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JUUL's Influence on the Youth Vaping Epidemic

Anne K
June 2, 2023

JUUL is one of the most popular e-cigarettes on the market, and its use among young people has risen exponentially.

Truth Initiative® surveys found that 56 percent of individuals begin vaping before their eighteenth birthdays, citing flavor availability and popularity as main motivators. The same surveys showed that youth between the ages of 15 and 17 are 16 times more likely to use JUUL e-cigarettes than those between the ages of 25 and 34.

Disturbing developments reveal that JUUL contributed to the youth vaping epidemic, and that its products have contributed to serious illness and death. JUUL lawsuits are ongoing in several states and in federal court. While litigators, lawmakers, and regulators are taking action, nothing can reverse the harm that JUUL’s actions have caused. If you or a loved one have been adversely affected, you can seek justice and help hold JUUL accountable.

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How JUUL Gained Popularity

Despite health problems associated with e-cigarettes in general, JUUL’s sweet, fruity flavors, popularity, and availability have driven the brand’s growth, tripling JUUL’s market share from 24 to 75 percent. Despite the perception that JUUL and other e-cigarettes are less harmful than traditional tobacco products, part of JUUL’s initial popularity came from its ability to deliver the buzz that young users crave.

In one survey conducted by Truth Initiative®, a full 21 percent of respondents cited that buzz as their main reason for using JUUL. Many young users didn’t realize that all JUUL products contain addictive nicotine, adding to misconceptions surrounding the potential for addiction and harm. Truth Initiative® research that was presented in the Spring 2017 issue of Tobacco Control noted that a stunning majority – that’s 63 percent – of users between the ages of 15 and 24 didn’t connect the dots between JUUL use and nicotine consumption.

There’s more. JUUL entered the e-cigarette market with products containing 5 percent nicotine. The manufacturer claimed that JUUL’s nicotine salt formulation assured a higher amount of nicotine would be delivered to the bloodstream, at a faster rate than products offered by competitors. On average, most other e-cigarette products contain 1 to 2.4 percent nicotine.

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JUUL is popular with underage consumers for yet another reason. The device itself bears a strong resemblance to a plain USB flash drive; in fact, it’s charged via USB. The size and shape of the JUUL e-cigarette make it easy to conceal for so-called stealth vaping, and the availability of wraps and skins makes it even easier for underage users to hide their JUULs.

Not only does the device’s design prevent detection by adults who are unfamiliar with the brand, it’s easily disguised. Kids head to YouTube and online forums to share methods for concealing JUULs inside other objects such as markers in hopes of making them even harder for parents and teachers to detect.

Harmful Side Effects of Vaping

Nicotine in general is harmful to young users, hampering brain development while putting youth at a higher risk for addiction. Those who begin using nicotine at a young age have a harder time quitting than those who take up vaping during adulthood and might be in a higher risk category for developing addictions to other harmful substances in the future.

While harmful effects associated with standard tobacco use typically occur over many years – often several decades – after use begins, vaping side effects can begin to occur with the first use

In a statement following a study conducted at the University of Pennsylvania School of Medicine and published in the journal Radiology, author Felix Wehrli said that “We’ve shown that vaping has a sudden, immediate effect on the body’s vascular function.”

The study showed that even nicotine-free e-cigarettes could damage blood vessels, heightening the risk of thickened arteries and reduced blood flow to the heart and brain, which could ultimately result in stroke, heart attack, and death.

Other vaping side effects include nausea, diarrhea, and headaches. Sometimes these are signs that the lungs aren’t working properly. These symptoms and others led the Centers for Disease Control and Prevention (CDC) to create an official name for illness related to vaping: EVALI. This acronym stands for e-cigarette or vaping product use-associated lung injury. The CDC states that there is a strong link between EVALI and vitamin E acetate, which is used as a thickening agent in vape fluids.

EVALI symptoms include chest pain, shortness of breath, chills and fever, an elevated heart rate, and rapid, shallow breathing. If you think that you have developed these or other complications after using JUUL or another e-cigarette brand, be sure to see a doctor on an urgent basis.

Research published in an online supplement to the American Journal of Respiratory and Critical Care Medicine found that some JUUL vaping products are contaminated with bacteria. The highest concentrations were found in the tobacco-flavored pods, with menthol-flavored pods coming in second.

In an article published by Healio Pulmonology, study co-author and Harvard research associate Mi-Sun Lee, PhD, MPH said “We are particularly concerned because tobacco-flavored JUUL products were excluded from the proposed FDA ban. Finding these toxins in nicotine vaping pods adds to the growing evidence of potentially harmful exposures in e-cigarettes.”

