Not just blowing smoke

The tobacco advertisements in the 1950s and 1960s that promoted smoking cigarettes as a safe way to relax seem laughable now.

Those days are back, though, says Erin Seedorf, assistant professor in the Department of Health Professions at Metropolitan State University of Denver.

This time, the product being promoted as safer by tobacco companies is electronic cigarettes that heat liquid-based nicotine into an inhalable vapor, consumed in a process known as “vaping.” Particularly popular today is Juul, a device that looks like a USB drive and delivers a nicotine hit almost twice the amount of other e-cigarette brands.

Seedorf, who has worked in public health and tobacco control for most of her adult life, notes a survey that found 60 percent of youth believe Juul pods don’t contain nicotine.

“The (tobacco) companies are out ahead again,” she says. “It’s a trend we’ve seen over and over, a new product being developed once cigarette consumption goes down.”

Nearly 12 percent of high school students and 3 percent of middle-school students used e-cigarettes in the past 30 days, according to the 2017 National Youth Tobacco Survey, released in June. By their senior year in high school, 25 percent of students have used e-cigarettes, Seedorf says.

These numbers support a recent report by the Food and Drug Administration that said vaping among younger populations has reached “…an epidemic proportion.”

They’re attracted to them for the same reason their parents were attracted to cigarettes: They get a buzz, at least initially, since nicotine is a stimulant. And smoking goes well with rebellion, providing a sense of adult independence.

Those who vape e-cigarettes, however, are at exceedingly high risk of becoming addicted.

“Exposing the brain to nicotine that young can cause the receptors targeted by nicotine to rewire. This makes it very, very difficult to stop using because addiction is enhanced,” Seedorf says.

Waiting for science to catch up

Israel recently outlawed the import and sale of e-cigarettes made by Juul Labs, citing public-health concerns given their excessive nicotine content. But in the United States, the Food and Drug Administration is still studying their impact. Some health groups have sued the FDA for delaying regulation of vaping products such as Juul.

“We’re waiting for science to catch up with the product,” Seedorf says, which is something the tobacco industry has relied on for decades.

In the 1980s, companies began producing flavored cigarettes while denying they were marketed to young people, she says.

And in the 1990s, they introduced products such as flavored snuff, which had nicotine levels that were not quite as strong as cigarettes but were a good way to familiarize children with nicotine products, including cigarettes.

“Now you have the same pattern with e-cigarettes and Juuling,” Seedorf says.

Advertisements that target kids

According to the manufacturer of Juul, e-cigarettes are smoking-cessation tools for adult smokers who want to quit.

“There is no research – except studies funded by the tobacco industry – that e-cigarettes help smokers quit,” Seedorf says.

In fact, according to a University of Pittsburgh study in 2017, youth who use e-cigarettes are four times more likely to start smoking cigarettes than their peers who don’t vape, she says.

E-cigarette companies such as Juul say they don’t market to children – even though they advertise on social-media sites frequented by teens and offer healthy-sounding flavors such as mango and mint.

Seedorf pointed out that e-cigarettes can be purchased online as long as customers click a box that says they’re over 18. They also are sold at convenience stores, just like cigarettes, where research has found it is easier for children to purchase tobacco products.

She says the e-cigarette industry is expected to grow 24 percent this year, adding, “The problem is these products are rolling out too fast for the FDA to get a handle on them.”