San Francisco-based e-cigarette company Juul makes headlines left and right due to its explosive surge in popularity (especially among teenagers) and market share.
But what exactly is Juul, and is it safe to use one? Here are all the details you need to know about Juul.
What is it?
Juul is like many other e-cigarettes, but with a couple caveats that set it apart. First, this vape is sleek and hardly noticeable: It's USB-drive design can be enclosed in the palm of a hand, and it doesn't produce a massive plume of vapor like some other e-cigarettes. Second, the nicotine content in its cartridges or "pods" set a new precedent for the e-cigarette market.
E-cigarettes work by converting liquid nicotine into a vapor that the user inhales. They're battery operated and intend to provide a similar stimulus to that of smoking regular cigarettes.
Developed by two former smokers, Juul's mission is to "improve the lives of one billion adult smokers by eliminating cigarettes." One way the company encourages the switch from cigarettes to Juul is with their Juul calculator, where people can estimate how much money they'd save if they used a Juul instead.
How does Juul compare to other e-cigarettes?
Juul's high nicotine content used to be an anomaly in the e-cigarette market, but now researchers note it seems to be the rule. After Juul's surge in popularity, other e-cigarette manufacturers began bumping up the nicotine content in their products.
Juul uses a closed system, which means users can't refill the pods themselves, a helpful factor for quality control. Some e-cigarettes, such as the Suorin Drop, use open systems that allow users to refill the vape themselves with bottles of e-liquid or e-juice.
Juul's small size, compact design and minimal plume make it more discreet than many other brands. With no buttons or switches -- just disposable, snap-on cartridges -- Juul is simple, and its built-in temperature regulation prevents you from experiencing a "dry hit." Dry hits occur when vape cartridges get too low on liquid or when they overheat, and produce a burnt taste and throat irritation.
What is in the liquid that the Juul turns to vapor?
The Juul comprises two parts. There's the e-cigarette itself, which contains the battery, temperature regulator and sensors that read the charge level. The pod contains Juul's patented e-liquid formula. A mixture of nicotine salts, glycerol, propylene glycol, benzoic acid and flavorings.
- Glycerol serves as a humectant, which means it adds moisture to the solution. Glycerol is classified as "generally recognized as safe" by the FDA, so it's approved for consumption.
- Propylene glycol is a synthetic compound commonly used in polyester production, but it's also approved as an additive for food, cosmetic and pharmaceutical products.
- Benzoic acid occurs naturally in many plants, but its synthetic form is also widely used as a food additive and preservative. It's "generally recognized as safe" for those uses, but can be an environmental and health hazard in large quantities.
- Flavorings is an ambiguous term, but most often refers to various natural and synthetic ingredients that companies use to flavor their products. For example, Juul doesn't specify what's in it's mint-flavored pod, but it probably contains peppermint extract or oil.
The nicotine salts in Juul pods are a type of nicotine that supposedly feels more like a cigarette when inhaled, as opposed to other vapes that use freebase nicotine. Freebase nicotine, which can cause coughing and leave a film in people's throats, is harsher and commonly used in cigars.
Juul pods currently come in eight flavors; cucumber, creme, mint, mango, menthol, fruit, Virginia tobacco and classic tobacco. It's worth noting that the FDA's Family Smoking Prevention and Tobacco Control Act banned flavored cigarettes in 2009, so it's possible that this might come into play for vapes one day, too.
How much nicotine does a Juul deliver?
Juul measures nicotine content by weight, which is different from most brands, which usually measure by volume. Juul originally only sold pods with 5 percent nicotine by weight, but started offering 3 percent pods in August 2018.
According to an older version of Juul's FAQ page, one 5 percent pod contains roughly the same amount of nicotine as one pack of cigarettes, or about 200 puffs. However, this information is no longer available on Juul's website, and there's no precise information about 3 percent pods, either. However, an article in the New England Journal of Medicine says that the 5 percent pods contain a concentration of 59 milligrams of nicotine per milliliter of liquid.
