E-cigarettes are known by many different names and brands with one of the more popular being JUULs. JUULing also can be known as vaping and is referred as such, because tiny puffs or clouds of vapor are produced when using the devices. So far, there have been 2,051 cases of vaping associated illnesses, reported in every state, except for Alaska, as of November 5, 2019. A recent break in a CDC investigation may have the answers to the cause of these deaths.
What Is A JUUL?
JUULs are battery-powered devices that heat an often flavored liquid, sometimes called "e-juice," "e-liquid" or "vape juice," that contain nicotine. Nicotine is the same addictive drug that is in regular cigarettes. They are inhaled like regular cigarettes and come in different shapes and sizes, including pens, USB sticks and flash drives, and other everyday items.
Even though e-cigarettes do not contain any tobacco, the Food and Drug Administration (FDA), classifies them as tobacco products.
Vitamin E And E-Cigarettes
According to US Centers for Disease Control and Prevention officials, vitamin E acetate, an additive sometimes used in THC and other vaping products, may be to blame for a national outbreak of e-cigarette-related lung injuries that's linked to dozens of deaths.
The CDC says vitamin E acetate usually does not cause harm when ingested as a vitamin supplement or applied to the skin. However, previous research suggests when vitamin E acetate is inhaled, it may interfere with normal lung functioning.
Vitamin E acetate is sticky when it goes into the lungs, and it hangs around. The CDC says its tests found vitamin E acetate in samples taken from 29 patients who were sick with vaping-related illness in 10 states. The CDC said it is continuing to test for a wide range of chemicals.
Until the investigation is complete, the CDC suggests people refrain from using all vaping products with THC, no matter where people buy them. The investigation has found that many of these products patients used were bought online or received through friends or family, rather than through vaping shops or at licensed THC dispensaries.
How Much Nicotine Is In A JUUL Pod?
The e-liquid in all JUUL pods and most e-cigarettes contains nicotine, but the nicotine levels are not always the same. JUULs have a significantly higher amount of nicotine per puff compared to other types of e-cigarettes and cigarettes and is designed to increase the rate of nicotine delivery. Sometimes product labels do not list the true nicotine content.
During the CDC’s investigation, nicotine metabolites were detected in 16 of 26 patient specimens.
One JUUL refill pod contains as much nicotine as a pack of 20 regular cigarettes.
According to the American Cancer Society, JUUL and JUUL-like products may be more addictive than other types of e-cigarettes.
What Are The Health Risks Of JUULing?
Originally e-cigarettes such as JUUL were marketed as tools to help people break their cigarette habit. However, with evolving evidence, there are lasting health consequences of e-cigarettes and products like them, including irreversible lung damage and lung disease.
You might be surprised to know that nicotine is just as addictive as heroin. Dependence on it is especially dangerous for adolescent brains, which are still developing.
Using nicotine impacts brain chemistry. It can potentially affect the parts of the brain responsible for the ability to focus and learn, make decisions and control impulses. Nicotine also can make teens more susceptible to other addictions and lead to smoking traditional cigarettes as well.
Because nicotine is highly addictive, it's hard for people to quit once they start using it. Nicotine withdrawal symptoms include:
- Intense cravings
- Anxiety and irritability
- Restlessness and difficulty concentrating
- Constipation or diarrhea
It's true that e-cigarettes don't have as many chemicals as traditional tobacco products, but that doesn't mean they're safe. E-cigarettes still contain ultrafine particles that cause lung disease, and cancer-causing chemicals and metals like formaldehyde and lead. More than 2,000 reports of severe lung disease after e-cigarette use, and 39 deaths after vaping, have been reported
"There is concern about the long-term effect of other compounds found in e-cigarettes, especially in regards to cancer since a number of these compounds are known potential carcinogens," said Faisal Khan, MD, Medical Director, Interventional Pulmonology and Endoscopy at Franciscan Health Indianapolis. "More and more data is coming out highlighting potential harms of these products."
E-cigarettes may be perceived as safer than traditional cigarettes, but two recent studies say e-cigarettes are just as dangerous, or even worse, for your heart.
One study found vaping can worsen several heart disease risk factors at levels equal to traditional cigarettes:
The second study analyzed heart blood flow in 19 smokers, ages 24 to 32, immediately before and after using either e-cigarettes or traditional cigarettes.
The study showed that in smokers who use traditional cigarettes, blood flow increased modestly after traditional cigarette inhalation and then decreased with subsequent stress, but in smokers who use e-cigs, blood flow decreased after both inhalation at rest and after handgrip stress.
Is JUULing Safer Than Smoking?
"There are more studies coming out that show it vaping is not a safe alternative to smoking," said Beth Segal, MSN, RN, Operations Manager at Franciscan Healthy Living Center in Lafayette.
A recent study published by the American Thoracic Society shows that a single session of vaping can deliver more nicotine to the airways than smoking one cigarette.
"Vaping, especially with nicotine, exposes your lung to more nicotine. It has a harder time to get into the bloodstream compared to traditional cigarettes. There is an increased mucus that the body has a difficulty clearing," Segal said.
The authors of the study found that e-cigarettes with nicotine hampered mucus clearance. Not only are your lungs filling with toxic chemicals when you vape, but it also makes it harder to clear those chemicals from your lungs once they're there.
Is Secondhand Smoke From Vaping Harmful?
When a person vapes, they inhale and exhale the aerosol from the e-cigarette, which produces, often, a sweet-smelling cloud. This cloud is actually vapor, which may smell better than the traditional cigarette smoke and not linger in the air or on clothing, but it is still harmful.
According to the CDC, substances found in vaping aerosol include:
- Ultrafine particles that can be inhaled deep into the lungs.
- Flavoring like diacetyl, a chemical linked to a serious, irreversible lung disease called obliterative bronchiolitis.
- Volatile organic compounds, or gases emitted into the air that may have adverse health effects.
- Cancer-causing chemicals.
- Heavy metals, including nickel, tin and lead.
A study published in the Journal Chest in January 2019 found that teens with asthma who were exposed to secondhand aerosol, without vaping themselves, were more likely to have an asthma attack. Also, some reports show bystanders can experience excess cough and lung irritation from being around secondhand vaping.
How To Quit JUULing
If you're ready to quit JUULing, you don’t have to do this alone! Segal suggests seeing your physician for help in stopping vaping. There are resources available. Many people find support groups and hotlines helpful when quitting e-cigarettes. Sometimes just knowing that someone understands and shares your struggle can help you stay smoke-free for good.
By Ariel Anderson
Social Media Specialist