US bans Juul, but young vapers are already switching to newer products

This week, the US effectively banned Juul after the Food and Drug Administration ordered the e-cigarette manufacturer to remove its popular products from the market.

Experts have hailed the move as significant. But they’re also concerned that such efforts can’t keep up with a rapidly evolving vape industry — one where young people are jumping from one product to another quickly.

The FDA ban ends years of controversy for Juul, whose discreet vapes have been accused of hooking a whole new generation of nicotine. In 2020, the FDA ordered mint and juice-flavored e-cigarettes off the shelves, hitting many of Juul’s products. This week’s escalation came as regulators said Juul had not provided sufficient evidence to rate their toxicity and dangers from their tobacco and menthol-flavored e-cigarettes, preventing the FDA from “assessing the potential toxicological risks of using the drug.” Juul products”.

Juul, meanwhile, has argued that its vapes are helping regular smokers quit, and has said it will fight back. Temporary Court of Appeal on Friday put the ban on hold while Juul appeals.

The ban is still important, says Lauren Czaplicki, a researcher at the Johns Hopkins Bloomberg School of Public Health, because it represents one of the first denials for a brand with significant market share in the US and for a menthol-flavored product. She points out that other brands such as Vuse, Logic and NJOY have received market permit for several tobacco-flavored e-cigarette products and systems, but Juul was denied.

Research shows that a ban on flavored cigarettes makes a difference – a 2020 study by George Mason University analyzed a 2009 FDA ban on flavored cigarettes and found that underage youth smoking was reduced by 43% and young adults at 27%

“It’s likely that the FDA’s marketing denial will have an impact,” Czaplicki says. “Juul is still a popular product among youth who do use e-cigarettes, and Juul has a degree of brand awareness and cultural cachet among youth who may be sensitive to nicotine use.”

But while Juul still has a dominant share of the U.S. market, its popularity among young people has declined in recent years, says Dr. Devika Rao, a pediatric pulmonologist at UT Southwestern. A recent federal investigation found that Juul was only the fourth most popular product among middle and high school students: the disposable e-cigarette Puff Bar came in first, with Vuse and Smok in second and third place.

“We know from data that Juul is not the most widely used,” says Rao. “Adolescents today prefer disposable vapes, devices that you can buy online or in a store.” They cost only $10 each for a single-use device and are not subject to the 2020 flavor ban, even though they use the same technology as Juul.

Adolescents often switch from product to product, creating a Whac-a-Mole prevention strategy, said Monica M Zorilla, a researcher at Stanford. When the FDA prioritized enforcement against flavored e-cigarettes like Juul in 2020, the FDA exempted single-use e-cigarettes and menthol-flavored e-cigarette products, Zorilla says. A Stanford study found that adolescents then switched to those e-cigarettes that were exempt. “Youth went from pod-based [like Juul] for disposables like Puff Bar,” says Zorilla. “As one young person said to me, ‘anything with fruit’ is popular among peers. This was partly due to enforcement and partly because the disposables continued to have many flavors.”

Rao points out that social media marketing is clever — and insidious — enough that teens will switch vape products before adults even know about it. She points out that the latest trend is the so-called wellness vapes, which are not even marketed as e-cigarettes. “You can vaporize things like melatonin or vitamins to help you feel better and fall asleep faster,” she says. These are really vaping devices in disguise and companies are under no obligation to list the concentration or what is in these products. “Newer products present a whole new level of risk.”

Flum Float disposable vape flavored e-cigarette products on display at a supermarket in El Segundo, California
Flum Float disposable vape flavored e-cigarette products on display at a supermarket in El Segundo, California Photo: Patrick T Fallon/AFP/Getty Images

More action is needed, Czaplicki says. She says the FDA must immediately issue an order to remove all vape products sold without marketing authorization from store shelves and online. This would including Puff Bar† “Reducing the number and type of flavored e-cigarette devices on sale in the US is likely to have a substantial impact on reducing vaping among young people,” she says. “At the same time, the usefulness of tobacco-flavored e-cigarettes is unlikely to be diminished by helping adult smokers to quit smoking completely.”

Vaping exposes a new generation to nicotine addiction, Rao says — and researchers are still figuring out how to treat nicotine addiction in children rather than adults.

These products are often seen as less harmful than smoking, but they still pose risks because adolescents are determined to become addicted to substances. Rao, who cares for patients at the Children’s Medical Center in Dallas, explains that Juul had figured out how to make the nicotine more potent to deliver a more powerful punch to the brain — allowing for a greater sense of pleasure from using the nicotine. vape was possible.

“It can only take a few hits for them to become addicted, and it affects things like school performance, athletic performance, and can lead to serious consequences like lung damage,” Rao says. Studies also show that vaping leads to an increase in heart rate and blood pressure.

She says vaping rates have fallen for two years during the pandemic, but doctors are now concerned that the recovery of social networks and the easing of restrictions means those rates could rise again.

“When I talk to my patients, they are vaping or all their friends are vaping and they may feel pressured to start using these products,” Rao says. “Parents and educators need to have these conversations about the harm they can have.”

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