How vaping and e-cigs like Juul affect your health

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Smoking kills. No other habit has been so strongly tied to death.

In addition to inhaling burned tobacco and tar, smokers
breathe in toxic metals like cadmium and beryllium, as well
as metallic elements like nickel and chromium — all of which
accumulate naturally in the leaves of the tobacco plant.

It’s no surprise, then, that
much of the available evidence suggests that vaping, which
involves puffing on vaporized liquid nicotine instead of inhaling
burned tobacco, is at least somewhat
healthier. Some limited studies have suggested that reaching
for a vape pen instead of a conventional cigarette might also
help people quit smoking regular cigarettes, but
hard evidence of that
remains elusive.

Very few studies look at how vaping affects the body and brain,
however. Even fewer specifically examine the
Juul, a popular device that packs as much nicotine in each of
its pods as a standard pack of cigarettes.

But a handful of studies published in the last few months have
begun to illuminate some of the potential health effects tied to
vaping. They are troubling. Most recently, researchers at the
Stanford University School of Medicine
surveyed young people who vape and found that those who
said they used Juuls vaped more frequently than those who used
other brands. The participants appeared to be insufficiently
aware of how addictive the devices could be.

Most e-cigs contain toxic metals, and smoking them may also
increase the risk of a heart attack

Eduardo
Munoz/Reuters

Researchers took a look at the compounds in several popular
brands of e-cigs (not the Juul) this spring, and
found some
of the same toxic metals (such as lead)
inside the device that they normally find in conventional
cigarettes. For
another study published around the same time,
researchers concluded that at least some of those toxins appear
to be making their way through vapers’ bodies, as evidenced by
a urine
analysis they ran on nearly 100 study participants.

In another study published this summer, scientists concluded that
there was substantial
evidence tying daily e-cig use to an
increased risk of heart attack. And this week, a
small study in rats suggested that vaping could have a
negative effect on wound healing that’s similar to the effect of
regular cigarettes.

In addition to these findings, of course, is a well-established
body of evidence about the harms of nicotine. The highly
addictive substance that can have dramatic impacts on the
developing brains of young adults.

Brain-imaging
studies of adolescents who begin smoking traditional
cigarettes (not e-cigs) at a young
age suggest that those individuals have markedly
reduced activity in the prefrontal cortex and perform less well
on tasks related to memory and attention, compared to people who
don’t smoke. Those consequences are believed to be a result of
the nicotine in the cigarettes rather than other ingredients.

Nicholas Chadi, a clinical pediatrics fellow at Boston
Children’s Hospital, spoke about the Juul at the American Society
of Addiction Medicine’s annual conference this spring. He said
these observed brain changes are also linked with increased
sensitivity to other drugs as well as greater impulsivity. He
described some anecdotal effects of nicotine vaping that he’s
seen among teens in and around his hospital.

“After only a few months of using nicotine [these teens] describe
cravings, sometimes intense ones. Sometimes they also lose their
hopes of being able to quit. And interestingly, they show less
severe symptoms of withdrawal than adults, but they start to show
them earlier on. After only a few hundred cigarettes — or
whatever the equivalent amount of vaping pods — some start
showing irritability or shakiness when they stop,” Chadi said.

A new survey suggests that teens who use Juul e-cigs aren’t aware
of these risks

A Juul advertisement from
2016.
Pax Labs

The Juul, which is made by Silicon Valley startup Juul Labs, has
captured more
than 70% of the e-cig market and was recently
valued at $15 billion. But the company is facing a

growing backlash from
the FDA and scientists who
say it intentionally marketed to teens.

Yet very little research about e-cigs has homed in on the Juul
specifically. 

So for a
study published this week, researchers from the Stanford
University School of Medicine surveyed young people who vape
and asked them whether they used the Juul or another e-cigarette.

Their results can be found in a widely accessible version of the
Journal of the American Medical Association called JAMA Open.
Based on a sample of 445 high-school students whose average age
was 19, the researchers observed that teens who used the Juul
tended to say they vaped more frequently than those who used
other devices. Juul users also appeared to be less aware of
how addictive the devices could be compared with teens who vaped
other e-cigs.

“I was surprised and concerned that so many youths were using
Juul more frequently than other products,” Bonnie
Halpern-Felsher, a professor of pediatrics and a lead author of
the study, said in a statement.

“We need to help them understand the risks of addiction,” she
added. “This is not a combustible cigarette, but it still
contains an enormous amount of nicotine — at least as much as a
pack of cigarettes.”