Juuls: a respiratory expert explains the risks

April 3, 2019

The classic paper-rolled tobacco cigarette — the likes of Marlboro, Camel  and Parliament — that dangled out of the mouths of college students for decades has in part been replaced by the cold metal rectangular tip of Juuls, the electronic cigarette now dominating the market. 


The relatively new product has raised questions of consumer safety and addiction risks.

Nicole McKenzie, an assistant professor in the Respiratory Care Program at the University of Toledo answered some of those questions in an email interview with the Independent Collegian. 


Are Juuls safer than cigarettes? Explain.


“The short answer is yes, electronic nicotine delivery systems (ENDS), like the Juul, are known to be safer than traditional combustible cigarettes. Standard position statements from respected organizations like the American Cancer Society and American Lung Association state that if a person is a current smoker, it would be beneficial to switch to using ENDS to decrease their health risks. However, if a person is not currently smoking, starting to use ENDS is not a good idea. 


There is rapidly developing research supporting the fact that ENDS are detrimental to your health—but not as detrimental as traditional smoking. Instead of lighting a bunch of chemicals on fire and then inhaling the smoke, you’re heating some chemicals up with a battery-powered element and then inhaling the vapor. Sure, you’re inhaling a few thousand less chemicals, but you’re still going to cause damage to your lungs, heart and brain. It’s like choosing diet soda over regular soda—they’re both bad, and long-term daily use is going to damage your body. You’re better off breathing fresh air, just like you’re better off drinking water.”


What are the risks and rewards of using a Juul?


“We don’t yet know long-term risks, simply because they’ve only been on the market for about 12 years. Some of the available literature shows that long-term use of nicotine products put [sic] you at higher risk for cardiovascular disease and stroke, as well as respiratory, reproductive and gastrointestinal disorders. Even nicotine-free variations are not risk-free, as the carrier liquids and flavorings are not proven safe to be heated, vaporized and repeatedly inhaled.


The main ingredients found in ENDS include propylene glycol, which is linked to irritation of the airways, throat and eyes when inhaled; and glycerin, which is linked to lipoid pneumonia when inhaled. Formaldehyde and acetaldehyde are both known carcinogens that are found in laboratory analyses of cartridge liquids as well, increasing your risk for cancers.  


One of the more concerning risks that college students and all young people should know are the harmful effects of nicotine on the brain. Using nicotine while the brain is still developing, which continues until the age of 25, impacts the parts of the brain that control attention, learning, mood and impulse control. Some studies have even linked nicotine exposure during the developing years to increased risk for mood disorders like anxiety and depression.”


Is there data to suggest the Juul is popular among college students? 


“Juul came on the market in 2015 and managed to surge ahead of its competitors pretty quickly. The Juul is well known for its appearance, which looks like a USB drive. I couldn’t find any literature specific to Juul, but a few news articles referenced that Juul may hold as much


as 72 percent of the market. Other data does suggest that vaping is common on college campuses, so it probably  wouldn’t be unreasonable to assume Juul is popular among college students.”


What else should students know?


“Most people think that vaping decreases their stress and anxiety, but it’s actually causing it. When your body craves nicotine, you become stressed and agitated. Taking a puff of your cigarette or vaping will immediately, but temporarily, calm you down from this state of high stress, making you think it helps decrease your stress. But really, the agitation was directly caused by the nicotine addiction to begin with. It’s a tough cycle to break, but people who have successfully quit enjoy decreased anxiety, depression and stress levels as well as higher quality of life and positive mood. Sometimes even the dosage of some medicines used to treat mental health problems can be reduced.” 


Do you have tips on quitting?
“It’s never too late to quit! You should always work with a health professional when you decide to quit. Particularly, if you have a mental health disorder. Nicotine withdrawal is known to temporarily exacerbate mental health disorders, and a medical professional can help monitor and balance that impact.”

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