged by authorities. It’s likely that another reason Juuling and vaping are gaining popularity is because they are “supported” (or at least not demonized) by certain health authorities and organizations, including the American Cancer Society, American Public Health Association and Royal College of Physicians. Organizations such as these feel that e-cigarette use is ultimately better than smoking cigarettes/tobacco use. For example, in February 2018, the American Cancer Society (ACS) Board of Directors issued the following guidelines to smokers: “Smokers who can’t or won’t quit should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.” (7)
Why would The American Cancer Society encourage the use of vaping devices? The organization’s argument is that combustible tobacco products, primarily cigarettes, are the single greatest cause of cancer that we know, responsible for the deaths of about 7 million people worldwide each year. In the U.S., an estimated 98 percent of all tobacco-related deaths are caused by cigarette smoking.
In the ACS’s defense, they also recommend that “clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using ANY tobacco product, including e-cigarettes … the ACS strongly recommends that every effort be made to prevent the initiation of e-cigarettes by youth.”
Fortunately, the U.S. Centers for Disease Control and Prevention (CDC) released news in November 2018 that cigarette use among American adults is at a record low. However, it’s not clear how much e-cigs have been part of the solution, as experts give much more credit to recent smoke-free policies and rising prices of tobacco products. (8)
Is Juuling Bad for You? 4 Dangers of Juuling
So is Juuling bad for you, or is it a safer alternative for smokers and a helpful companion in the battle to quit? Many seem to believe that the use of e-cigarettes is less harmful than smoking cigarettes, but the health effects of long-term use are still not known. And according to some study findings, there is reason to believe that e-cigarette use causes as much or more damage as conventional cigarettes.
Whether or not future research shows that Juuling is favorable compared to smoking cigarettes, dangers of Juuling still include:
1. Consumption & Addiction Among Teens/Young Adults
In May 2016, the FDA banned the sale of vaping products to children under 18 years old. But there’s still concern that teens are using e-cigarettes and Juuls in growing numbers. Juuls can be purchased at gas stations, convenience stores and smoke shops. (8)
Experts also believe that young e-cigarette users face an increased risk for both starting to smoke and becoming long-term users of cigarettes and/or other combustible tobacco products. (9)
2. Higher Risk for Cardiovascular Disease
Juuls contain nicotine, a stimulant that can increase heart rate and raise blood pressure. It’s also a risk factor for developing heart disease. (10) That being said, certain health authorities feel that nicotine use via Juuling/vaping does not increase the risk for suffering from a heart attack.
One study found that e-cigarette exposure narrows arteries by 30 percent and decreases the blood vessels’ ability to widen. (11) Additionally, vaping/Juuling can stiffen the aorta, the main artery in the body that supplies oxygenated blood to the circulatory system. Aortic stiffness is considered an early warning sign of cardiac and vascular-related diseases, such as atherosclerosis, stroke and aneurysm.
3. DNA Damage
Recent research shows that vaping may modify genetic material/DNA in the oral cells of users. (12) In one study run by the Masonic Cancer Center at the University of Minnesota, researchers recruited five e-cigarette users and collected saliva samples before and after a 15-minute vaping session to analyze them for chemicals that are known to damage DNA.
Increased levels of DNA-damaging compounds, including formaldehyde, acrolein and methylglyoxal, turned up in the saliva after vaping. Compared with people who don’t vape, four of the five e-cigarette users showed signs of increased DNA damage. The researchers believe this may increase the risk of developing into cancer.
4. Respiratory/Lung Damage
Surveys show that it’s the flavors of Juuls and similar vaping products that draw young users in. (13) In fact, research conducted at the Yale University School of Medicine found that teenagers preferred sweet-flavored e-cigarettes that didn’t contain nicotine over e-cigs with nicotine but no sweetness. Unfortunately, these flavors change chemistry when combined with vape fluid and are capable of creating undisclosed chemicals.
In order to create unique vaping flavors, manufacturers use flavoring compounds such as diacetyl, acetoin and 2,3-pentanedione. Studies show these chemicals can wreak havoc on the respiratory system and contribute to health problems like bronchiolitis, severe respiratory illness and irritation to the eyes, skin, mucus membranes and lungs.
According to a 2018 report published by the American Physiological Society (APS), these chemical components seem to be capable of becoming embedded in the lungs, causing inflammation and leaving the lungs vulnerable to infection. (14) Recent research showed an increase in markers of inflammation, mucus production and altered lung function in people using e-cigarettes containing propylene, propylene plus nicotine and flavoring groups for three days.