In contrast, most vapes pre-Juul frenzy contained roughly one to three percent nicotine by volume. A study in the journal Tobacco Control notes that the new average seems to be rising to that 5 percent mark. Juul's creators increased the nicotine because they felt other vapes on the market couldn't compare to the sensations delivered by regular cigarettes.
Is it addictive? Is it more addictive than cigarettes?
Nicotine is a known addictive substance, and Juul is no exception. There are no studies that prove whether or not Juul is more addictive than regular cigarettes, but I certainly know people who seem as addicted to their Juul as they are to their iPhones, and I've watched friends throw fits when their pod runs dry.
Nicotine is a harmful drug, regardless of delivery method. It's linked to various changes in the body and brain, and public health officials worry that most people, especially youth, aren't aware of the potential consequences.
What are the risks of vaping?
Many people consider vaping a safer alternative to smoking because it eliminates tobacco, which is a known carcinogen. But cigarettes contain many chemicals beyond tobacco, and e-cigarettes contain some of the same.
Not all e-cigarette liquids contain all of these toxic compounds, and even in those that do contain them, the concentration isn't always high enough to present concern. No studies to detect these chemicals have been conducted specifically on Juul e-liquid.
The real issue arises when companies don't disclose what's in their products. Juul openly states its e-liquid ingredients, all of which appear to be safe in reasonable doses -- except the nicotine.
Nicotine is a highly addictive substance that causes cravings and bonafide withdrawal symptoms when those cravings are ignored. Whether or not vaping is a "gateway" to cigarette smoking is irrelevant because vaping itself is an addictive habit.
Nicotine isn't just addictive, but it's also toxic. It stimulates your adrenal glands, spiking adrenaline production and leading to a series of bodily reactions: Users experience a release of glucose and an increase in heart rate, breathing rate and blood pressure.
The drug seems to act as both a stimulant and a depressant at the same time, as it's linked to increased alertness but also increased relaxation.
Use of nicotine is also associated with a number of side effects on organs and organ systems, including:
- Increased risk of blood clots
- Peptic ulcers
- Changes in heart rhythm
- Lung spasms
Nicotine can also alter or harm the development of the brain in children and teens.
"The prefrontal cortex, the area of the brain responsible for decision-making, logic, personality expression, and many other traits integral to one's personality, is not fully mature until around the age of 25," Dr. Lawrence Weinstein, Chief Medical Officer of American Addiction Centers, told CNET. "Introducing nicotine to the brain 10 years prior to that, without speaking of the massive amount of nicotine contained in each cartridge, will undoubtedly alter that developing brain."
Lastly, e-cigarettes work by heating a liquid into an aerosol that the user inhales. While the amount of aerosol in a single puff isn't likely to harm anyone, it's worth noting that inhaling aerosols is associated with impaired judgment and functioning.
Can vaping cause heart disease?
The Stanford School of Medicine released a study in May 2019 that suggested the e-liquids in Juuls and other vapes could increase a person's risk of heart disease. When inhaled, the e-liquid affects a certain kind of cells, called endothelial cells, that line the inside of blood vessels.
Researchers found that endothelial cells exposed to e-liquid or to blood collected from people who smoked e-cigarettes exhibited DNA damage and cellular death. Damage occurred even in the absence of nicotine, which means other compounds in the e-liquids are harmful.
Interestingly, the severity of the damage varied by flavor, with cinnamon and menthol found as the most harmful.
The endothelial cells the researchers tested were grown from stem cells, but the implications still mean a lot for human endothelial cells.
"This study clearly shows that e-cigarettes are not a safe alternative to traditional cigarettes," said Joseph Wu, director of the Stanford Cardiovascular Institute, in a press release. "... We saw significant damage. The cells were less viable in culture, and they began to exhibit multiple symptoms of dysfunction."
