Juul exits US market, but you might be able to try TAKI
Jun 27, 2022
On June 26, the U.S. Food and Drug Administration this week ordered e-cigarette makers to remove their popular products from the market. Experts hailed the move as significant, but they also worried that the efforts had failed to keep up with the fast-growing vaping industry — an industry in which young people jumped quickly from one product to another.
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In 2020, the U.S. Food and Drug Administration (FDA) removed mint- and juice-flavored e-cigarette pods, affecting many of Juul's products. This week's escalating ban comes after regulators said Juul failed to provide enough evidence to assess the toxicity and harms of its tobacco and menthol-flavored e-cigarettes, leaving the FDA unable to assess the potential toxicological risks of using Juul's products.
Meanwhile, Juul argues that its e-cigarettes can help regular smokers quit and says it will fight back. On Friday, an appeals court temporarily stayed the injunction during Juul's appeal.
Lauren Czaplicki, a researcher at the Johns Hopkins Bloomberg School of Public Health, said the ban still matters because it was one of the first marketing denials of a brand and mint-flavored product that has a large market share in the United States. She noted that other brands such as Vuse, Logic and NJOY have received marketing authorization for various tobacco-flavored vaping products and systems, but Juul was rejected.
Research shows that banning flavored cigarettes does have an impact—a 2020 George Mason University study analyzed the 2009 FDA flavored cigarette ban and found it reduced underage smoking by 43 percent and youth by 27 percent .
"The FDA's marketing denial is likely to have an impact," Czaplicki said. “Juul remains a popular product among young people who do use e-cigarettes, and Juul has some brand recognition and cultural cachet among young people who may be vulnerable to nicotine use.”
While Juul still dominates the U.S. market, its popularity among young adults has declined over the past few years, said Dr. Devika Rao, a pediatric pulmonologist at UT Southwestern. A recent federal survey found that Juul was only the fourth most popular product among middle and high school students: the single-use e-cigarette Puff Bar was No. 1, and Vuse and Smok were No. 2 and No. 3.
"We know from the data that Juul is not the most used," Rao said. “Teenage today prefers disposable e-cigarettes, which you can buy online or in store. Disposable devices cost as little as $10 and are not part of the 2020 flavor ban, even though they use the same technology as Juul.”
Teens often switch from one product to another, says Stanford University researcher Monica M Zorilla.
When the FDA prioritized enforcement of flavored vaping devices like Juul in 2020, it exempted single-use e-cigarettes and menthol-flavored vaping products, Zorilla said.
A Stanford study found that teens then turned to those exempted from vaping. "Young people went from reload-based [like Juul] to disposables like Puff Bar, and as one young man said to me, anything with fruit was popular among their peers. That's part of the Because of law enforcement, and in part because single-use items still come in many flavors.”
Rao points out that social media marketing is clever — and insidious — enough to get teens to switch vaping products before adults realize it.
She noted that the latest trend is so-called healthy vaping, which is not even marketed as an e-cigarette.
"You can take things like melatonin or vitamins to make yourself feel better and fall asleep faster," she says. “These are really disguised vaping devices, and companies don’t need to state the concentration or composition of these products. Newer products introduce a whole new level of risk.”
More action is needed, Czaplicki said. She said the FDA should immediately issue an order to remove from retail shelves and online all vaping products sold without market authorization, which would include Puff Bars. "Reducing the number and types of flavored vaping devices sold in the U.S. could have a significant impact on reducing youth vaping, while helping adult smokers quit smoking altogether is unlikely to reduce the usefulness of tobacco-flavored vaping."
E-cigarettes are exposing a new generation to nicotine addiction, and researchers are still studying how to treat nicotine addiction in children, not adults, Rao said. These products are generally considered less harmful than smoking, but they still carry risks because teens are naturally addicted to substances. Rao, who cares for patients at Children's Medical Center in Dallas, explained that Juul has figured out how to make nicotine hit the brain more effectively -- making e-cigarette use more pleasurable.
"It may only take a few puffs before they become addicted, and it affects school performance, sports performance, and can lead to serious consequences like lung damage," Rao said. Studies have also shown that e-cigarettes can increase heart rate and blood pressure.
E-cigarette use has fallen for two years in a row during the pandemic, but doctors now worry that re-establishing social networks and easing restrictions means those rates could rise again, she said.
“When I talk to my patients, they are either vaping or all their friends are vaping, and they may feel pressure to start using these products,” Rao said. "Parents and educators need to have these conversations about the harm they can cause."