Juul’s High-Nicotine Products has Led to a “Nicotine Arms Race”

Juul Labs, makers of the highly popular Juul e-cigarettes, increased the nicotine content of their products, spurring other e-cigarette makers to do the same. This, experts say in a new report, has led to a serious vaping epidemic among teens and young adults, and a nicotine “arms race” among e-cigarette companies.

Juul e-cigarettes first hit the market in 2015. Their liquid nicotine “pods” contained 5% nicotine at the time, while similar products made by other companies only contained 1-2% nicotine concentrations. Today, some competing brands contain as much as 7% nicotine.

You may hear that a single 5% pod delivers the same amount of nicotine as a pack of cigarettes, and since many people vape more than 1 pod per day, the habit is causing nicotine addiction. Keep in mind, e-cigarettes are touted by the industry as a way to help adults quit smoking traditional cigarettes. When it comes to young people, e-cigarettes are having the opposite effect.

But it’s difficult to pinpoint exactly who should choose the various pod strengths based on one’s smoking habits. One pod may equal a pack of cigarettes in terms of how long it would last for a smoker, but based on the information available, it seems that the nicotine delivered is often much more than a pack of cigarettes. Vaping liquid has become extremely potent.

Robert Jackler, a researcher at Stanford University and study senior author, said during an interview:

“Until recently, most e-cigarette liquids carried 1 to 2 percent nicotine, with a few considered ‘super high’ at 3 percent, intended for the two-pack-a-day smoker.”

Hmmm, so is a 5% pod equal to a pack of cigarettes, or is as little as 3% equal to 2 packs a day?

From Juul’s website:

“Each 5% JUULpod is designed to contain approximately 0.7mL with 5% nicotine by weight (approx. 40 mg per pod based upon 59 mg/mL) at time of manufacture. Each 3% JUULpod is designed to contain approximately 0.7mL with 3% nicotine by weight (approx. 23 mg per pod based upon 35 mg/mL) at time of manufacture. Nicotine content may decrease over an extended period of time.”

According to various sellers of vaping products, a heavy smoker picking up vaping might want to start (though shouldn’t) with a strength of 24 mg/ml, while ‘normal’ smokers or those wanting to wean themselves off may begin with 14-18 mg/ml pods. Again, a 5% JUULpod contains 59 mg/ml.

Here is an image showing what I’m talking about. Note that it is from another e-cigarette seller.

And another:

On an equally-disturbing side note, a survey released earlier this year found that a whopping 63% of actual Juul users didn’t know that every Juul pod contains nicotine. 

Dr. Frank T. Leone, director of the Comprehensive Smoking Treatment Program at Penn Medicine, explained that the nicotine found in Juul pods gets delivered to the brain very rapidly because of the method the company uses to increase nicotine concentrations. Leone did not participate in the study.

Juul used a patented “nicotine salt” – a mixture of nicotine and an organic acid – which masks the naturally unpleasant taste of nicotine.

Read: E-Cigarette Makers Juul, Altria Failing to Reduce Youth Vaping

Poor Regulations and Increasing Compeition

Due to the wide variation of pods, nicotine liquids, and tank systems, it has been “almost impossible to put any regulatory guardrails around these products,” Leone said.

The U.S. Food and Drug Administration (FDA) currently does not require e-cigarettes go through pre-market approval before reaching store shelves. In 2017, the agency decided that vape products that were on the market prior to August 2016 could remain on store shelves through 2022 without any pre-market review. Health advocates are calling for more regulation, sooner rather than later.

Juul asserts that high-nicotine e-cigarette products existed on the market “prior to the rise and of the popularity of the Juul device.” However, Jackler pointed out that most e-cigarette products contained less nicotine. Therefore, it was the popularity of Juul that led to a widespread spike in nicotine concentrations throughout the industry.

Jackler said:

“When Juul came out with very high-nicotine electronic cigarettes, it triggered a nicotine arms race amongst competitive companies seeking to emulate the success of Juul.”