As vaping is a relative newcomer, its long-term effects have not been studied. Truth Initiative® compares JUUL users and others who vape to human test subjects.

Health Risks of Vaping

Vaping, including the use of JUUL products, poses significant health risks to young users. Nicotine exposure during adolescence can hinder brain development and increase the risk of addiction. Those who start using nicotine at a young age may find it more challenging to quit and could be at higher risk for developing addictions to other harmful substances in the future.

Studies have shown that vaping has an immediate effect on the body's vascular function, leading to potential long-term health issues. Even nicotine-free e-cigarettes have been found to damage blood vessels, increasing the risk of cardiovascular problems such as stroke, heart attack, and reduced blood flow to vital organs.

Furthermore, vaping has been associated with a condition called e-cigarette or vaping product use-associated lung injury (EVALI). Symptoms of EVALI include chest pain, shortness of breath, fever, and rapid, shallow breathing, with vitamin E acetate, a thickening agent used in vape fluids, being linked to the illness.

FDA Regulations

On April 24, 2018, the U.S Food & Drug Administration (FDA) requested documents from JUUL. In a letter addressed to JUUL labs, FDA officials noted “growing concern about the popularity of JUUL products among youth,” and mentioned that “JUUL products may have features that make them more appealing to kids and easier to use, thus causing increased initiation and/or use among youth.”

Following an extensive probe into JUUL use by underage individuals and a CDC announcement that at least 2,505 lung injuries and 55 deaths throughout the US and its territories could be linked to vaping, the FDA moved to ban most e-cigarette flavors In January 2020. At the same time, Health and Human Services Secretary Alex Azar warned that manufacturers would be held responsible if they did not take measures to prevent minors from accessing electronic nicotine delivery systems including JUUL.

More regulations are needed. In an interview for Healio Primary Care, Dr. Michael Siegel, MD, MPH, professor at Boston University School of Public Health said that the FDA needs to focus more on nicotine and less on flavors. “The epidemic we have is not one of youth flavor use, but of youth addiction to the JUUL device, and that is occurring not because JUUL is flavored but because JUUL has more than 50 mg / mL of nicotine salts compared to less than 25 mg / mL in most other products on the market.”

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The Case Against JUUL: Lawsuits Underway

Of all the factors under consideration in ongoing JUUL lawsuits, those concerning the company’s focus on cultivating young devotees are most disturbing.

JUUL claims that its e-cigarettes are only marketed to adults, but company promotions depicting trendy, youthful users lead to questions about whether their target audience Is made up solely of adult smokers who prefer vaping as an alternative to traditional tobacco products. In addition, JUUL’s decision to purchase advertisements on websites aimed at children calls their motives into question.

The company purchased ads on sites that help middle school kids and high school students develop math and social studies skills. In addition, JUUL bought banner ads on websites designed specifically for children, including Cartoon Network and Nickelodeon sites. Social media campaigns appeared to target underage users as well.

Worse yet, when congressional investigators scoured internal documents from JUUL labs, they found that the company “deployed a sophisticated program to enter schools and convey its messaging directly to teenage children” under the guise of youth prevention and education.

As part of this scheme, schools were paid $10,000 to allow JUUL representatives to have access to children via presentations that took place without parents or teachers present. A press release from the House Committee on Oversight and Reform revealed that JUUL targeted kids as young as eight years old and recruited “thousands of online influencers to market to teens.”

During these presentations, company representatives demonstrated how easy it was to use JUUL products. Similar presentations took place at other programs and summer camps attended by preteen kids.

In 2019, JUUL labs co founder and chief product officer James Monsees told congress that “Unlike traditional cigarette manufacturers, our company has no incentive to see minors use our products. We know there is skepticism on the point, but it is simply the truth.”

Following an increase in lawsuits naming JUUL as the defendant, hundreds of JUUL lawsuits were combined and transferred to a federal court in San Francisco. Experts estimate that the number of cases to join the ongoing legal action against JUUL could be in the thousands. Marlboro cigarette maker Altria, which owns more than one-third of JUUL, has been named a defendant alongside JUUL labs.

You Can Fight Back

If you have been harmed by JUUL products, you can take part in the legal action. Ongoing JUUL lawsuits could help you or a loved one receive compensation for injuries, and they can help create the change that is needed to hold JUUL accountable for its actions.

Momentum is growing as more affected individuals, school districts, and families join the fight for justice. If you have been harmed, or if you know someone who has suffered side effects after using JUUL, it’s easy to find out if you are eligible to join the lawsuit using our free evaluation form.


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