I recently spoke to a group of high school parents and administrators about the current substance use trends among teens. After the presentation, one of the school counselors brought out a box and dumped out its contents onto a table for the parents to see all the different types of e-cigarettes, vapes, and pods that had been confiscated. 

The parents were in shock by how many of them did not look like e-cigarettes. It was a wake-up call for those parents. America is facing its own wake-up call to the disturbing growth and popularity surrounding vaping. 

What is Vaping?

On the one hand, it’s quite easy to define vaping. To vape is to inhale vapor that is created from a liquid that is heated up inside a particular device. On the other hand, things get quite complicated when it comes to everything else about vaping.

The device that heats up the liquid has many names: vape pens, e-cigarettes, e-cigs, pod mods, electronic nicotine deliver devices (EMDS), e-hookahs, tanks, tank systems, and Juuls. 

The liquids used also have many designations: it might be called e-liquid, pods, cartridges, e-juice, or oils. 

The majority of vape liquids contain a combination of propylene glycol or glycerol (also called glycerin) as a base, and nicotine, marijuana, or flavoring chemicals. The devices use batteries to power heating elements made of various materials that aerosolize the liquid.

Why is Vaping Worrying Parents and the Surgeon General?

On December 18 of last year, Surgeon General Jerome Adams issued an advisory from his office. “I am officially declaring e-cigarette use among youth an epidemic in the United States,” Dr. Adams said.

Why is vaping such a concern? Today, more than 3 million middle and high school students say they regularly vape with e-cigarettes. According to the 2018 National Youth Tobacco Survey, from 2017 to 2018, the number of high schoolers who reported using e-cigarettes increased 78 percent.

In 2017, nearly 8 percent of high school students said they had smoked a cigarette in the past month. That’s nearly half of what the rate was in 2011, according to the Centers for Disease Control and Prevention.

In my home state of North Carolina, I regularly speak to schools about the risks of drug and alcohol use among teens. The 2018 Charlotte-Mecklenburg Youth Drug Survey, with 10,000 youth participating, shows high school youth smoking cigarettes at an all-time low of 5.1 percent, however one in five (19.6 percent) high school youth are currently using e-cigs with white teens using at the highest rates (34 percent).

The 2017 North Carolina Youth Tobacco Survey shows that 39.6 percent of our 12th graders statewide are vaping.

Behind drinking alcohol, vaping was the second-most common form of substance use, the study showed, with 17.6% of eighth-graders, 32.3% of 10th-graders and 37.3% of 12th-graders reporting vaping in the past year in North Carolina.

Last year, the annual survey found that prevalence of vaping nationally was 13.3% among eighth-graders, 23.9% among 10th-graders and 27.8% among 12th-graders.

In a time where almost all other forms of drug and alcohol use amongst teens is declining, vaping is the one behavior that is seeing a drastic spike. Why?

Misinformation and Marketing

Many young people think vaping is mostly harmless. Pediatricians and educators are discovering that more and more teens and adults are not fully aware of the health risks associated with vaping.

Marketing efforts have emphasized the sweeter flavored pods such as mango or cotton candy to be key signifying feature of vapes. In the early days, the nicotine or risk of addiction was significantly downplayed or outright neglected.

In a USA Today article published last month, young adults who spoke with the newspaper for the piece claimed that “many college students think of vaping as something fun to do with friends, not as a tobacco product with health risks.”

“Many young people think vaping is mostly harmless.”

Another marketing angle that has driven the popularity and sales of e-cigarettes is the claim that vaping is safer than traditional tobacco products and helps current smokers quit. But does vaping help current smokers quit? 

According to health researchers from Yale University who study the health effects of vaping and e-cigs, the data doesn’t add up. Vaping has not been proven to help adult smokers quit smoking. Moreover, vaping is shown to actually increase the risk of teens smoking regular cigarettes later.

The companies of many vaping devices have come under scrutiny from the FDA for marketing practices that seem aimed at attracting teens and young adults.

According to an announcement the FDA released on September 12, “The agency is asking each company to submit to the FDA within 60 days plans describing how they will address the widespread youth access and use of their products,” the news release stated.

The Crown JUUL of All the Vapes

Although vaping devices only began appearing in the United States in the last 8-10 years, one particular brand is worrying to parents, school administrators, the federal government, and addition researchers; the Juulpod.

Juuls are a “pod mod” device that arrived late to the e-cigarette market in 2015.  But the company, called Juul Labs, has surged ahead of all its competitors. Last year, Juul accounted for 72 percent of the e-cigarette market.

Sleek, slim, and easily concealed, the Juul has been established among youth as the vaping device of choice. The brand has even morphed into its own verb – juuling – and many teens view it differently than other vaping options.

“When we ask teens about their vaping or e-cig habits, they don’t even consider juuling to be a part of that,” says Suchitra Krishnan-Sarin, PhD, co-leader of the Yale Tobacco Center for Regularly Science, one of 14 centers in the country funded by the National Institute of Health (NIH) and the FDA to guide tobacco regularly research.

“Juuls are a “pod mod” device that arrived late to the e-cigarette market in 2015.”

One key feature that differentiates Juuls from some other e-cigarettes is that with traditional vaping devices it is possible to buy liquid without nicotine. This is not possible to do with Juuls.

According to Juul’s website which has since been removed, a single Juulpod contains 40mg of nicotine, which is the equivalent to the nicotine found in one pack of cigarettes. 

Teens and young folks are especially drawn to Juul because the device resember a computer flash drive and is easily concealed. Also, unlike most other vaping devices that stream clouds of scented vapor, Juul emits short puffs that quickly dissipate.

Its popularity among teens has provoked a backlash from authorities, and the announcement last month that it would join forces with Altria, which makes Marlboro cigarettes, has only ramped up the controversy.

Juul Labs made close to $1.5 billion in retail sales for its e-cigarettes over the 52-week period ending October 6, according to a Wells Fargo Securities analysis of Nielsen data.

The company has about 75 percent of all e-cigarette revenue, excluding online sales and sales at specialty shops, according to Nielsen. The firm is now worth more than thirty-eight billion dollars.

Flash in the Pan or Long-Term Viability?

Clearly, vaping is not going away. The e-cigarette market is estimated to reach $44,610.6 million by 2023. So what’s the number one step that the American people need to take?

Talk to your families about e-cigarettes. Don’t assume that your child or teen knows that vaping and Juuls have tobacco or are addictive. Talk to your child or teen about why e-cigarettes are harmful for them. It’s never too late.

Click here for more content by Jonathan Hetterly, LPC!

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