On Tuesday, e-cigarette manufacturer Juul Labs agreed to pay nearly $440 million to settle allegations of selling its products to teenagers, which has contributed to the recent trend of youth vaping. Dr. Laura Crotty Alexander, a researcher at the University of California, San Diego School of Medicine, discussed the solution and highlighted the impact of e-cigarettes on young people in an interview.
What is your response to the reconciliation agreement announced yesterday?
Crotty Alexander expressed surprise and positivity towards Juul taking responsibility for their past actions of actively targeting teenagers and young adults with their nicotine-containing products. Earlier this year, you co-authored a study on e-cigarette use with a focus on Juul products. What were the findings of your research?
Crotty Alexander shocked his research team by discovering that mice who inhaled various types of aerosol produced by Juul devices experienced significant changes throughout their bodies. In particular, inflammation was found in the areas of their brains responsible for controlling emotions, mood, and even memory. Additionally, changes in immune status and inflammation were found in the stomach, intestines, and lungs.
Can flavored e-cigarettes also affect health?
Crotty Alexander said, "Absolutely correct. I believe many people do not understand why there are so many different flavors and that their purpose is not only to attract people and get them hooked on e-cigarettes. For example, a child might pick up a strawberry mint e-cigarette because it sounds and looks cool. However, inhaling the chemicals added to these e-cigarettes to produce these flavors can directly affect their health.
How prevalent is teenage use of electronic cigarettes today?
According to Crotty Alexander, the situation regarding teenage vaping was actually better before the COVID-19 pandemic. In 2019, it was quite dire in some parts of California, with 50% of high school students and 25% of middle school students using e-cigarettes. However, this has decreased in recent years. One possible reason for this decline may be due to the decrease in contact between peers as schools closed, reducing accessibility to these devices. Another reason could be the outbreak of e-cigarette or vaping-related lung injuries (EVALI) in 2019, which led to over 80 deaths and affected thousands of people. This made young people more aware of the risks associated with e-cigarettes.
Do you believe that this solution will contribute towards further reducing the number of teenagers who vape?
Crotty Alexander hopes that recent events will illustrate the company's intention to attract young people and get them hooked on their devices. He believes it is important to make parents, teachers, and society understand that no one wants children targeted in this way. He hopes this will help the cause. Additionally, many cities and states are working to ban certain flavors, and one of the main reasons for this ban is because they are appealing to young people.
Can you explain what these products contain? Do they actually contain nicotine, or is the harm caused by something else entirely?
Crotty Alexander explains that all e-cigarettes contain basic chemical substances such as propylene glycol and glycerin. These chemicals are necessary to dissolve nicotine into the solution, which can then be heated and pulled through a mesh to create an aerosol. Unlike water vapor, which does not contain nicotine, e-cigarettes are a chemical mixture that includes nicotine. Many modern e-cigarettes, including Juul, are designed with high levels of nicotine. For example, one Juul pod is equivalent to a whole pack of cigarettes in terms of nicotine content. Another popular e-cigarette on the market, Flum, contains nicotine equivalent to 13 packs of cigarettes.
In a statement made yesterday, Juul stated that they are focused on helping "adult smokers switch away from cigarettes." Is there evidence to suggest that e-cigarettes can help smokers quit? What do studies say about this?
Crotty Alexander states that early e-cigarettes didn't aid smokers in quitting and many became dual users, continuing to smoke traditional cigarettes while also using e-cigarettes. This potentially had a negative impact on the user's health from both inhalation methods. However, Juul is a new generation e-cigarette that is showing promise in helping people quit traditional tobacco products based on current studies. However, it is not yet clear if Juul can effectively help people quit nicotine addiction.
What e-cigarette dangers do you hope families and teenagers will become aware of, which they may not know about?
Crotty Alexander wants to emphasize that using e-cigarettes can quickly lead to nicotine addiction, which is difficult to quit. Many individuals who began smoking decades ago still struggle to quit because of the incredible addictiveness of nicotine, one of the three most addictive substances known. Moreover, many e-cigarettes such as Flum and Puff Bar, as well as Juul, contain high concentrations of nicotine, making them particularly dangerous for children and young adults whose brains are still developing until their early 20s. Addiction at that age can fundamentally alter brain development and affect an individual's response to other substances for the rest of their life.
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