This week, the United States effectively banned Juul after the Food and Drug Administration ordered the e-cigarette manufacturer to remove its popular products from the market.
Experts have hailed the move as important. But they are also concerned that such efforts are failing to keep pace with a fast-moving vaping industry – one in which young people are rapidly jumping from one product to another.
The FDA ban limits years of controversy for Juul, whose discreet vapes have been accused of helping to hook a whole new generation of nicotine. In 2020, the FDA ordered e-cigarette capsules with mint and juice flavors from the shelves, and hit many of Juul’s products. This week’s escalation came because regulators said Juul failed to provide sufficient evidence to assess their toxicity and the dangers of their tobacco and menthol-flavored e-cigarettes, making the FDA unable to “assess the potential toxicological risks of using Juul. products “.
Juul, meanwhile, has claimed that their fumes help regular smokers quit smoking, and has said they will fight back. On Friday, a court of appeal temporarily imposed the ban while Juul anchors.
The ban remains important, says Lauren Czaplicki, a researcher at the Johns Hopkins Bloomberg School of Public Health, because it is one of the first marketing denials for a brand with significant market share in the United States and for a menthol-flavored product. She points out that other brands such as Vuse, Logic and NJOY have received marketing authorization for various e-cigarette products and tobacco-flavored systems, but Juul was denied.
Research shows that bans on flavored cigarettes make a difference – a 2020 study by George Mason University analyzed a ban on flavored cigarettes by the FDA in 2009, and found that it reduced smoking among minors by 43% and young adults by 27%.
“It’s likely that the FDA’s marketing denial will have an impact,” says Czaplicki. “Juul is still a popular product among young people who use e-cigarettes, and Juul has a certain degree of brand recognition and cultural cachet among young people who may be exposed to nicotine use.”
But while Juul still has a dominant share of the US market, its popularity among young people has declined in recent years, says Dr Devika Rao, a pediatric pulmonologist at UT Southwestern. A recent federal study found that Juul was only the fourth most popular product among middle and high school students: the disposable e-cigarette Puff Bar came first, with Vuse and Smok the second and third most popular.
“We know from data that Juul is not the most used,” says Rao. “Youth today prefer disposable weapons, devices you can buy online or in a store.” They cost as little as $ 10 each for a disposable unit and do not fall under the taste ban in 2020, even though they use the same technology as Juul.
Adolescents often switch from product to product, creating a Whac-a-Mole prevention strategy, says Monica M Zorilla, a Stanford researcher. When the FDA prioritized the enforcement of flavored e-cigarette devices like Juul in 2020, it released disposable e-cigarettes and menthol-flavored e-cigarette products, says Zorilla. A Stanford study found that young people then moved to the e-cigarettes that were exempt. “Youth went from pod-based [like Juul] to disposable items like Puff Bar, says Zorilla. “As one teenager told me, ‘everything with fruit’ is popular with peers. This was partly because of the enforcement and partly because the disposable products continued to have many flavors. “
Rao points out that social media marketing is smart – and insidious – enough for teens to switch vaping products before adults are even aware of them. She points out that the latest trend is so-called wellness vapes that are not even marketed as e-cigarettes. “You can evaporate things like melatonin or vitamins to feel better and fall asleep faster,” she says. These are really disguised vaping devices, and companies are not required to state the concentration or what is in these products. “Newer products offer a whole new level of risk.”
More action is needed, says Czaplicki. She says the FDA should immediately issue an order to remove all vape products sold without a marketing authorization, from retail shelves and online. This will include the Puff Bar. “Reducing the number and type of flavored e-cigarette devices for sale in the United States is likely to have a significant impact on reducing youth smoking,” she says. “At the same time, it is unlikely to reduce the benefits of tobacco-flavored e-cigarettes from helping adult smokers quit smoking altogether.”
Vaping exposes a new generation to nicotine addiction, says Rao – and researchers are still finding out how to treat nicotine addiction in children instead of adults.
These products are often perceived as less harmful than smoking, but they still carry a risk because young people are addicted to drugs. Rao, who takes care of patients at a pediatric center in Dallas, explains that Juul had figured out how to make nicotine more potent to give a stronger blow to the brain – giving a greater sense of joy by using the steam.
“It can take only a few strokes of a vape before they become addicted, and it affects things like school performance, athletic performance and can lead to serious consequences such as lung damage,” says Rao. Studies also show that vaping leads to increased heart rate and blood pressure.
She says that the steam frequency fell for two years during the pandemic, but doctors are now worried that the re-establishment of social networks and easing of restrictions means that these rates can rise again.
“When I talk to my patients, they vaporize either or all of their friends, and they may feel pressured to start using these products,” says Rao. “Parents and teachers need to have these conversations about the harm they can have.”