Arguments about the relative safety of JUUL and other e-cigarette devices have been part of the public discourse since vapes first came on the market. While some argue that vaping is healthier than smoking, others contend that electronic nicotine delivery systems - or ENDS, as the FDA refers to them - are just as harmful in different ways. Some of these severe effects have even led to people filing e-cigarette lawsuits.
Given that there are no major long-term studies on the adverse effects of vaping (or "juuling," as the kids call it), these arguments are likely to continue for some time. Even studies that look at the effects of nicotine or other compounds found in both traditional cigarettes and e-cigarette flavor pods might not be translatable, because the absorption of those chemicals into the body is likely different depending on different formulations in each product.
New evidence is emerging, however, that the health risks of JUUL are even worse than most people have thought and may lead to e-cigarette addiction.
Does Juuling Cause Seizures?
Last month, the FDA announced that they have received reports of young people experiencing seizures and convulsions after juuling. Between 2010 and 2019, the regulatory agency received at least 35 reports of people suffering seizures after vaping, most of whom had no prior history of seizures.
As a result of these reports, the FDA has put out a call for additional information. The agency has asked those who have experienced seizures or other severe side effects from vaping to report those adverse events.
While studies on the specific effects of vaping are few, we do have solid evidence that nicotine exposure can lead to a number of harmful effects, such as nausea and vomiting, dizziness, tremors, an increased heart rate, seizures, and even death. Contact of e-liquids - which contain concentrated nicotine salts - with the skin, eyes, or mouth can induce acute symptoms of nicotine poisoning very quickly, especially in young children.
E-Liquid Suicide Attempts
Because of the highly dangerous nature of e-liquid cartridges, including JUULpods, some young people have used them to attempt or commit suicide. A case report in the Journal of Korean Medical Science shared two incidences of attempted suicide using concentrated nicotine liquid, one by a 27-year-old man and another by a 17-year-old girl. An earlier case report from 2014 involved a man who drank the contents of four e-liquid packets along with some wine in an attempt to end his life.
According to The Journal of Pediatrics, the rate of suicide attempts by poisoning among young people (aged 10 - 24) increased significantly between 2000 and 2018. JUUL and other vape makers have gotten in trouble for actively marketing their products to teens and young adults in this age group, and the added risk of making deadly e-liquids readily available to a population that suffers from a high percentage of depression and loneliness makes the situation even more serious.
More Injuries from Explosions
While exploding ENDS are relatively rare, there are still regular reports about burns, broken bones (or teeth), and even deaths from malfunctioning vapes. Last week, the New England Journal of Medicine published a gruesome case study about a boy in Nevada who suffered from pain, swelling and jaw injuries after an e-cigarette exploded in his mouth. According to news reports, the teen had to travel 250 miles to the closest hospital to seek treatment.
Earlier this year, a man in Texas died when an e-cigarette exploded in his face. A study in Tobacco Control (a BMJ journal) estimated that there were more than 2,000 e-cigarette burns and other injuries from exploding ENDS between 2015 - 2017. That number could be much higher, especially if there were injuries for which the victims did not seek medical attention.
E-Cigarette Ban Pressure Rising
Calls for bans due to the increased health risks of JUUL and other e-cigarettes are mounting. In San Francisco last week, city supervisors voted to ban sales of electronic cigarettes. They cited the desire to curb youth vaping as the primary motive for the ban. While the ban doesn't specifically prohibit vaping, the hope is that banning sales will reduce overall usage and possibly prevent high rates of teen vaping addition.
Earlier this month, Aspen, CO, banned the sale of flavored nicotine products, also citing the rise of youth vaping as a primary concern. At least 37 other cities around the U.S. have put similar bans in place, including Chicago, Minneapolis and San Francisco.
Whether a national ban or some other regulation gets put in place will ultimately depend on the FDA. If the seizures and other severe side effects being investigated now are ultimately determined to have been caused by the concentrated nicotine in e-liquids, the agency could issue a complete ban on ENDS altogether.