The U.S. Food and Drug Administration and the Federal Trade Commission issued 13 warning letters last year to manufacturers, distributors and retailers for selling e-liquids with labeling and/or advertising that cause them to resemble kid-friendly food products, some of them with cartoon imagery. Photo courtesy of FDA
By Kayla Berenson
Some trends come and go, but vaping is steadily growing.
Vaping was originally marketed to adults as an alternative to smoking cigarettes and a way to help smokers quit. However, vaping devices, including e-cigarettes and Juul pods, have grown in popularity among a younger demographic locally and nationally.
A recent report from the Centers for Disease Control and Prevention showed an increase in the number of middle and high schoolers’ use of e-cigarettes from 2.1 million in 2017 to 3.6 million in 2018. A youth drug survey in Mecklenburg County produced findings consistent with national trends.
Doctors have recently seen an increase in vaping-related lung injuries among both adolescents and adults.
“I think a lot of us had thought that they were safer earlier on because they don’t have the tar that traditional tobacco products do,” pulmonologist and professor of medicine at Atrium Health and Levine Cancer Institute Dr. Jaspal Singh said. “That lack of a tar component, theoretically, is safer … I think what we’re seeing now is increasing scientific research and evidence that there might be some additional additives, some additional concerns.”
Medical professionals are still researching what exactly is causing these lung injuries, but they are certain about the link between these cases and e-cigarettes, according to Dr. Michael Beuhler, medical director for the North Carolina Poison Control.
Doctors advise the public, especially youth and adolescents, to avoid these products at all costs.
The increase in usage among teenagers can be
attributed to their misconceptions regarding vaping devices, according to Dr. Shamieka Dixon, of the Levine Children’s Hospital Department of Adolescent Medicine.
“Two-thirds of adolescents don’t actually know that these vaping devices contain nicotine,” Dixon said. “And what we know about it is, for our adolescents that vape, they are more likely to go on to smoke traditional tobacco products and actually to also use marijuana if they were not using it before.”
The gateway to usage of tobacco products comes from the amount of nicotine in an e-cigarette, which is equivalent to the amount in one pack of cigarettes, Atrium Health Tobacco Treatment Specialist Chelsea Cain said.
Despite vaping advertising companies claiming to avoid targeting youth and the fact that those under 18 are not allowed in vape shops, Dixon believes these companies knowingly attract younger consumers.
“Mango flavor, bubble gum flavor, fruit punch – all geared towards children,” Dixon said. “If you look at Twitter for some of the most popular vaping devices, 80% of their Twitter followers are 13 to 20. They know exactly what they’re doing, and they’re specifically targeting children.”
These flavors, now under threat of being banned by the Federal Drug Association, are what North Carolina high schoolers said attracted them to using e-cigarettes, according to the Mecklenburg County Public Information Department.
North Carolina Attorney General Josh Stein commended the FDA on its step toward reducing vaping among youth, but said his fight against vaping companies is not over.
“My lawsuits against Juul, Beard Vape, Direct eLiquid, Electric Lotus, Electric Tobacconist, Eonsmoke, Juice Man, Tinted Brew, and VapeCo. will continue as we work to hold these companies accountable for fueling a vaping epidemic among high school and middle school students,” Stein said.
Though flavors could be banned, there was no evidence that flavored products were safer than non-flavored vaping products because they still contain nicotine.
“The high concentration of nicotine in some of these products are also extremely addictive and so you have to sort of think about all these aspects,” Singh said. “And the flavoring themselves, there’s no clear indication either that they’re safer. So especially in an inhaled form, you can get a very high concentration of these relatively quickly in your bloodstream.”
Doctors, vaping activists and vape store owners are on the same page about stopping the epidemic of e-cigarette use among teens, but differ when it comes to stopping vaping as a whole.
The American Vaping Association is a nonprofit that advocates for sensible regulation of vaping products.
“Multiple state health departments and news outlets are very clearly linking these illnesses to illegal, black market street vapes containing contaminated marijuana oils,” AVA president Gregory Conley wrote in an email to South Charlotte Weekly. “Youth need to know that it’s not OK to vape anything, but it’s also important that they know what particular type of product is sending people to the hospital after just one day of use. Hyping fears by conflating store-bought, FDA-regulated nicotine vaping products with potentially deadly bootleg marijuana cartridges sold by drug dealers will do absolutely nothing to stop these illnesses from continuing to occur.”
Local vape shop owners also blame illegal online vape products, along with gas stations, for the spread of e-cigarette use among youth.
“Gas station retailers and convenience stores, they don’t check IDs,” Vapor Smoke Shop owner Suhail Thaker said. “And online, anybody can go behind a computer, type in what they want and there’s very little restriction on age limits. The only age restriction that comes up is, ‘Are you 21?’ or ‘are you 18?’ and you just hit yes or no.”
Thaker also said he believes vaping should not be banned as it has helped him and many of his clients quit smoking. He no longer smokes or vapes.
However, with recent reports and news articles, Thaker said he has seen a significant decrease in sales at his store.
“Now, the CDC and the FDA and the Trump administration want to take it into a different context and ban vaping altogether,” Thaker said. “But you can’t ban vaping because of six people died from vaping an illegal product that should’ve never been in the country in the first place and should’ve never been authorized to make that purchase because people were able to purchase it so readily and so easily over the internet and gas stations.”
If only authorized retailers were allowed to sell vape products, there would be fewer adolescent vape users, Thaker said.
Moving forward, Dixon said it is important to be specific when asking youth about their use of e-cigarettes.
“Most of my kids will tell you, ‘No, I do not smoke,’ Because to them, it’s not smoking, right?” Dixon said. “Most of them don’t know that there’s nicotine and addictive substances in it, so you have to be specific about what you’re talking about. So vaping, Juuling, you have to know what you’re looking for because those devices also look different depending on what product you’re buying.”
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