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Juul Madness

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Juul Madness

Vaping prohibitionists ignore the vast public-health benefits of the new technology. July 15, 2018
Health Care
Politics and law

Tobacco-company stocks have plunged this year—along with cigarette sales—because of a wonderful trend: the percentage of people smoking has fallen to a historic low. For the first time, the smoking rate in America has dropped below 15 percent for adults and 8 percent for high school students. But instead of celebrating this trend, public-health activists are working hard to reverse it.

They’ve renewed their campaign against the vaping industry and singled out Juul Labs, the maker of an e-cigarette so effective at weaning smokers from their habit that Wall Street analysts are calling it an existential threat to tobacco companies. In just a few years, Juul has taken over more than half the e-cigarette market thanks to its innovative device, which uses replaceable snap-on pods containing a novel liquid called nicotine salt. Because the Juul’s aerosol vapor delivers nicotine more quickly than other vaping devices, it feels more like a tobacco cigarette, so it appeals to smokers who want nicotine’s benefits (of which there are many) without the toxins and carcinogens in tobacco smoke.

It clearly seems to be the most effective technology ever developed for getting smokers to quit, and there’s no question that it’s far safer than tobacco cigarettes. But activists are so determined to prohibit any use of nicotine that they’re calling Juul a “massive public-health disaster” and have persuaded journalists, Democratic politicians, and federal officials to combat the “Juuling epidemic” among teenagers.

The press has been scaring the public with tales of high schools filled with nicotine fiends desperately puffing on Juuls, but the latest federal survey, released last month, tells a different story. The vaping rate last year among high-school students, a little less than 12 percent, was actually four percentage points lower than in 2015, when Juul was a new product with miniscule sales. As Juul sales soared over the next two years, the number of high-school vapers declined by more than a quarter, and the number of middle-school vapers declined by more than a third—hardly the signs of an epidemic.

Nicotine prohibitionists have been claiming for years that e-cigarettes are a “gateway” to smoking addiction, but studies have repeatedly shown that they’re not even a gateway to regular vaping, much less smoking. (See “The Corruption of Public Health,” Summer 2017.) Few teenage vapers do it daily—most are “party vapers”—and few teenage or adult smokers got started by vaping. A recent survey of Juul customers found that nearly 90 percent had already smoked cigarettes at some point before trying Juul, and the smokers reported a phenomenally high rate of success at quitting. Of the roughly 12,000 people who were current smokers when they tried Juul, more than 7,500 reported giving up cigarettes (and most of the rest reported cutting back). Meanwhile, among the roughly 2,400 Juul customers who had never previously smoked, just 50 went on to become occasional smokers, and only 5 of them became daily smokers.

But all this good news hasn’t changed the minds of nicotine prohibitionists. During the Obama administration, they promulgated regulations to take effect this year that would have outlawed most vaping products on the market and prevented new ones from being introduced by small companies and entrepreneurs—like the creators of the Juul. Those regulations, fortunately, have been postponed by Scott Gottlieb, the head of the Food and Drug Administration. But a coalition of prohibitionists has sued to reinstate the rules, a move that’s also being demanded by a group of Democratic senators that includes Chuck Schumer, Dick Durbin, and Elizabeth Warren. The activists and senators have further demanded that the FDA restrict flavors in vaping devices, ostensibly to protect teenagers from being enticed by the taste of mint or mango, but those restrictions would lessen the appeal for adults, too.

While Gottlieb has been much more sensible than his predecessors at the FDA, he has echoed the prohibitionists’ alarms about Juul and is threatening to restrict flavors. He has also ordered Juul to supply his agency with documents about its research and marketing, and he has announced undercover operations to catch retailers selling Juul to minors. Aside from harassing the company and its retailers, it’s hard to see what this campaign could accomplish. Juul has not been marketing to minors, and has a program to prevent them from making online purchases. The federal government’s surveys show that more than 99.5 percent of the e-cigarettes sold in stores are being bought by adults, not minors, according to oral pathologist Brad Rodu, who holds a chair in Tobacco Harm Reduction Research at the University of Louisville’s James Graham Brown Cancer Center. “Like alcohol and cigarettes, most e-cigarettes used by teens are obtained from social sources, not directly from stores, so it makes no sense to go to war against retailers,” Rodu says. “We don’t want kids to use e-cigarettes, but many more are using marijuana and getting drunk, which are much more dangerous. We have to put these behaviors in perspective.”

Democrats who favor liberalizing marijuana laws, like Senator Schumer, want to restrict e-cigarettes, even though they pose much less risk while making a major contribution to public health. E-cigarettes are at least 95 percent safer than tobacco cigarettes, according to British medical authorities (who have been far saner on this issue than their American counterparts), and the rate of smoking has declined much more rapidly since the emergence of vaping devices than during the previous years.

While there’s a general consensus to discourage teenagers from vaping, the zeal to protect them has had perverse consequences, as demonstrated in a new study analyzing New York City’s decision to raise the age for e-cigarette purchases to 21 from 18. Since the city enacted that restriction four years ago, the rate of youth smoking has declined more slowly in the city than in other parts of the state that allow sales to 18-year-olds.

Another perverse consequence of the campaign against Juul is that the wave of publicity is probably inducing teenagers to try it. The more they hear about this fad supposedly sweeping the nation’s schools, the more they’ll be tempted to taste this new forbidden fruit. But even if the rate of teen vaping rises, and even if a few of those teenagers become regular vapers, that’s still no reason to crack down on a product whose proven benefits far outweigh any potential harms.    

“The Juul isn’t causing substantial health damage,” notes Michael Siegel, a professor at the Boston University School of Public Health who studies tobacco control policies. “There is no evidence that even long-term Juuling increases the risk for disease. And Juul is helping hundreds of thousands of smokers to quit and perhaps save their lives.”

You’d think that progressive activists and journalists would be cheering the small company whose life-saving product has become an existential threat to Big Tobacco. But the lower the smoking rate falls,  the less work there is for anti-smoking activists at groups like the Campaign for Tobacco-Free Kids, which has helped lead the attack on Juul and the vaping industry. The activists need a new cause and a new enemy, and they’re not about to let the public’s health get in their way.

Photo: vaping360.com

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