People are freaking out over this type of e-cigarette that's taking over the market, but that doesn't mean you should use it. Here's what a doctor has to say.
Photo: Shutterstock/Diego Cervo
Over the last few years, e-cigarettes have grown in popularity—and so has their reputation for being a "better for you" option than actual cigarettes. Part of that is due to the fact that hardcore smokers do use them to cut down on their habit, and part of that is due to good marketing. After all, with e-cigs, you can vape anywhere without lighting up or reeking of nicotine afterward. But e-cigarettes, and especially Juul—one of the latest e-cigarette products—are likely responsible for more people getting hooked on nicotine.
What Is Juul?
Juul is an e-cigarette that came on the market in 2015, and the product itself is pretty similar to other e-cigarettes or vapes, says Jonathan Philip Winickoff, M.D., assistant professor of pediatrics at Harvard Medical School and a specialist in family health and smoking cessation at Massachusetts General Hospital. "It has the same ingredients: a liquid filled with nicotine, solvents, and flavorings."
But the USB shape of the device is what makes it so popular with teens and adolescents, who make up the majority of Juul's consumers, says Dr. Winickoff. The design makes it easy to conceal, and it literally plugs right into your computer to heat up and charge. There have been reports of kids using them behind teachers' backs, and some schools have even banned USBs entirely to get Juul out of the classrooms. And yet, this year, Juul is already responsible for more than half of all e-cigarette retail market sales in the U.S., according to a recent Nielsen data report.
The other reason Juul appeals to a younger crowd: It comes in flavors like crème brulee, mango, and cool cucumber. Not exactly the tastes a hardened tobacco smoker might be seeking, right? In fact, U.S. Senator Chuck Schumer actually condemned Juul in a 2017 letter to the Food and Drug Administration for promoting "flavors that are attractive to young people." In September 2018, the FDA demanded that Juul and other top e-cigarette companies develop plans for curbing teen use. In response, Juul announced this week that it will only offer mint, tobacco, and menthol flavors in stores. The other flavors will be available online only, and customers will have to verify that they're over 18 by giving the last four digits of their social security number. In addition, the company shut down its Facebook and Instagram accounts, and will only use its Twitter for "non-promotional communications."
Juul isn't exactly cost-prohibitive; a "starter kit," including the e-cigarette, USB charger, and four flavor pods, sells for about $50, while individual pods ring up at around $15.99. But those add up: The average Juul smoker spends $180 per month on Juul pods, according to a survey by LendEDU, a financial education company. That's less than the amount of money survey respondents had formerly been spending on traditional nicotine products like cigarettes (an average of $258/month)—but the habit still isn't cheap.
Is Juul Bad for You?
It's hard to outdo the cigarette in terms of health risks, and yes, there are fewer toxic compounds found in Juul than in cigarettes, says Dr. Winickoff. But it's still made with some very bad-for-you ingredients. "It's not just harmless water vapor and flavor," says Dr. Winickoff. "Not only is it made with N-Nitrosonornicotine, a dangerous Group I carcinogen (and the most carcinogenic substance we know of), you're also inhaling Acrylonitrile, which is a highly poisonous compound used in plastics and adhesives and synthetic rubbers." (Related: Coffee Warning? What You Need to Know About Acrylamide)
The nicotine in Juul is also specially engineered—with a proton group that attaches to it—to taste mild and be inhaled easily (likely another reason for its popularity with teens). And how much nicotine is in a Juul will blow your mind. "You can inhale a whole package worth of nicotine without even thinking twice," says Dr. Winickoff. (Related: New Study Says E-Cigarettes May Increase Your Risk of Cancer.)
That makes Juul incredibly addictive, so it's not the kind of thing you want to dabble in or experiment with—Dr. Winickoff says that, with the amount of nicotine in each pod, you could easily get hooked within a week. "In fact, the younger you are, the more quickly you get addicted," he adds. "It changes your brain to be nicotine-hungry by upping the regulation of receptors in the reward center of the brain, and there's some good evidence that nicotine addiction itself potentiates, or increases, addiction to other substances." Which means it'll be even harder to quit. (Related: Smoking Effects Your DNA—Even Decades After You Quit.)
Juul Side Effects
Juul has only been on the market for three years, so right now doctors and researchers don't really know what health risks the product might lead to. "The chemicals in electronic cigarettes, in general, have not been tested," says Dr. Winickoff.
That said, there are known side effects of nicotine inhalation. "It can cause coughing and wheezing, as well as asthma attacks," says Dr. Winickoff. "And it can cause a kind of allergic pneumonia called acute eosinophilic pneumonitis." Not to mention, puffing just one e-cigarette has been linked to an increased risk of heart disease, according to a study published in the journal JAMA Cardiology (researchers found it to increase adrenaline levels in the heart, which could lead to heart rhythms issues, heart attacks, and even death).
Recently, an 18-year-old who had been vaping for about three weeks made the news when she ended up in the hospital for respiratory failure. Doctors diagnosed her with hypersensitivity pneumonitis, or "wet lung," which is when the lungs get inflamed due to an allergic reaction to dust or chemicals (in this case, the e-cigarette ingredients). "The whole case is pretty telling that the compounds in the chemicals and in electronic cigarettes are not safe," says Dr. Winickoff. (Related: Is Hookah a Safer Way to Smoke?)
One other major issue? You might think you're vaping Juul, but because there's so little regulation around e-cigarettes, you might not actually know what you're inhaling. "There are a huge number of knock-offs out there, and with kids trading pods all the time, you don't really know the source of your product," says Dr. Winickoff. "It's almost like you're playing Russian Roulette with your brain."
At the end of the day, if you're a long-time smoker who's trying to quit, Juul or e-cigarettes could be an option to help wean you off. But that doesn't mean they're safe. "I wouldn't recommend anyone who hasn't smoked before to ever try Juul," says Dr. Winickoff. "Stick to breathing good, clean air."