From the Editor – February 2019

Parents: Don’t Be Fooled by the Dual Face of JUUL

A few years ago, you’d probably heard of e-cigarettes but may have been vague on Juul, and could be excused if you had no idea how to spell it. But that state of innocence is no longer acceptable. Now, Juul is not only a word most parents have heard, it’s a huge teen health problem. The little electronic cigarette that resembles a flash drive has become a teen sensation, thanks to its power to deliver a mind-blowing hit (one tiny Juul“pod” carries the equivalent of an entire package of cigarettes) or to double as a THC drug delivery system (yes, kids load their Juuls with other drugs, too).

If you aren’t a smoker yourself, Juul isn’t a product you’d seek out, but your kids and their friends view it differently. They don’t use Juul to wean themselves from cigarettes as adults do; rather, it’s their starting point. Kids are drawn to it. It exudes a “coolness” factor for several reasons: it’s tiny (tiny things are easy to hide, and kind of cute); its design is sleek, high tech, subtle; the nicotine pods come in a variety of flavors (recently restricted by the FDA to menthol and mint for under age customers); and best of all, the little device is a devious master of camouflage – it looks like a USB drive, so handling it in school can be a fun, daring exercise in undercover ops. Kids can pull it out in class, take a quick hit while the teacher is turned away, and blow the wisp of vapor into a sweater, hoodie, or a backpack. They then palm the tiny thing and slip it into a pocket or sleeve before the teacher turns back.

Juul delivers more nicotine than a traditional cigarette, at a level that is quickly and powerfully addicting and dangerous for teens. According to an NBC news report, Milagros Vascones-Gatski, a substance abuse counselor at Yorktown High School in Arlington, VA, thinks “this is going to be the health problem of the decade,” because with the intense nicotine “head rush” Juul delivers, kids become addicted swiftly. In nearly 17 years working with teens, Vascones-Gatski says she’s never seen a tobacco product “become so popular so quickly.”

A November 2018 New York Times article on Juul and nicotine addiction in teens reported on a high schooler trying his first vape:

“’It was love at first puff,’ said Matt, now 19. The next day, he asked to hit his friend’s Juul again. And the next and the next. He began seeking it out wherever he could, that irresistible feeling — three, sometimes four hits a day.” He loved the ease of concealment, even under the eyes of his teachers. “The Juul was super, super sneaky and I loved it,” he said. However, nictotine, in that sneaky vaporized form, is absorbed by the body much faster than it is via chewing gum or patches and has “potent, addictive properties,” say doctors, that are marked in teens. Further, the impact of Juul on the developing brains of teens is disturbing: “Nicotine may disrupt the formation of circuits in the brain that control attention and learning,” said Dr. Rachel Boykan, a clinical associate professor of pediatrics at Stony Brook University School of Medicine and an executive member of the American Academy of Pediatrics.

JUUL, when used by adult smokers seeking to quit, may be helpful. The irony is, that for teens, Juuling actually makes them MORE likely to start smoking cigarettes – even if they wouldn’t have done so otherwise. Anti-smoking campaigns in schools have paid off; many kids are not tempted to start smoking after having been exposed to years of warnings in school and ads. But they have no similar frame of reference linking JUUL to addiction, and likely haven’t heard of popcorn lung (a condition that can occur with exposure to flavoring agents in Juul pods). The device’s popularity is seductive, and soaring.

Health organizations and watchdogs are fighting back. The US Food and Drug Administration has denounced “an epidemic of regular nicotine use among teens,” and confirmed that “its agents made a surprise inspection [in October 2018] of JUUL Lab’s San Francisco headquarters, seizing more than a thousand pages of documents on its marketing practices.”

In a January 12, 2019 article, The New York Times notes that JUUL Labs, the company that makes the devices, has been “sued by users and lambasted by lawmakers.” The article goes on to note that the FDA is “investigating whether JUUL’s marketing practices deliberately targeted underage users…”

A device that started out claiming to be safer than smoking, has shown another darker face: one that, for young people, provides a shockingly fast path to nicotine addiction, with effects like loss of focus, impulsivity, anxiety and sleep problems. According to a study released by the CDC, “youth and young adults are more vulnerable than adults to the long‐term consequences of nicotine exposure, including susceptibility to nicotine addiction and potentially reduced impulse control, deficits in attention and cognition, and mood disorders…”

Schools are now aware of the problem and are doing their best to get the word out to parents and students, but it’s a game of catch-up at best. No one was prepared for the way Juul would hit the teen population. Juul has ceased marketing on Social Media, but the word is already out among kids. Parents now need to do their part by becoming familiar with Juul facts so they can monitor their kids for signs of use, and more urgently, talk to them candidly, early and often about why they should not Juul.

To help you get started, here are two sources:

1) “Facts for Parents about E-Cigarettes and Vaping”

2) Child Mind Institute’s “Teen Vaping: What You Need to Know.”

Don’t let the dual face of JUUL fool you: while it may be a benign aid to adults trying to wean themselves from cancer-causing cigarettes, it poses a significant threat to the well-being of tweens and teens.

Melanie Wells,


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