After years of warnings about the dangers of cigarettes, their usage had been declining among youths.
But along came electronic cigarettes, which produce a vapor instead of smoke, and the promise of a safe alternative to tobacco cigarettes.
In the past couple of years, a growing number of youths have turned to e-cigarettes, which have proven to be just as addictive as normal tobacco cigarettes.
Kevin Schroth of the Rutgers Center for Tobacco Studies and Dr. Michael Steinberg, the director of the Rutgers Tobacco Dependence Program, outlined the rise in “vaping” – the use of e-cigarettes – at a special forum on vaping, held at Princeton High School on Nov. 25.
Setting the stage for the discussion, Schroth said tobacco is the leading cause of death in the United States.
Tobacco is responsible for 480,000 deaths annually, as compared to 189,000 deaths combined from gun violence, opioid overdoses and alcohol.
“One death is a tragedy. One million deaths is a statistic. That’s what Joseph Stalin said. We can’t lose sight that tobacco kills nearly 500,000 people every year,” Schroth said.
An e-cigarette is an electronic nicotine delivery system. It is a battery-operated device which heats a liquid containing nicotine and other chemicals. Users refer to it as “vaping” because it produces a vapor, not clouds of smoke. The perception is that it is harmless water vapor.
The original e-cigarettes resembled tobacco cigarettes, but newer models are smaller, Schroth said. Many e-cigarettes resemble key fobs or USB drives. They are slick in design, he said.
There are many manufacturers, but JUUL has come to dominate the e-cigarette market, Schroth said.
Using research from tobacco industry files that date back several decades, JUUL learned how to minimize the bitter taste of nicotine, he said.
JUUL e-cigarettes deliver an increased level of highly addictive nicotine, but without the bitter taste. Within minutes, the user experiences a nicotine “hit,” and that’s what make users come back for more, he said.
Some critics blame the use of flavored pods – a liquid-filled container that is inserted into the e-cigarette – for attracting young users, but that is not the case, Schroth said.
E-cigarette use was declining in use as late as 2016, until JUUL emerged in 2017.
JUUL’s popularity and market share “exploded” in 2018, Schroth said. While flavors are a factor in a young person’s decision to try vaping, JUUL’s appeal is a combination of its design, marketing to young people and the addictive nicotine “hit” that a user gets, he said.
Advertisements show young people using e-cigarettes, he said. The pitch is that e-cigarettes are an evolution of smoking. They provide a simple-to-use product and an intensely satisfying experience. Much of the marketing is done on social media and on JUUL’s own website.
Although e-cigarettes are billed as a safe alternative to tobacco cigarettes, they are not without danger, said Dr. Steinberg, the director of the Rutgers Tobacco Dependence Program.
It is still possible to become addicted to e-cigarettes because of the presence of nicotine, and its effect on the brain. It provides a pleasurable experience for the user.
Steinberg said one out of three users becomes addicted to vaping because of the addictive properties of nicotine. It is more addictive than alcohol or heroin.
As to the health effects of vaping, there had been nearly 50 deaths related to vaping as of Nov. 20, and nearly 2,300 reported cases of lung injuries, Steinberg said.
While there is evidence that vaping can damage the lungs, there is no available evidence to link vaping to heart disease, stroke and peripheral artery disease, he said.
There is evidence that some of the chemicals in e-cigarette vapors can cause DNA damage.
E-cigarette purchases are banned for persons under 21 years old, Schroth said, but the majority of young people who use e-cigarettes get them from a friend.
More than 70% of high school students acquired e-cigarettes from a friend; the rest bought them at a vape shop or online.
To curtail their availability, it has been suggested that restrictions should be placed on the purchase of flavored e-cigarette pods. Cracking down on retailers is another approach. Retailers should be required to electronically scan ID’s presented by would-be purchasers, Schroth said.
