There’s Nicotine In It?

Americans have begun to believe that e-cigarettes are a safe alternative to cigarette smoking. It helps current smokers quit the traditional cigarette by eliminating tobacco and other harmful chemicals from the electronic products. However, the JUUL, the newest e-cigarette in the business, is escalating its popularity with its high concentration of nicotine and its massive percentage of users being under the age of 18. The JUUL is known for its attractive design that compel teenagers to participate in vaping. With early exposure to teenagers, health risks can serve as a barrier in their growth as well as increased risks of severe addiction later on in their lives. Adolescent affiliation with the JUUL triggered the Food and Drug Administration (FDA) to conduct inspections within JUUL laboratories to prevent JUUL companies to sell their product to underage people. The procedures that the FDA take are provocative because the future of the youth depends on their regulations against the improper distribution of JUUL.

Majority of the teenagers who utilize the JUUL are actually unaware of what chemicals are involved and if there are health risks in the future. So what exactly is in the JUUL?

The JUUL website, its original virtual company, thoroughly breaks down the e-liquid contained in the JUUL:

• “Glycerol and Propylene Glycol have commonly used humectants in vaporization liquids, and also used in a number of consumer products like toothpaste.” (JUUL)
• “Benzoic Acid is a naturally occurring acid found in the tobacco plant, which is a part of our proprietary formulation that makes JUUL the ultimate vaping experience.” (JUUL)
• “As a policy, our development and manufacturing process does not add diacetyl and acetyl propionyl (or 2,3-pentanedione) as flavor ingredients.” (JUUL)
• “Nicotine content: 0.7mL with 5% nicotine by weight (approx. 40 mg per pod based upon 59 mg/mL, ~ to the nicotine yield of a pack of cigarettes).” (JUUL)

This list is provided to JUUL owners to give them a sense of what is specifically entering their body. The company does a proper job explaining the chemicals, but I think the company does not do a proper job in advertising the chemicals because the underage customers are still unaware of what they are allowing entry to their body. Compared to a cigarette, which contains a toxic fusion of over 7,000 chemicals that damages nearly every organ in the human anatomy (FDA), the JUUL does a pretty effective job at keeping the number of chemicals involved to a minimum. Despite discarding several chemicals that cigarettes contain, the JUUL still contains one of the most crucial chemicals detrimental to the human health: nicotine. Nicotine is a chemical composed of nitrogen that is heavily addictive and exposes smokers to the extremely dangerous health effects of drug dependency. A single cigarette from the leading brand, according to Nicotine Content of Domestic Cigarettes, Imported Cigarettes and Pipe Tobacco, contains approximately 0.19% nicotine, therefore translating to an average of 3.82% nicotine in a whole pack of cigarettes (Taghavi). A JUUL pod contains 5% of nicotine, which is approximately 1.18% more than what a pack of the leading cigarette company contains. Despite the fact that JUUL companies claim on their website that one JUUL pod is equivalent to one entire pack of cigarettes in terms of nicotine, Julia Belluz from Vox states in an interview that “the precise equivalency [of nicotine] is difficult to determine because not all the nicotine released in cigarette smoke is inhaled, and some are trapped in the filter” (Belluz).  Belluz’s analysis evidently explains how the JUUL contains more nicotine than what the traditional cigarette has because the JUUL is systemized to fully vaporize the entire e-liquid within the pod, administering 100% of the nicotine to the user.

As the e-cigarette generation advances, researchers develop new ways to satisfy e-cigarette customers, therefore ultimately touching base with how they enhance nicotine. Vox introduces the idea of nicotine salts. JUUL laboratories analyzed that “freebase nicotine” (the type of nicotine inside a cigarette) causes an unpleasant feeling near the back of the throat after inhalation because of its higher pH level. With the addition of benzoic acid in the liquid JUUL pod mixture, the nicotine pH level is much lower, therefore reducing the rash feeling and allowing vaping to be bearable on the first few tries. This also results in a more addictive feeling because of the induced head rush that is stronger than a cigarette’s. This form of nicotine drastically empowers the JUUL’s image compared to other leading brands of e-cigarettes. Because nicotine salts are more prevalent to modern e-cigarettes, old e-cigarette companies cannot challenge the success that the JUUL is making in the industry. AAFP Offers Resources as ‘JUULING’ Increases Among Youth discuss how JUUL pods contain more than double the concentration of nicotine that the leading brand of e-cigarettes contains. According to the article, “the concentration of nicotine in each JUUL pod is about twice that of many other e-juice nicotine concentrations, listed at 5% nicotine by weight versus the more common 2.4% or less in other e-juices.” (Crawford) The essence of JUUL is its concentration of nicotine, which comparatively makes it better than other e-cigarette brands. Some sources even suggest the presence of formaldehyde in the JUUL. ‘Is Your Patient JUULing?’ expresses that formaldehyde, a chemical that falls into the Cancer Group 1 Carcinogen category, can be present in the JUUL pods (Burkhart). Though cigarettes are known to have extreme levels of formaldehyde, leading to one of the main causes for cancer and death, JUULs and other high-voltage e-cigarettes can have formaldehyde develop within their oils because the mechanical coils in the JUUL can overheat. This defeats the purpose of replacing a cigarette since it still has the ability to form dangerous chemicals.

