Hidden Juuls: E-Cigarette Use on the Rise Among Teens

While their parents’ generation were sneaking cigarette breaks, post millennial teens have found a new and unexplored way of ingesting nicotine: electronic cigarettes.

Known by many as “vaping,” the use of electronic cigarette products has skyrocketed among the high school demographic in the past few years as an estimated 20 percent of students nationwide have reported using a vaping device.

Electronic cigarettes are devices that aerosolize liquid that contains nicotine, humectants, and flavoring agents and mimic the experience of cigarette smoking. While they were first introduced in the US market back in 2006 as smoking cessation aids, there is no conclusive scientific evidence that e-cigarettes promote successful long-term quitting. But, unlike adults’ reasons for using e-cigarettes, adolescents’ top reason is not a desire to reduce cigarette smoking; for adolescents, curiosity, appealing flavors, and peer influences rank as higher reasons. Now, roughly one in every four high school students are estimated to be using a tobacco product.

The increased use of e-cigarettes by teens is deeply troubling,” said Center for Disease Control Director Tom Frieden, M.D., M.P.H.  “Nicotine is a highly addictive drug.  Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”

“A lot of people do it and no one really thinks of the consequences on our bodies and it has really become more of a habit. I would not recommend [vaping] to others considering no one is educated on what it does to our health,” said a Hills West junior who wished to remain anonymous.

Besides the easily-addictive nicotine found in tobacco products, e-cigarettes can contain potentially harmful ingredients including ultrafine particles that can be inhaled deep into the lungs. Flavorings such as diacetyl have also been found in multiple e-liquids (which have been traced to inflamed bronchioles or ‘popcorn lung’) as well as volatile organic compounds and heavy metals such as nickel, tin, and lead. Some e-cigarette brands contain chemicals including formaldehyde–often used in building materials– which is a key ingredient used in antifreeze that may cause cancer.

The use of any tobacco product during adolescence has been found to harm developing brains and affect memory and attention. With 3 million US students currently vaping and the numbers only rising, it is estimated that 5.6 million Americans currently younger than age 18 are predicted to die prematurely from a smoking-related disease.

However, e-cigarettes remain largely unregulated as lawmakers across the country are scrambling to keep up with the ever-changing technology. Governor Andrew Cuomo alongside the New York State Department of Health proposed a $12 tax on 30 ml bottles of vaping liquids and a ban on vaping indoors, a proposition that many legislators are anticipated to meet with support.

Additional efforts to limit e-cigarette usage has been progressing as lawmakers in Albany continue to vouch for the prohibition of selling vaping devices and flavored e-liquid in pharmacies and potentially ban the sale of liquid used in vapor products altogether.

According to New York State law, electronic cigarettes are included in the Smoke-Free Air Act, meaning retailers cannot sell tobacco or electronic cigarette products to anyone under 21. While no person is permitted to be smoking on school grounds, the consequences for students caught in possession of a vaping device isn’t quite written in stone as administration races to catch up with this new technology.

“Right now, we’re still combing through [the repercussions]; what I can say for sure is that if anyone is found with the oils that are found to be cannabis oil, that is a clear drug suspension and that would go to a hearing,” said Dr. Catapano. “Students found in possession of the [vaping] device are going to be suspended and it depends on what is in the device at that time. It’s going to be something that we’re going to be learning from as we go along; the repercussions aren’t going to be as simple as a detention.”

E-cigarettes remain the most commonly used tobacco products among middle and high school students in the US for the second year in a row, according to a report from the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration’s (FDA’s) Center for Tobacco Products. But with the use of traditional cigarettes at the teenage demographic at an all-time low, the golden question arises: why are e-cigarettes so popular among the same group? Tim McAfee, director of the CDC’s Office on Smoking and Health, said the increase “shows the power of 21st century marketing.”

“About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, M.D., M.P.H., director of the CDC Office on Smoking and Health.  “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical.”

John Schachter, director of state communications for Campaign for Tobacco-Free Kids, expressed concern about the Juul campaign because of the youth of the men and women depicted in the campaign, especially when adjoined with the design. Mr. Schachter said the organization has noticed obvious trends that appeal to adolescents in e-cigarette campaigns such as celebrity endorsements, sponsorships and various flavors.

“We’re seeing more and more irresponsible marketing of unregulated products such as e-cigarettes,” Schachter wrote in a statement about the Juul campaign. “We are concerned any time a new product or new advertising campaign goes public regarding cigarettes and tobacco and their addictive nicotine.”

Only within the last 2-3 months [in-school vaping has become an issue],” said Dr. Catapano. “Maybe mid-March is when it really came to my attention. I heard some instances and I’d seen people using them outside of school, but it was brought to my attention through the faculty [and] staff that they had received reports from students that other students were using these devices in school [and] on the school bus. We began to investigate it, and we found it to be a little more widespread than I originally thought.

“We’re doing our best to try to curtail the use: We sent a letter home to parents from the school district … informing them of the increased use of these devices and the potential dangers, reminding them of the school district policies of no tobacco on school grounds and the banning of e-cigarettes. We’ve made the staff more aware of it; I’ve had conversations with the faculty and the teaching staff to be more aware of it so they can have some education on it themselves…”