Read: The FDA is Threatening to Yank E-Cigarettes off the Market

There are 39 Juul knock-off e-cigarette devices that offer equal or higher amounts of nicotine than Juul. Worse, Jackler said many of them mislabel the amount of nicotine contained in the product. [2]

And because nicotine “juice” can be purchased in bottles, e-cig users can purchase high-nicotine liquids cheaper than they could purchase individual Juul nicotine pods. [1]

Adults and kids alike can become increasingly addicted, for less.

Jackler said:

“The rush to higher and higher nicotine concentration has reduced the cost of nicotine addiction.”

Despite the deluge of warnings over the addictive nature of Juul and copycat products, sales of Juul skyrocketed 641% from 2017 to 2018. [2]

According to Jackler, e-cigarettes are not only a gateway to traditional cigarettes, but they may also be a gateway to harder drugs.

“For a teen, becoming nicotine-addicted greatly increases the likelihood that they will graduate to traditional, combustible cigarettes. Importantly, nicotine addiction during adolescence increases the vulnerability to subsequent addictions, like opioids or cocaine. For most users of illicit drugs, their initial addiction was to cocaine.”

The report is published in the journal Tobacco Control.

Sources:

[1] CNN

[2] UPI

Fortune

Time

U.S. Cigarette Smoking Rates Fall to Historically-Low Levels

The U.S. Centers for Disease Control and Prevention (CDC) offered some good news on November 8 when it released data showing that smoking rates in the U.S. are the lowest they’ve ever been. Unfortunately, there was some bad news to go with it.

 

  • Smoking rates have fallen by 67% since 1965 when the U.S. government first began tracking smoking rates.
  • An estimated 14% of adults smoked in 2017, down from 15.5% in 2016.
  • The rates were even lower among adults 18-24: from 13% in 2016 to 10% in 2017.

In a press release, CDC Director Robert Redfield said:

“This new all-time low in cigarette smoking among U.S. adults is a tremendous public health accomplishment – and it demonstrates the importance of continued proven strategies to reduce smoking. Despite this progress, work remains to reduce the harmful health effects of tobacco use.”

While smoking rates fell, other forms of tobacco use remain prevalent, including e-cigarettes, hookahs, cigars, smokeless tobacco, and water pipes. About 47 million Americans use tobacco in some form.

When adding those other categories, 16.2% of adults, or 47 million people, used tobacco products of some kind in 2017, according to the CDC. The second-most used products behind cigarettes were cigars, cigarillos or filtered little cigars, with 3.8% of adults (9.3 million people) saying they used them. [2]

E-cigarettes have been touted as a smoking cessation method, and many people swear by it. However, overall, the nicotine delivery devices have proven to be more harmful than helpful.

Brian King, a deputy director in the CDC’s office on smoking and health, said:

“If e-cigarette use was responsible [for declines in cigarette use], you would expect to see a perfect correlation, but that’s not what we’re seeing. If anything, e-cigarettes have complicated the tobacco product landscape.”

A Pricey Coping Mechanism

The CDC says in the report that certain groups of people were more likely to use tobacco than others, including: [1]

  • People with incomes below $35,000
  • Those who had a GED
  • The uninsured
  • Those insured by Medicaid or who received public assistance

Among ethnic groups, non-Hispanic American Indian/Native Americans, multiracial Americans, and white or black adults were the most likely to use tobacco.

Adults who identified as lesbian, gay, or bisexual were also more likely to use, as well as those who were divorced, separated, widowed, single, never-married, or not living with a partner.

Adults living in the Midwest or the south tended to use tobacco the most.

Have you started to see a pattern yet? In many cases, tobacco users tended to be those facing hardship and stress. Indeed, the CDC mentioned in its report that psychological distress was associated with an increase in tobacco use, with 40.8% of adults who reported distress saying they used tobacco compared to 18.5% who reported not being severely distressed.

NCI Director Dr. Norman E. Sharpless said in the press release:

“For more than half a century, cigarette smoking has been the leading cause of cancer mortality in the United States. Eliminating smoking in America would, over time, eliminate about 1/3 of all cancer deaths. The persistent disparities in adult smoking prevalence described in this report emphasize the need for further research to accelerate reductions in tobacco use among all Americans.”