E-cigarettes may intend to decrease the percentage of cigarette smokers, but it certainly does not decrease the chances of teenagers smoking the cigarette after getting addicted to the JUUL. “It’s believed that teens are more susceptible to nicotine addiction than adults. Nine out of every 10 cigarette smokers started before age 18,” according to the U.S. Centers for Disease Control and Prevention (Preidt). The chemicals that are showcased on the JUUL website, as well as the hidden chemicals found by other researchers, merge to develop health risks imposed towards the youth. Doctors and public health officials carry concern about the immediate side effects of nicotine on the youth’s developing anatomy. According to Scott Gottlieb, the commissioner of the FDA, “nicotine in these products can rewire an adolescent’s brain, leading to years of addiction… and there’s strong evidence that vaping may encourage young people to try cigarettes.” (FDA). I personally relate to Gottlieb’s claim of vaping encouraging to try cigarettes. One of my best friends became addicted to the JUUL and began purchasing several JUUL pods and accessories, such as colorful JUUL coats, to begin a trading business. Just when the JUUL was not satisfactory enough, he began to experiment with the cigarette. He explained to me how the cigarette gives a rough tension at the back of his throat, but the blood rush to his head leaves him very eased. To him, it differs from the JUUL because the cigarette gives off a “tough” vibe which combines a mesmerizing rush in his head and the intense tobacco flavor that takes over his entire throat, whereas the JUUL is very sweet and more waves of relaxed feeling sweep his brain. At just 18 years old, he feels compelled to smoke a cigarette twice a day- once before the gym and once after. The JUUL initiated his addiction for nicotine, which resulted him in participating in smoking the cigarette.

I believe that JUUL laboratories are increasing their consumer rates with higher levels of nicotine. This is unsafe because addiction will rise within the adolescents who use the product, as exemplified by my friend. With more addiction in the rise, customers are bound to return to buy more from the JUUL companies. What deeply confuses me is that nicotine is the reason why quitting smoking is difficult, yet JUUL adds even more concentration of nicotine in its content. According to Cosmos magazine, “nicotine binds to an area of the brain known as the adrenal medulla, which increases the flow of adrenaline.” (McCall) An elevated flow of adrenaline leads to increased blood pressure and heart rate, which exacerbate existing heart problems. Obviously, the nicotine discharges an awful response from the body, posing a threat to the average adult smoker. Now imagine a much higher intake of nicotine in a premature body. Several more undesirable reactions can take place because the body develops with the nicotine inside.

The JUUL companies further boost the attraction of their products by dispensing several unique flavors, distracting consumers from the unforgiving concentration of nicotine inside each puff. “Pods come in a variety of colors and flavors, from cucumber to creme brûlée, mango, and tobacco,” (Belluz). With such a disguise, it is even more difficult to acknowledge the presence of nicotine in the JUUL. Not only that, the unique resemblance of a flash drive allows students to smoke the JUUL without any suspicion from parents and teachers. The attractive model of the JUUL allows for curiosity to rise amongst the youth.

Although the rate of cigarette smoking has significantly decreased, the rate of e-cigarette smoking (primarily JUULs) has significantly increased. The majority of the population of e-cigarette smokers is composed of underage smokers, specifically high schoolers. “The percentage of high school students who reported using e-cigarettes in the previous month has increased from 1.5 percent 2011 to 11.7 percent in 2017.” (Henry). RAYSAC (Roanoke Area Youth Substance Abuse Coalition) does an investigation at a local high school in Roanoke Valley to see the JUUL at a teenager’s perspective and develops a successive list of reasonings:

• It’s small and easy to carry around everywhere. (Farmer)
• They’re extremely easy to buy. Teens are constantly selling them online or passing them around among friends. (Farmer)
• They’re simple to use. Juice refills come in packs like a carton of cigarettes and the Juul itself is charged just like a phone. (Farmer)
• They’re popular. Teens are easily persuaded to follow what their peers are doing. Just as it used to be in style to smoke cigarettes without actually knowing the health risks involved, the same is happening today with young vapers. (Farmer)
• They don’t think it’s bad for them. This is the most common and most dangerous excuse that is heard. When asking students why they choose to vape, nine times out of ten they’ll respond with something along the lines of, “Why does it matter, it’s just vapor.” (Farmer).