If You’re Already Vaping as a Tool to Quit Smoking
What does the science say — is vaping really safer than smoking?
- It’s generally accepted that vaping is a better alternative to smoking cigarettes, but it’s still far from a healthy habit and has been linked with a number of health concerns.
- Agents used in vaping products might be generally safe to consume, but we don’t know exactly how their chemical structure and effects change when they are heated and inhaled, which can still potentially lead to serious lung irritation. (19)
- Vaping products that contain nicotine can still have addictive qualities, so you’ll still likely deal with withdrawal effects when stopping, such as irritability, anxiety, jitters, changes in appetite, headaches and so on.
- According to the FDA, there’s no evidence that any e-cigarette is totally safe or effective at helping smokers quit. The American Heart Association therefore tells that e-cigs should only be used as a last resort way to quit.
Ways to Stop Juuling and Vaping
Fortunately, recent studies suggest that even though e-cigarettes continue to represent an increasing share of the tobacco market, smoking rates among both adults and children continue to decline in countries, including the U.S and U.K. (15)
If you’re already using vaping as a tool to quit smoking, what steps can you take to start tapering off of vaping and quitting altogether? Talk to your doctor about medications, patches and so on that may help you wean off of nicotine with fewer side effects. Look into other strategies that are proven tools to help you quit smoking, such as meditation.
If you are someone who uses a Juul, another vaping device or who smokes cigarettes, these tips can offer help when it comes to quitting:
- Try mind-body practices, including mindfulness meditation. There’s strong evidence that mind-body practices like yoga, meditation, tai chi, hypnotherapy, biofeedback and guided imagery help with quitting smoking. They offer help with stress management, chronic fatigue, chronic pain and symptoms tied to withdrawal.
- Group relaxation training. One way to learn mind-body practices is in a group setting, such as a support group, or during a private session led by a coach/therapist. You can learn to better deal with cravings and triggers by starting counseling or therapy, especially with a specialist in cognitive behavioral therapy.
- Nicotine gum/patches or other replacements. Over-the-counter nicotine replacement therapies are somewhat controversial as they continue to fill the physical need without addressing the psychological and behavioral sides of a nicotine addiction. However, research suggests they are able to help ease the process of quitting and are much less addictive. You can visit Quit.com for information about these products and tips that may help increase quitting success.
- Seek an online program. The American Lung Association’s Freedom From Smoking program is an example of an online group support resources that also offers tips and help with techniques shown to assist smoking cessation. Smokefree.gov is another good resource for finding help.
- Consider trying black pepper essential oil, which may help reduce cravings for nicotine and decrease withdrawal effects, according to certain studies. (20) Black pepper oil can actually be vaped in order to provide a similar sensation to smoking. In one study, 48 cigarette smokers were randomly assigned to one of three conditions: one group of smokers puffed on a device that delivered a vapor from essential oil of black pepper; a second group puffed on the device with a mint/menthol cartridge, and a third group used a device containing an empty cartridge. Craving for cigarettes was significantly reduced in the group using black pepper oil compared to the other control conditions. Negative effects and somatic symptoms of anxiety were also alleviated in the black pepper oil group. Additionally, intensity of sensations in the chest was significantly higher for the black pepper group, which mimicked the feeling of smoking and seemed to help satisfy the smoker’s urge. (21)
Authorities like the FDA can also help stop the use of Juuls/vaping products by making efforts to reduce the toxicity, addictiveness and appeal of tobacco products currently on the market. Government authorities can also implement policies and public health measures known to prevent the initiation and use of all tobacco products. For example, the ACS recommends establishing “appropriate taxation, retail policies (for example, raising the minimum age of purchase to 21), tobacco and e-cigarette aerosol-free policies and funding of evidence-based prevention and cessation programs.”
Final Thoughts on Juuling
- A Juul is a type of e-cigarette (electronic cigarette) that features the shape of a small USB drive. It contains nicotine but does not contain tobacco. It uses a battery and contains a solution of nicotine, flavorings and other chemicals, some of which may be harmful.
- Juuling is considered a type of vaping. Vaping is the use of e-cigarettes to mist a nicotine solution so it can be inhaled. Juul devices deliver similar amounts of nicotines as cigarettes and can still be additive, despite some groups saying they are safer than cigarettes.
- Dangers of Juul devices include: increased use among teens and young adults, potentially contributing to brain development problems, increasing risk for cardiovascular problems, causing DNA damage and causing lung and respiratory problems.
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