“JUUL” is a brand of electronic NICOTINE delivery system officially offered as an alternative to traditional cigarettes and other vaping systems. What does it look like? Pretty much identical to a flash drive. Let that sink in…would it catch your eye as a teacher or a parent if your student or son/daughter were holding one? Probably not. Are teens using this? YES. The AAFP notes that “nearly 1 in 5 students ages 12-17 have seen (JUUL) used in school”. The National Institute on Drug Abuse notes that 9.5% of 8th graders have used e-cigs in the last month, with this number increasing to 16.2% of high school seniors.

Is there nicotine? You bet. In fact, JUUL has a HIGHER concentration of nicotine than most other e-ciggs, with each “pod” (the cartridge containing the flavored oils that will turn to vapor when you insert it into the device) containing as much nicotine as a pack of cigarettes. Interestingly, most teens who JUUL are unaware that it contains nicotine, many believing this is harmless. And since I mentioned FLAVORS…let’s go there: Cool mint, fruit flavors and even a creme brûlée.  As noted in a 2018 study, adolescents consider flavor the most important factor in choosing e-cigs, and flavors made them more likely to start vaping. So we’ve got yummy flavors to entice young people to try to smoke, introducing them to one of the most addictive substances on the planet – nicotine. Add in that 30.7% of teens who start using e-ciggs like JUUL also start smoking traditional cigarettes within six months.

JUUL pods contain nicotine salts (obtained from tobacco leaves) that produce an immediate “buzz” similar in intensity to traditional combustible cigarettes, yet JUUL’s vapor causes less throat and chest discomfort. (Translation- novice users don’t have much negative feedback, unlike having to “learn” to smoke without coughing.)

So is JUULing is “safer” than smoking cigarettes? Honestly, that’s the wrong question for what I’m addressing today. Yes, if you are an adult smoker who does not WANT to quit, switching to e-cigarettes will give you less exposure to toxic chemicals than traditional cigarettes. JUUL’s mission statement is to “improve the lives of one billion adult smokers” to help them cut back or quit smoking. (Note that to date, studies show conflicting evidence at best of whether or not e-ciggs actually help smokers to quit. As a staunch advocate to help patients quit smoking, I do respect the concept behind JUUL’s creation.)

JUULing is NOT safe for adolescents, however, but it is an excellent pathway to nicotine addiction and cigarette use. And slimming your wallet. The basic JUUL starter package that includes a USB charging dock costs $42 at Walmart, and the nicotine-containing pods cost $4 each (pack of 4 for $16)- feel free to multiply this times nicotine addiction.

BOTTOM LINE: Parents and teachers, look closely at your kids’ “flash drives” and talk to them about the real risks of nicotine dependence from JUULing (and other e-cigs.)

Want to hear more? Check out pediatric surgeon, Dr. Deborah Burton’s blog and podcast

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