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FDA threatens ban on Juuls and e-cigarettes amidst addiction, health risks

The Food and Drug Administration (FDA) issued a warning on Wednesday, September 12 that teenage and underage usage of flavored electronic cigarettes has reached “ an epidemic proportion,” and as result sent out over 1,200 letters of warning to various retailers, as well as large fines to over 130 establishments, for selling their products to minors. The agency stated that if makers of these products cannot prove they can halt the flood of sales to minors in 60 days, their products may be removed from the market.

This announcement from the FDA was the result of the largest coordinated enforcement action in FDA history, following a recent and unpublished study that showed a 75 percent increase in e-cigarette smoking among middle and high school students from 2017. FDA Commissioner Scott Gottlieb cited the rising sales trends and concerns from both parents and teachers as signs of the rising epidemic. Federal law prohibits the selling of cigarette products to anyone under the age of 18, however, the study showed that over two million underage students are regular smokers of e-cigarettes.

Stores included in the warning letters were Walgreens, Walmart, 7-Eleven, Exxon, Circle K, Shell and Citgo gas stations. Fines were imposed for up to $11,182 against retailers that had repeated instances of selling their products to people under the age of 18. Five manufactures, including Juul Labs, were threatened with a ban if they cannot submit a plan to curb sales to minors. Gottlieb stated that if the plans cannot reverse this trend substantially the FDA will take steps to ban flavored products.

Many companies, including Juul and Blu, use flavors in their products, which some argue draw in young consumers, while others claim they help adults quit smoking traditional cigarettes. Gottlieb described the risk of another generation becoming addicted to nicotine as being “paramount.” While e-cigarette smokers inhale less toxins than traditional cigarette users–and fewer toxins are expelled into the air– e-cigarettes can contain higher amounts of addictive nicotine.

Vaping and smoking e-cigarettes are now commonplace at most colleges and universities in the United States. “I love vapes because they’ve helped so many of my friends quit smoking cigarettes,” Autumn Carney’19 said. “Freshmen year I think all of my friends smoked cigarettes, but slowly they’ve been taking on vaping instead.  I personally like vaping, although I keep it at the lowest nicotine level so I won’t really go through…withdrawal. Also it’s kind of just a healthier oral fixation than other things like cigs or chewing tobacco or something. I’m not really a fan of juuls because the nicotine levels are too high for me.”

In January, the National Academies of Sciences, Engineering and Medicine found that the continued usage of flavored products will eventually lead to consuming traditional cigarettes. The long term effects of Juuls (which tend to have more potent nicotine levels) and other e-cigarette products on the respiratory system, including the effects of chemicals created by the addition of heat in the electronic devices, are unknown. “The developing adolescent brain is particularly vulnerable to addiction,” the FDA stated last Wednesday. Researchers have also pointed out that brain development can continue over the age of 25.

“The problematic aspect of [the high levels of nicotine in Juuls] is that people often become more addicted to nicotine because of the convenience,” Noel Murray ’21 said. “While it is possible to make a pod last a week or two (like a pack of cigarettes), often this is consumed much faster and it’s easy to become more hooked…I ended up smoking more in the end.” When it comes to students vaping on campus, Murray stated, “I have no problems with juuling inside, or on sidewalks, same with cigarettes. I have always been annoyed by those massive vapes that people carry around and use to blast industrial-amounts of sugary smoke into my face…but those are thankfully becoming less common.”

In July of 2016, the American Lung Association found that diacetyl, a flavoring product formerly used in popcorn and dairy products, is now used in e-cigarette vapor. The chemical has resulted in deaths and hundreds of cases of bronchiolitis obliterans, otherwise known as “popcorn lung,” which causes scarring, inflammation, thickening and narrowing of the tiny air sacs in the lungs. Symptoms are similar to that of chronic pulmonary disease, including coughing, wheezing, shortness of breath, exhaustion, and skin irritation. The resulting scarring to the lungs and constriction of the airways is irreversible. Treatment is centered around reducing symptoms and preventing further damage. Harvard researchers in 2015 found that 39 out of 51 e-cigarette flavors contain diacetyl, and that 92 percent contain either diacetyl or other known harmful chemicals. Juul Labs does not currently use diacetyl in its liquid.

The Chief Executive of Juul Labs, Ken Burns, stated that they “will work pro­actively with the FDA in response to its request. . . . We are committed to preventing underage use of our product, and we want to be part of the solution in keeping ­e-cigarettes out of the hands of young people.” Juul Labs has also taken steps to delete social media posts that target youths.

Gottlieb is also calling for a plan to lower nicotine levels in traditional cigarettes in order to make them non-addictive. The FDA does not currently enforce electronic cigarette companies to disclose all ingredients used in their products.

Sources: The Washington Post, The New York Times, American Lung Association, The New Yorker

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