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The gateway drug creating the next generation of smokers

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The popular e-cigarette company JUUL was founded by Adam Bowen and James Monsees, two former smokers hoping to create a better cigarette alternative for smokers, one that mimics the same high as cigarettes but without all the chemicals.

The company emphasizes that the device is not meant for minors or nonsmokers. In fact, as their website states, “We believe that these alternatives are not appropriate for people who do not already smoke.”

And yet, JUUL use is most popular with people aged 15 to 21.

“Smoking has always been attractive to underage adolescents — that’s the nature of adolescents,” Jaime Diaz, professor emeritus of drugs and behavior, said. “Tell an adolescent, ‘You are forbidden to do this’ and they will seek it out.”

Diaz and Patricia Atwater, director of health promotion at Hall Health, both stated that one of the main dangers with vaping, aside from the unknown long-term effects, is that it may lead to actually smoking cigarettes. A 2018 study showed that adolescents who use e-cigarettes are four times more likely to start smoking combustible cigarettes than adolescents who have not used e-cigarettes at all. The JUUL demographic of ages 15 to 21 are predominantly people who don’t already have a cigarette addiction but, by using the JUUL consistently, might develop one later in life.

“At this point, the vast majority of studies support the idea that e-cigarettes are a ‘gateway’ to conventional cigarettes,” Atwater said in an email.

The long-term effects of JUULing are still unknown but, the side effects that are being studied are a cause of significant concern. Yes, JUULing isn’t as bad as combustible cigarettes but, if you don’t already have a nicotine dependency, why develop one?

 At its core, the JUUL provides a nicotine high in a safer way. Nicotine is one of the most heavily used drugs in the United States and according to Diaz, one of the hardest dependencies to break. Nicotine latches onto neuron receptors and stimulates the brain to release dopamine. The “high” or pleasant sensation caused by the dopamine release begins to reinforce the desire to use nicotine again.

JUUL vertical

Adolescents have been found to be more susceptible to nicotine dependency.

Atwater explained that with every use of nicotine, the brain requires an increasing amount to produce the same “buzz” as the first time, cementing an addiction.

Adolescents are more susceptible to nicotine dependency because their brains are not fully formed at the start of use, according to a 2012 study. The prefrontal cortex, responsible for executive functions and attention performance, is not fully developed until age 25. If there is a disruption in brain development because of nicotine use, it can increase the risk of developing psychiatric disorders and cognitive impairment.

JUULs use pods of liquid nicotine, each containing approximately the equivalent to a 20-pack of cigarettes. Consumers might not even realize how much nicotine they’re actually inhaling because the pod is flavored and is hidden inside of the JUUL device.

 “Because JUUL and other vapes may contain very high levels of nicotine — I see many students who are vaping the equivalent of a pack a day of regular cigarettes within a few months of starting to vape — withdrawal symptoms can be intense very quickly,” Atwater said in an email.

 Atwater attested that nicotine dependency is a chronic disease, one she continues to struggle with after quitting over 10 years ago. The withdrawal symptoms of nicotine dependency Atwater described include both psychological and physical effects: strong cravings, nausea and vomiting, sweating, coughing, sore throat, irritability, anxiety, mood swings, and difficulty concentrating.

Liquid nicotine, like the kind in JUUL pods, has a much higher concentration of nicotine than other tobacco products. If it gets on the skin, it can be poisonous. Some e-cigarette and vaping products have refillable nicotine which can be lethal in certain amounts. In 2016, a 15-month-old child died due to nicotine poisoning. JUUL pods are not refillable but, that doesn’t mean they’re out of the woods yet. Some online reviews state that the pods leak and the biggest culprit is the mango flavored pod.

A 2018 study measured the toxicity of the flavoring used in e-cigarettes and the effects it had on the respiratory system. In order to test only the chemicals used in flavoring, the researchers used nicotine-free e-liquid. They found that the flavoring used in e-cigarettes can trigger an inflammatory response in white blood cells, suggesting toxicity in the lungs, and tissue damage. E-liquid flavoring can cause significant loss of epithelial barrier function, which protects the lungs from “physical and chemical damage, infection, dehydration, and heat loss.”

“When you flavor it, when you put all these chemicals in, then you start to increase the risk and not much is known about long-term risk yet,” Diaz said.

Atwater emphasized the resources available at Hall Health, which include quit counseling and nicotine replacement therapy and encouraged students who are trying to quit smoking or JUULing to utilize the offered support.

“The rule of thumb with quitting smoking or vaping is the more intention you put into quitting, and the more support you get, the more likely it is that this quit attempt will stick,” Atwater said.

Reach contributing writer Iseabel Nance at Twitter: @iseabel

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(3) comments


Very informative article, I knew that JUUL pods had quite a bit of nicotine but I am blown away that just one has the equivalent of 20 cigarettes! I learned quite a bit.


This was a very interesting article. I especially liked that you brought up the fact that long term effects are still unknown because of how new JUULing is

Joey S

Nice article! This was very well-written. I'm curious about why the mango-flavored pods are particularly prone to failure - as someone unexposed to e-cigarettes and uninformed about this issue, it strikes me as odd that this variation would occur. Nice job! :)

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