Have you heard of the new electronic smoking device called a JUUL (pronounced ‘jewel’)? It looks like a long USB flash drive and has become increasingly popular among young adults and teenagers nationwide. JUULs work just like any other electronic smoking device (ESD) — they are battery operated and heat up an e-liquid, which contains chemicals (such as flavorings and nicotine), to produce an aerosol that the user inhales. Here’s what you should know about JUULs:

How does the JUUL work?

JUULs have three main components: the battery, the JUULpod (which contains the e-liquid and serves as the mouthpiece) and the external charger. JUULs are manufactured as closed-pod systems, which means they are not intended to be modified.

What should you know about JUULs?

According to JUUL manufacturers, the product was designed to help adult smokers quit. However, research on the effectiveness of ESDs as a cessation device is unclear, and more teens and young adults are actually starting to use JUULs.

The U.S. Food and Drug Administration’s commissioner, Dr. Scott Gottlieb, stated there is an “epidemic of e-cigarette use that has gripped the nation’s youth.” JUUL is at the forefront of this epidemic, accounting for 73 percent of the ESD market share as of September 2018.

In 2018, almost 21 percent of high school students reported using an electronic smoking device in the past 30 days, according to a study by the Centers for Disease Control and Prevention. This is a significant, and concerning, increase from the 2011 data, where 1.5 percent of high school students reported using an ESD in the past 30 days.

Why are we concerned about JUULs?

Each JUULpod (the mouthpiece containing e-liquid) contains the same amount of nicotine as one pack of cigarettes. This is especially dangerous for teens and young adults, because the nicotine can harm brain development, which continues until age 25.

According to the Truth Initiative (a non-profit working on reducing tobacco use in youth):

» 63 percent of JUUL users (between the ages of 15 and 24) did not know that JUULs always contain nicotine.

» Youths who use e-cigarettes are four times more likely to also smoke regular cigarettes.

What are JUUL trends among teens?

JUULing (the act of using a JUUL) is especially popular among teenagers and young adults, who do not consider it to be “vaping,” when in fact it is.

JUULing at school has increased. Students have taken to smoking JUULs in classrooms, hallways or bathrooms. Bathrooms are even referred to as “JUUL rooms.” The Truth Initiative reported that 18 percent of students (ages 12 to 17) have seen JUULs used in school. Because of the sleek design and limited emissions, it’s easy to hide. JUULers also post photos and videos of themselves using the product on social media, often with trending hashtags like #doitforjuul, #doit4juul and #juul.

What can you do?

Everyone should know the facts and the risks about electronic smoking devices like e-cigarettes, vapes and JUULs for teens and young adults.


» Communication is key. Talk to your teens about the risks of using electronic smoking devices and the importance of remaining tobacco free.

» Lead by example and live a tobacco-free life. Free help to quit smoking is available by calling (800) QUITNOW.

Educators and school administrators:

» Incorporate discussions about tobacco use (including e-cigarettes and JUULs) into classroom activities.

» Develop, implement and enforce tobacco-free policies at schools.

Healthcare providers:

» Ask about e-cigarette use (including JUULs) when talking to patients.

» Warn patients about tobacco use and the harmful effects of any nicotine on the developing brain of teens and young adults.

» Refer patients to local resources for help to quit smoking.

For more information, visit https://truthinitiative.org/news/what-is-juul or contact the Thomas Jefferson Health District’s Tobacco Control Coordinator at alessandra.capriles@vdh.virginia.gov.


This column, which promotes community health, is sponsored by Sentara Martha Jefferson Hospital, Region Ten Community Services Board, Thomas Jefferson Health District and the University of Virginia Health System.

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