In two new studies, Georgia State researchers upend traditional thinking on e-cigarettes.
In two new studies, Georgia State researchers upend traditional thinking on e-cigarettes.
In the little over a decade that e-cigarettes have been on the market, they’ve gone from an obscure quit-smoking aid to a ubiquitous “lifestyle” product that’s particularly popular among young people, thanks in part to a major manufactuerer’s slick, youth-oriented marketing campaign.
This has created a divide among public health experts and policymakers about the best way to regulate what is now a $5 billion industry in the U.S. Because while vaping may be a safer, healthier alternative for smokers who want to quit, it’s also attracting teenagers and young adults who otherwise might never light up.
Now a recent study by faculty at the university’s School of Public Health casts doubt on vaping’s major purported health benefit — helping smokers ditch cigarettes. The researchers examined the responses of more than 850 smokers who participated in an initial survey in 2015 and a follow-up survey a year later, and found that 90 percent of those who used both traditional cigarettes and e-cigarettes were still lighting up at the end of the year.
This may be because smokers just don’t find e-cigarettes satisfying, says lead author Scott Weaver, a research assistant professor of epidemiology and biostatistics.
“A lot of e-cigarettes, particularly the older generations available in 2015, simply aren’t as effective at delivering that hit of nicotine, so smokers just give it up,” he says. Weaver also notes that some smokers use e-cigarettes — which are sometimes allowed in places that ban traditional cigarettes, like offices or restaurants — as a way to supplement their nicotine intake.
However, there’s a newer type of e-cigarette that comes very close to mimicking cigarettes’ ability to deliver a potent dose of nicotine with each puff — JUUL. Released in the U.S. in 2015, the product took off two years later as more and more consumers took up vaping. Today, JUUL commands nearly 70 percent of the retail e-cigarette market — more than Marlboro had at the peak of its popularity.
While Weaver and his team say that JUUL could potentially be a more powerful tool to help smokers quit, in a separate study university researchers have found that it’s also designed as a powerful temptation for young people.
“In 2017, the Centers for Disease Control published data showing a sharp decline in e-cigarette use among high school students and young adults, and yet anecdotally we’re constantly hearing reports about this new product that all the kids are using,” says Jidong Huang, the study’s lead author and an associate professor of health management and policy. “Part of our motivation in conducting this research was to evaluate whether the national survey was really capturing the JUUL consumer.”
According to Huang, the discrepancy may be because many teens and young adults who vape do not identify as e-cigarette users.
“A lot of teens are using JUUL, but they don’t think they’re using a tobacco product and they’re not reporting it,” says Huang. “They think of it as technology product — a new gadget.”
That the JUUL device more closely resembles a flash drive than a cigarette doesn’t help.
Teenagers may also be naive about just how much nicotine they’re getting. JUUL uses a pre- filled e-liquid cartridge known as a “pod,” which comes in a variety of flavors (mango, mint). Just one pod contains more than twice the amount of nicotine in a pack of cigarettes.
Huang and his colleagues examined JUUL’s sales data and marketing campaigns, and found that — despite the company’s insistence that its product is intended for adult smokers who want to quit — JUUL has been marketed primarily via social media channels such as YouTube and Instagram that are disproportionately used by teens and young adults. The company has used social media influencers to promote the product to their followers and relied on interactive marketing campaigns such as “DoIt4Juul,” a popular hashtag that encourages people to post and share photos and videos of themselves using JUUL.
Since the study was published, the Food and Drug Administration has declared teenage use of e-cigarettes “an epidemic.” While JUUL has promised to stop featuring youthful models in its ads and to work with social media platforms to remove teen- centric content, the FDA says that’s not enough. E-cigarette makers need to prove they can keep their products out of the hands of minors.
“[JUUL] knows if they keep up with this strategy they’re going to run into trouble,” he says. “But if you walk into any school and ask a student about JUUL, they know. The message is out.”