This list exhibits teenage desire to participate in a bandwagon brought upon them by social media attractions and even their own peers. The JUUL’s physicality allows for easy transportation and accessibility, as well as no fear for it being finished since it uses refillable pods. I agree that teenagers are easily persuaded because Farmer states that the same situation with the cigarette- rising popularity occurred before health risks became prevalent. Farmer makes some exclusive points about the teenage perspective of the JUUL, enhancing the idea that JUULs were targeting the youth as one of their primary consumers.

JUUL companies have brought something fresh and exclusive to our society, receiving extreme attention from all ages. Its particularly stealthy shape and exchangeable e-liquid pods caused massive attention by the media, portraying it as something new to appreciate. Social media sites, such as Twitter and Instagram, became platforms at which JUUL rose to its popularity, unlike cigarettes and other e-cigarettes that were advertised billboards or in magazines. In the Journal of Adolescent Health, Dr. Kar-Hai Chu approached this issue by investigating the youth involvement in the JUUL’s official Twitter page. As per his findings, “out of the 681 retweeters for whom an age could be proven or estimated, 171 were under 18, with 107 identified as “followers” of JUUL on Twitter.” (Carroll) I find this statistic shocking because approximately one out of four of the Twitter retweets are underage owners of the product, which proves that the tweets are immense influencers of this product. Perhaps if the tweets and advertisements pertained less on using teenager models and boasting popularity, the youth would not be as inclined to owning and using the JUUL as much as they do now. Michael Blaha, an epidemiologist specializing on the cardiovascular effects of e-cigarettes, also inputs in the Journal of Adolescent Health that many students perceive vaping as different from smoking because the JUUL does not contain any tobacco (Blaha). I agree with Dr. Blaha’s statement because several high school students, including my prior peers, would advertise the JUUL as just a harmless vaping mechanism. Had the tweets or advertisements mentioned the presence of nicotine, more teenagers would be aware of what they would get themselves into. AAFP Offers Resources as ‘JUULING’ Increases Among Youth, states, “‘Kids like the flavors and trade them back and forth, as the e-juice pods are removable… [and] there are many anecdotes about kids starting JUUL to be cool but ending up needing to use it every day.’”(Crawford) Elijah Luna, a sophomore at Vista del Lago High School in Folsom, California, tells Vox that his peers “take a hit, sucking on the device as they would a cigarette and they blow into their backpacks … or into their sweater when the teacher isn’t looking.”(Belluz) JUULs have become a mechanism of incognito smoking, going as far as allowing students to smoke during class. I think this has gotten out of hand because e-cigarettes are not meant to be smoked by teenagers, let alone during school hours. Several schools in California have banned flash drives because of this contagion, and I think metal detection can also prevent the JUULs from entering the school premises.

The JUUL’s societal representation has left several teenagers addicted to the nicotine because they were not warned about the addictive backlash that comes with boasting their ownership of this e-cigarette. With youth-friendly flavors such as mango and creme brulee that makes the JUUL vastly different from other e-cigarettes, its pod system allows for a convenient trading system and it gives an initiative to many oblivious teenagers to consume as many of such flavors as possible. I think that the JUUL company’s tactic on luring customers with popular flavors is clever, since other e-cigarettes look relatively the same to each other and do not have exchangeable flavors. In fact, according to the FDA statistics, “81% percent of current youth e-cigarette users cited the availability of appealing flavors as the primary reason for use.” (FDA) This shows that the JUUL showcased amazing flavors that produced commercial success, only to the wrong audience.

