It looks like a flash drive, and it plugs into a laptop’s USB port like a flash drive, but it’s not a flash drive. It’s actually an electronic cigarette, or e-cigarette, and it’s been causing a stir in schools across the country since it was introduced in 2015.
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Juul® is a sleek, black vaping pen that fits in the palm of your hand. Like other top-selling e-cigarettes on the market (including Vuse®, Logic®, Blu® and MarkTen®), it comes with little cartridges of “juice” that contain nicotine, fruity flavorings and other chemicals. The cartridges snap into the device, and the juice is heated up when a user inhales, creating a vapor that delivers a quick hit of nicotine — and the pleasant sensation that smoking cigarettes creates, explains pulmonologist Humberto Choi, MD.
But unlike other kinds of e-cigarettes, Juul and the newest class of devices are discreet enough that teenagers are using them in school bathrooms, hallways and even classrooms. They’re small and easy to hide, and the fruity-smelling smoke dissipates quickly. Not only has “juuling” become so popular that it’s now a verb, but it’s even inspired a series of social media hashtags.
Though the companies that make these products say they’re intended to be used as alternatives for adult smokers over 21, teenagers are still getting their hands on them. In fact, use among teens is so rampant that the Food and Drug Administration (FDA) is officially authorizing all Juul brand flavored e-cigarettes to be pulled off the market.
“The agency has dedicated significant resources to review products from the companies that account for most of the U.S. market,” said FDA Commissioner Robert M. Califf, MD, in a statement. “We recognize these make up a significant part of the available products and many have played a disproportionate role in the rise in youth vaping.”
Dr. Choi explains the potential health concerns over vaping and what steps you can take to address it with your teens.
What do we know about the dangers of vaping?
While there’s been a significant drop in youth smoking over the last decade, the use of other tobacco products like e-cigarettes in this age group continues to climb. Youth are taking up e-cigarettes most often because family members or friends use them, or because the juice comes in appealing flavors like mint or fruit, according to a 2016 survey.
In that same survey, 17% of middle and high school-aged users also said they turned to e-cigarettes because of the belief that they’re less harmful than other forms of tobacco, like cigarettes.
While there’s still research being done on the long-term safety of e-cigarettes, health experts like Dr. Choi say caution is warranted. A recent study by the American Journal of Preventive Medicine found that e-cigarettes are a significant risk factor for respiratory diseases.
The risks of nicotine
There’s also concern over the rise of e-cigarettes and their potential risk for nicotine addiction. Because of the attractive design and appealing flavors, young people may not understand that they’re actually taking in high concentrations of nicotine (juices contain up to 5% nicotine), which is highly addictive and damaging to brain development.
Vaping vs. smoking
So, what is the difference between vaping and smoking? The main thing that separates them is that one (smoking) burns tobacco, while the other (e-cigarettes) heats nicotine combined with flavorings and other chemicals into an aerosol. In both cases, a significant amount of vapor and fumes enter your lungs.
While vaping has been considered less harmful than smoking, that doesn’t mean it doesn’t come with its own set of long-term and short-term risks.
“We know that in the short-term they can cause inflammation in the airways and in the lungs,” Dr. Choi explains. “It will take a while until we see the long-term consequences, but our expectation is that they can cause harm similar to smoking cigarettes.” Experts also worry that teens who use e-cigarettes may be more likely to start smoking tobacco.
Other harmful ingredients
It’s not just the nicotine that can have a negative effect. E-cigarettes don’t contain tobacco or tar, but they do contain “many other chemicals that can be harmful, sometimes in combination,” Dr. Choi says. Propylene glycol, for example, is one ingredient. It’s commonly used as a food additive and considered safe for ingestion, but it’s not clear if it’s safe to be inhaled for a prolonged period of time.
“I think the point here is that we cannot consider the aerosols with these chemicals safe when inhaled,” Dr. Choi notes.
Vaping and marijuana
Vaping marijuana is often done through the use of marijuana concentrate, which contains highly potent amounts of tetrahydrocannabinol (THC). According to the Drug Enforcement Administration (DEA), vaping pens with marijuana concentrate can be up to four times stronger than other types of marijuana. A recent report from the Centers for Disease Control and Prevention (CDC) also showed that the use of THC vaping products has been linked to EVALI, a medical condition where a person’s lungs become severely damaged.
“Most of these THC-containing products come from informal and unregulated sources so they may contain unknown substances,” cautions Dr. Choi.
There are also concerns over the trend of vaping CBD oil, mostly because it can also contain unregulated substances and harmful chemicals.
Turning your concerns into conversations
The truth is, your child may have been already exposed to the overall concept of vaping.
Whether or not you suspect your child may be participating or being pressured to vape, Dr. Choi suggests taking up the subject with your teenagers. “I think it’s important to have the conversation anyway,” he says. “Odds are, they will come across a situation where someone is using e-cigarettes or they may be offered to use one.”
Different people are attracted to e-cigarettes for different reasons, Dr. Choi notes, so there’s no one good way to bring up their potential dangers with your kids. But understanding what might motivate them to try, or talking through ways to respond to peer pressure can be a good start.
Keep open and ongoing conversation
It’s normal for this conversation to happen over time, so don’t feel discouraged if the first couple chats don’t feel productive. You can also try working in the conversation about e-cigarettes and vaping through everyday situations such as:
- Passing by a cigarette shop.
- Seeing an e-cigarette in a TV show or movie.
- Seeing an e-cigarette advertisement at a store or online.
Set a good example
Another good way of deterring your teen from vaping (or smoking) is to lead by example. Even taking the steps toward being tobacco-free in your own life may help influence your child’s future actions.
What if they’re already vaping?
If you suspect that your teen may have picked up vaping, the best you can do is approach it through open communication. Before you have “the talk” about e-cigarettes, it may be a good idea to get a fact sheet together on the harms and risks of vaping. Coming armed with information could be the best way to sway your teen from it.
“The American Academy of Pediatrics actually recommends that pediatricians screen families and counsel patients about the health risks of e-cigarettes,” Dr. Choi says. “Unfortunately, the increase in the use of e-cigarettes among teenagers is so concerning that we need to be more proactive.”
If you feel like you’re not getting through, ask your doctor to discuss the dangers of smoking and e-cigarettes at your teen’s next appointment. Other resources such as the Office of the Surgeon General can also be helpful in presenting information to your teenager about vaping.