Government Crackdown

https://www.123rf.com/photo_34581221_hand-holding-an-electronic-cigarette-over-a-dark-background.html?term=e%2Bcigarettes&vti=ljyupdbyuqghko4iqh-1-12

FDA Commissioner Scott Gottlieb said he was encouraged by the findings and said the FDA is committed to accelerating declines. [3]

“We’ve taken new steps to ultimately render combustible cigarettes minimally or non-addictive and to advance a framework to encourage innovation of potentially less harmful products such as e-cigarettes for adults who still seek access to nicotine, as well as support the development of novel nicotine replacement drug therapies. At the same time, we’re also working to protect kids from the dangers of tobacco product use, including e-cigarettes.”

In September, the agency warned 5 e-cigarette makers, including Juul, that they had 2 months to prove to the FDA that they’d taken steps to prevent the sale of their products to young people.

The companies were told that their failure to do so could result in the agency requiring them to change their sales and marketing practices, stop their distributing of products to retailers who sell to kids, and the removal of flavored e-cigarettes and nicotine products from the market.

Then, in early October, the FDA raided the Juul offices and confiscated thousands of documents as part of its effort to pressure the company into doing more to keep its products out of the hands of young people.

Juul e-cigarettes, which look like USB drives, are extremely popular among high-schoolers. The devices come with pods filled with nicotine liquid that is available in 6 flavors. Each pod delivers as much nicotine as up to 2 packs of cigarettes. [4]

Sources:

[1] ABC News

[2] CNBC

[3] CBS News

[4] Vox

CDC: The Smoking Rate Dropped to 15% in 2015

Adult smokers in the U.S. are kicking the habit at a rate that researchers haven’t seen in 20 years. The rate of smoking fell to 15% in 2015 due to the biggest 1-year decline in 2 decades.

The rate fell 2 percentage points from 2014, when approximately 17% of adults in a large national survey said they had recently lit up. The last time Americans kicked the habit at that pace was from 1992 to 1993, when the smoking rate dropped 1.5 percentage points, said Brian King of the CDC.

People have been tossing their packs of smokes in the trash for decades, but the smoking rate typically drops only 1 point or less than a year.

The statistic – which has experts a bit baffled – was announced by the CDC on May 24. The number is based on a large national survey which the government uses to measure many health-related trends. The agency can’t specify why the smoking rate dropped so dramatically in 2015, or if it will drop that way again.

Many of us have heard tales of how “everybody” used to smoke. There was a time when you could smoke on airplanes (not all that long ago, actually), you could smoke at work, heck, TV reporters could even smoke on the air. Fifty years ago, 42% of the population sucked on cigarettes and thought nothing of it, including pregnant women. Anti-smoking ad campaigns, cigarette taxes, and smoking bans made many people kick the habit.

smokingrates
Source: Gallup

E-cigarettes, which heat liquid nicotine to vapor without releasing the dangerous byproducts created by burning tobacco, have helped smokers both continue to get their nicotine fix more safely, or use the devices to quit entirely. However, the jury is out on just how safe e-cigarettes truly are, and studies show the devices may be getting kids who never smoked before addicted to nicotine. [1]

The CDC report also shows:

  • 16.7% of adult men smoke traditional cigarettes, compared with 13.6% of women
  • Males between ages 18 and 44 represent the largest smoking segment at 18.5%
  • Adult whites smoke at a 17.4% rate, along with 16.8% for blacks, and 9.9% for Hispanics

Read: 3 Cigarette/Tobacco Facts You May Not Know About

Smoking is the leading cause of preventable disease and death in the U.S., resulting in 480,000 premature deaths every year, and more than $300 billion in direct health care expenditures and productivity losses.

Though the smoking rate may be dropping Big Tobacco continues to show quarterly and annual revenue gains. This is partly due to per-pack list price increases to distributors that are passed on to consumers.

Some smokeless tobacco advocates had predicted that e-cigarettes, vaporizers, and hookahs would outsell traditional cigarettes within 5 to 10 years, but that might not be a possibility, now that the FDA announced it will regulate e-cigarettes the way it regulates other smokeless tobacco products. The regulations could destroy thousands of small vape businesses, and perhaps make vaping a thing of the past.

Sources:

[1] The Associated Press

[2] Winston-Salem Journal

Gallup


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