With the rise of vaping among teenagers and the concern of addiction at such a young vulnerable age, another vice has presented itself to the teenage market: juuling.

Juuling is a lot like vaping in that it’s like an e-cigarette with a pleasant odor and minimal amounts of vapor.  Fun flavors, such as fruity flavors or bubblegum flavors, are available and are especially enticing to younger individuals.  A major cause for concern, however, is the amount of nicotine the juuling devices contain and the way the substance is packaged.

For instance, among high school and college students, the use of juuling is very much on the rise.  This is due in part to the fact that students can hide the device used in the process very easily since it looks very much like a flash drive.  In fact, the device is plugged in to a USB port to charge.  So, in essence, teachers and others are struggling to identify if kids are using the products.  Further complicating the issue is that the exhaled vapor cloud is very easily hidden in a shirt sleeve.  Some campuses have banned flash drives in a effort to stop the use of the devices.

Also, the amount of nicotine in a device used for gulling is about equivalent to an entire pack of cigarettes.  With teenage brains still in the development process, the amount of nicotine inhaled creates a haven for addiction.  Most kids find they don’t even feel the effects of a single juuling session after not too long and need to do juuling more and more often. Marketers indicate they are not targeting teens, but the devices are definitely appealing to that age range.

Juuling and Teens: Fact Sheet

The American Academy of Family Physicians (AAFP) issued a Fact Sheet on juuling: “JUUL works similar to other e-cigarette devices, but has several features that make it different and potentially more dangerous. Features that distinguish JUUL from other e-cigarettes include:”

  • “JUUL resembles a USB drive. It can be concealed as a USB drive and used in public spaces, such as schools. It is charged in the USB port of a computer or laptop.”
  • “The liquid in JUUL pods contain nicotine salts from tobacco leaves. The nicotine salts are absorbed into the body at almost the same rate as nicotine from a combustible cigarette. Inhaling vapor from nicotine salts goes down smoothly and doesn’t produce the irritating feeling in the chest and lungs that combustible cigarettes do.”
  • “JUUL has more than twice the amount of nicotine concentrate as many other brands of e-cigarettes. This has raised concerns that it may have a higher risk of addiction than other e-cigarettes. One cartridge, called a pod, has roughly the equivalent amount of nicotine as one pack of cigarettes.”

Juuling and Teens: How Big is the Problem?

The U.S. Centers for Disease Control released a powerful report: Reasons for Electronic Cigarette Use Among Middle and High School Students. It helps explain how big the problem is.

Among the findings:

  • Electronic cigarettes (e-cigarettes) were the most commonly used tobacco product among U.S. middle school and high school students in 2016.
  • CDC and the Food and Drug Administration (FDA) analyzed data from the 2016 National Youth Tobacco Survey (NYTS) to assess self-reported reasons for e-cigarette use among U.S. middle school (grades 6–8) and high school (grades 9–12) student e-cigarette users.
  • Among students who reported ever using e-cigarettes in 2016, the most commonly selected reasons for use were 1) use by “friend or family member” (39.0%); 2) availability of “flavors such as mint, candy, fruit, or chocolate” (31.0%); and 3) the belief that “they are less harmful than other forms of tobacco such as cigarettes” (17.1%).
  • The least commonly selected reasons were 1) “they are easier to get than other tobacco products, such as cigarettes” (4.8%); 2) “they cost less than other tobacco products such as cigarettes” (3.2%); and 3) “famous people on TV or in movies use them” (1.5%). Availability of flavors as a reason for use was more commonly selected by high school users (32.3%) than by middle school users (26.8%).
  • Efforts to prevent middle school and high school students from initiating the use of any tobacco product, including e-cigarettes, are important to reduce tobacco product use among U.S. youths.

Juuling and Teens: Public Health Concern

The CDC further concludes that juuling is a public health concern, noting that:

  • The U.S. Surgeon General has concluded that e-cigarette use among youths and young adults is a public health concern. The prevalence of e-cigarette use among youths increased substantially during 2011–2015.
  • In 2016, e-cigarettes were the most common tobacco product used among adolescents, although the overall prevalence of use declined from previous years. The Surgeon General has also concluded that e-cigarettes can contain harmful and potentially harmful constituents, including nicotine; exposure to nicotine during adolescence can cause addiction and can harm the developing adolescent brain.
  • Recent research indicated that e-cigarette use declined among adolescent students in 2016, likely in part because of population-based efforts to prevent youths’ e-cigarette initiation and use. Continued efforts are important to further reduce all forms of tobacco product use, including e-cigarettes, among U.S. youths.
  • As noted by the Surgeon General, population-level strategies include incorporating e-cigarettes into smoke-free indoor air policies, restricting youths’ access to e-cigarettes in retail settings, licensing retailers, and establishing specific package requirements.

What Parents Need to Know About Juuling and Teens

According to the Cleveland Clinic: “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.”

It continues: “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.”

More education about the dangers of vaping, smoking, and juuling needs to be presented to the teens and young people in our schools.  Hopefully this type of prevention education, along with parent and teacher awareness, can put an end to juuling among teens.

The CDC notes that further action is needed:

  • Comprehensive strategies to prevent and reduce the use of all tobacco products, including e-cigarettes, among U.S. youths are warranted.
  • Regulation of the manufacturing, distribution, and marketing of tobacco products by FDA, along with sustained implementation of comprehensive tobacco control and prevention strategies, could reduce youths’ e-cigarette initiation and use.
  • In addition, continued monitoring of e-cigarette use, including reasons for use and product characteristics, is important to guide strategies to prevent and reduce use of e-cigarettes among youths.
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