Electronic Cigarettes are an on-trend phenomenon for high school students and smokers of all ages. One brand, Juul, which has been called the Apple of Vaping and the iPhone of Vaping, has risen to the top in popularity, and accounts for one in three electronic cigarettes sold today. Though the sale of electronic cigarettes, including Juuls in Massachusetts is restricted by law to individuals over the age of 21, as reported by the Boston Globe last year, use of Juuls are extremely popular among high school aged students. Likely partially due to the flavors available for Juuls, which appeal to young people, and the ability to order them online; and partially due to a lack of knowledge among young people, who, as reported by the Globe, feel that Juuling is not harmful. Initially foreign to parents and teachers, the concept of electronic cigarettes, including Juuls, are becoming more widely understood, and has become more carefully criticized by government regulatory agencies.

To combat widespread use of Juuls by young people, Massachusetts Attorney General Maura Healey announced an investigation into Juul and online E-Cigarette retailers in July of this year. The outcome of that investigation has not yet been published. Though this investigation may have come as a surprise, the Massachusetts Attorney General’s office is not alone in scrutinizing the makers of electronic cigarettes. Earlier this month, the FDA (Food and Drug Administration) performed a surprise inspection of Juul Labs, and seized more than 1,000 pages of documents in what is being called the latest indication of an intensifying crackdown on underage vaping. According to a recently released report from the Center for Disease Control and Prevention, sales of Juul brand electronic cigarettes sales increased 641% from 2016-2017 with 2.2 million devices sold in 2016 and 16.2 million sold in 2017. While the number of Juul devices sold may seem high, it pales in comparison to the number of traditional cigarettes smoked each year in the United States, which was reported in 2015 to be more than 250 billion cigarettes.

Despite a common misconception that electronic cigarettes are somehow not harmful to users, the U.S. Surgeon General has concluded that e-cigarette use among youth and young adults is a public health concern and that e-cigarette aerosol is “not harmless.” Further, the director of the CDC Office on Smoking and Health reports that e-cigarette products contain extremely high levels of nicotine, which can harm the developing adolescent brain. Because they have only recently become available, the effects of long term chronic electronic cigarette use is not yet known. Perhaps more concerning, however, are the short term effects of electronic cigarette use. Users of popular electronic cigarettes describe a “head rush” from use, causing potential temporary impairment. Further, some vaporizer liquids contain alcohol which is inhaled during use. The effects of alcohol inhalation has not been widely studied in humans and the risks – both in the short term and the long term – are unknown. To the extent that electronic cigarettes create neurocognitive impairment in users, vapor inhalation could interfere with activities such as driving and job performance.

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Valentine, Gerald W., et al. “The Effects of Alcohol-Containing e-Cigarettes on Young Adult Smokers.” Drug and Alcohol Dependence, vol. 159, 2016, pp. 272–276., doi:10.1016/j.drugalcdep.2015.12.011.