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Dangers of Vaping and Juuling

The Public Health Issue Families Need to Address

Electronic cigarettes – known as e-cigarettes – are the most commonly used tobacco product among youth. Why are e-cigarettes so popular with young people? There are two main reasons: the taste of flavored e-cigarettes (menthol, candy, fruit, chocolate, alcohol, etc.) and the misconception that this product is less harmful than other tobacco products.

According to the National Youth Tobacco Survey (NYTS), rates of e-cigarette use among young people generally declined between 2015 and 2017. However, the 2018 data showed that between 2017 and 2018, e-cigarette use among middle and high school students increased in a sharp and startling fashion with over 3.6 million kids using e-cigarettes in 2018. This change is attributed to the use of USB flash drive-like e-cigarettes, including Juul, which have continued to grow in popularity among young people. These products have high nicotine content, appealing flavors, and they can be easily used and concealed. 

Federal law prohibits the sale of tobacco-containing products to anyone under eighteen, but one in five high school students have reported using e-cigarettes. A recent report by the Surgeon General indicates that 99 percent of adult smokers started smoking
by the age of twenty-six. If young people are attracted to smoking e-cigarettes in middle school and high school, there are alarming implications for long-term usage and addiction. The use of e-cigarettes is an emerging health hazard and a public health concern. 

What are e-cigarettes?

An e-cigarette is a battery-operated device that emits doses of vaporized nicotine or non-nicotine solutions for the user to inhale. It aims to provide a similar sensation to inhaling tobacco smoke, except there is no actual smoke in e-cigarettes. E-cigarettes are sometimes called e-cigs, vapes, e-hookahs, vape pens, and electronic nicotine delivery systems (ENDS). Some e-cigarettes look like regular cigarettes, cigars, or pipes, and some delivery systems look like USB flash drives, pens, and other everyday items. 

An increasingly popular e-cigarette device is the Juul. Juul is available in several flavors, including cool cucumber, fruit medley, mango, and mint. Use of the Juul is sometimes called Juuling. All Juul e-cigarettes have a high level of nicotine. According to the manufacturer, a single Juul pod contains as much nicotine as a pack of twenty regular cigarettes. Juul became available for sale in the United States in 2015. By December 2017, Juul was the top-selling e-cigarette brand in the United States.

The truth about e-cigarettes  

E-cigarettes do not expose users to many of the components of cigarette smoke, like tar, oxidant gases, and carbon monoxide that are responsible for many of the tobacco-attributable diseases. However, most e-cigarettes do contain a number of potentially toxic chemical substances including nicotine, heavy metals (lead and volatile organic compounds), and cancer-causing agents. Despite this, most public health experts believe that inhaling e-cigarette vapor is likely to be less harmful than inhaling cigarette smoke. It should be noted that the consequences of chronic inhalation of e-cigarette vapor are largely unknown and levels of toxic and carcinogenic compounds may vary by e-cigarette liquid components and the device used. 

Most e-cigarettes contain nicotine, which has known health effects. Nicotine is highly addictive and acute exposure can be toxic. Nicotine can harm adolescent brain development, which continues into the early to mid-twenties. Children who smoke may immediately experience increased heart rates and blood pressure. Long-term effects include respiratory problems, reduced immune function, increased illness, tooth decay, gum disease, and precancerous gene mutations. 

For years, e-cigarettes have been promoted not only as a less harmful alternative to traditional cigarettes, but also as an option for adult smokers to quit or reduce their use of tobacco. The opposite may be true in young people, who may be more likely to go on to use regular cigarettes after using e-cigarettes.

Although many people promote e-cigarettes as less harmful than traditional cigarettes, it’s important to recognize that the harmful effects of these products are still unknown.

Overall, studies have concluded that although e-cigarettes may be of some benefit in adults who are trying to quit smoking combustible cigarettes, they may act as a gateway product in teenagers and young adults to smoke traditional cigarettes and, eventually, becoming daily smokers.

Who plays a role in prevention?

Parents, teachers, coaches, and healthcare providers can help prevent and reduce the use of e-cigarettes by young people.

At area schools, it’s crucial to enforce tobacco-free policies. Tobacco use-prevention curriculum and educational programs should include all tobacco products, including e-cigarettes.

At home, parents should be patient and ready to listen to their kids. Avoid criticism and encourage kids to have an open conversation. 

Educate your children about the harm nicotine can do to developing brains. Let your kids know you are firmly opposed to them using any tobacco products, including e-cigarettes, now or in the future. This is important, especially if no one in your family smokes. Your children might not realize you have an opinion on this issue if they don’t see the impact of tobacco use on the family.

If you need additional assistance talking with your child, schedule an appointment with a healthcare provider so your kids can hear from a medical professional about the health risks of e-cigarettes.

Anuradha Gonuguntla, MD, is a family practitioner at Commonwealth Primary Care. She lives with her family in Glen Allen.
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