The JUUL’s popularity boost amongst the youth soon caught the attention of the Food and Drug Administration (FDA). The FDA is responsible for regulating the manufacturing, marketing, and distribution of tobacco products as well as reduce the tobacco use by minors to protect the overall public health. As reported by Tobacco Control Policies, the NYS Health Law prohibits the sale of e-cigarettes to minors under the age of 18 (Department of Health). Since a massive portion of JUUL users are under 18 years of age,  JUUL labs were under investigation by the FDA for the assumption of luring teenagers into this epidemic. According to several interviews within the New York Times article Did JUUL Lure Teenagers and Get ‘Customers for Life’? Pax Labs, the creator of the JUUL, developed marketing strategies that incorporated an e-cigarette with a sleek design resembling a flash drive that would attract most smokers (Kaplan). The catch here is that the leaders of the labs knew that this could highly appeal to minors as well. Understanding that the JUUL wave has already spread to teenagers all over the country, the FDA decided to step in and conduct a few regulations.

The FDA realized that small, private services such as eBay and local gas stations are taking advantage of this crime. Therefore, according to FDA Cracks Down on JUULing Among Teenagers, “the F.D.A. has issued warning letters (regulations) to 40 [services] that it says violated the law preventing sales of vaping devices to anyone under 21,” (Cote). The FDA made a smart move of going undercover to catch these services red-handed, which displays evidence of the FDA beginning to cause change. I support the FDA’s undercover investigation because the services that are violating the FDA regulations will not be able to hide from undercover investigators that they are still selling JUULs to teenagers for a quick buck. To further delve into their investigations, the FDA, as stated by Did JUUL Lure Teenagers and Get ‘Customers for Life’?, “demanded that JUUL Labs turn over company documents about the marketing and research behind its products, including reports on focus groups and toxicology.” (Kaplan) The FDA followed through with such procedures to better understand which age group the JUUL production is targeting. The Vox article vouches for the FDA’s decision in investigation, suggesting that “many young people know about Juul, though they aren’t aware of its potential harms… most respondents were not aware that Juul pods always contain nicotine,” (Belluz). This shows that JUUL companies do not properly broadcast their product’s ingredients, therefore taking responsibility for the abuse that minors induce from smoking the JUUL.

The FDA eventually initiated their new “Youth Tobacco Prevention Program” as a response to the JUUL epidemic among teenagers. The “Youth Tobacco Prevention Program” attacks three main objectives: preventing youth access to tobacco products, curbing marketing of tobacco products aimed at youth, and educating teens about the dangers of using any tobacco product, including e-cigarettes. The FDA also educated retailers about their key roles in protecting the youth from exposure to these deceptive devices. (FDA). They actively began researching about the influences of teenage smoking by further demanding the JUUL companies to submit its marketing methods (as part of the “Youth Tobacco Prevention Program”) and what they knows about JUUL use among adolescents. They discovered that JUUL labs have become affiliated with eBay and eBay became the most popular platform of selling JUUL. Therefore, the FDA went on to tell eBay to diminish the selling of JUUL because of the large number of contributions the site has related to selling JUUL to minors.  Unfortunately, Gottlieb delayed until 2022 “the requirement that vaping products go through a rigorous approval process – filing a pre-market tobacco application – to remain on the market.” (Belluz) Although disclosed as to why Gottlieb decided to delay this process, if this were effective sooner, JUUL industries would not be so liberated in distributing their product to almost everyone. Such a rigorous approval process would be able to detect if JUUL could effectively disperse information to their consumers as well as track if they are maintaining the regulations of not selling to ineligible customers. Several major health organizations, including the World Health Organization, sued the FDA for delaying this procedure.

The research spans from the chemicals involved in the JUUL pods to how the FDA decides to act against the selling of JUUL to young people. Because of the high concentration of nicotine, the JUUL has become a very addicting e-cigarette and that causes more and more young people to become hooked to the product. The FDA accused the JUUL labs of specifically targeting younger people because of their sleek design resembling a flash-drive which initiates incognito use. To prevent long-term health effects, such as improper brain development and improper functionality of the immune system, the FDA fought to shut down several services that illegally sell JUULs to minors. Such services, such as eBay, complied with their orders, whereas other small companies that sell JUULs were fined for further selling this product to young people. While supporting the intention of the JUUL’s appearance as being a way to quit smoking for older people, the FDA close their statements with the claim that they must do something to protect the youth, although barely any solutions were proposed. I feel like the best solution is to put the approval procedure into effect as soon as possible because this regulation discreetly affects how the JUUL produces itself amongst the society. Social media can detract attention away from advertising JUUL as a “trendy” device and prevent teenagers from becoming intrigued to try it. The JUUL epidemic serves as a severe impediment to the prosperity of our youth, and the FDA is still figuring out how to decrease the JUUL involvement within the younger generation.