Why is Juul so popular, especially among teens?
Although Juul demands age verification upon navigating to its website and holds a firm stance against minors' use of Juuls, these vapes are still wildly popular with teens.
Depending on the state, no one under 18 or 21 is supposed to be able to purchase e-cigarettes, or any tobacco products. But according to a report from the CDC, e-cigarette use is rising among middle school and high school students, and more than 3.5 million of them used e-cigarettes in 2018.
Advertising is part of the problem. According to the CDC, more than 18 million high school and middle school students combined were exposed to e-cigarette ads in 2014. And Stanford researchers point out that Juul's marketing hasn't been congruent with its adults-only stance.
One can guess it's so popular for a few reasons:
- It's relatively inexpensive: You can buy Juul's "starter kit," which includes the e-cigarette, USB charger and four pods for $50. After that, packs of four pods cost $21.
- It's discreet: People may be more inclined to use Juul because its compact design is easy to hide from parents, teachers and other authority figures.
- It doesn't smell like a cigarette: Cigarette smoke permeates the air in a relatively large radius. Juuls, on the other hand, don't give off the smell of tobacco or smoke.
- It comes in many flavors: Juul's sweet flavor options make it a more palatable option than regular cigarettes and many other e-cigarette options. One CDC survey notes that 31 percent of survey respondents (all students in grades six to 12) chose e-cigarettes because of "flavors such as mint, candy, fruit, or chocolate."
The explosive popularity of Juul and others like it among kids is particularly troubling because they often do not see it as harmful. A report showed that 63% of people aged 14 to 25 aren't even aware that vaporizers like Juul contain nicotine at all.
What's the FDA's stance on Juul?
Well, the FDA doesn't love Juul.
In April 2018, the FDA demanded that Juul submit marketing and research documents, and explain what Juul knows about the use of its products among teens. A month later, as part of the FDA's Youth Tobacco Prevention Plan, the agency also requested information from several other e-cigarette manufacturers. And in October 2018, to gather information on the company's sales and marketing tactics.
Despite the fact that selling tobacco products to minors is illegal, the FDA has so far uncovered 40 violations for illegal sales of Juul products to young people. Warning letters were issued for those violations. The company also in November 2018 to avoid promoting its product to teens and non-smokers -- two groups that Juul specifically says it does not want to become customers.
In a statement, FDA commissioner Scott Gottlieb said, "...the nicotine in these products can rewire an adolescent's brain, leading to years of addiction."
But, he continues: "Make no mistake. We see the possibility for electronic nicotine delivery systems (ENDS) products like e-cigarettes and other novel forms of nicotine-delivery to provide a potentially less harmful alternative for currently addicted individual adult smokers ... But we've got to step in to protect our kids."
How did the company get its start?
Juul Labs spun off from Pax Labs in 2015. Founders Adam Bowen and James Monsees co-founded the company when, as former smokers, they decided they wanted a better alternative to cigarettes than anything that was already on the market.
Their idea of "better" manifested as Juul's high nicotine content and slim design that puts off very little vapor compared to other vapes. Since its debut, Juul has grown to dominate more than 50 percent of the market share.
In December 2018, Altria -- one of the largest companies in the world that produces tobacco products -- bought a 35% stake of Juul for $12.8 billion dollars. Altria owns Phillip Morris, which owns the brands Marlboro, Virginia Slims, Parliament and other cigarette brands.
Juul's staggering success prompted many e-cigarette brands to follow suit with high nicotine content and new designs. The FDA isn't happy with these copycat brands, and neither is Juul, who filed a complaint with the US International Trade Commission for patent infringement.
The attributes of these vapes -- attractive, compact and free of odor -- make them popular with young people because they can easily hide them from authority figures, like teachers and parents.
Juul's popularity and the influx of similar products raises concern that this new "pod mod" class of e-cigarette products is not just a trend and will influence the decisions and habits of adolescents for their entire lives.