Juul e-cigarettes pose a risk of dependence for young users | Information Center

Stanford researchers decided to ask questions about Juul as part of a study on tobacco use conducted in 10 California high schools. During the first phase of the study, completed in 2014 and 2015, more than 700 students out of 9 or 12^thStudents answered questions about their use and perceptions of tobacco products. The new findings are from follow-up questionnaires completed by 445 participants in this study. They were in 12^thor a few years of high school when new data has been collected.

Participants answered questions to find out if they had ever heard of Juul. if and how often they used conventional cigarettes, Juul or other types of electronic cigarettes; their use of flavored electronic cigarette products; their perceptions of the social acceptability of different products; and their perception of the risks and benefits of the products. Participants who used any form of electronic cigarette also completed a standardized questionnaire to assess their degree of nicotine addiction.

About half of the participants had heard of Juul and 15.6% had used the brand. The other electronic cigarettes were used by 30.4% of the participants, while the conventional cigarettes were smoked by 24.3% of the participants. About two-thirds of the participants who used these products used more than one type of product: a combination of Juul, other electronic cigarettes, and conventional cigarettes.

Participants reported using Juul about twice as often as conventional cigarettes when asked about the use of tobacco products in the past seven or 30 days.

Believed to be less harmful

Participants felt that Juul electronic cigarettes were less harmful or addictive than the other products mentioned in the survey. However, among those who tried Juul, 58.8% reported using Juul in the last 30 days. Among participants who had previously tried other electronic or conventional cigarettes, 30.1% and 28.3%, respectively, reported having consumed them in the past 30 days. This is the most striking difference between Juul users and users of other electronic and conventional cigarettes, and it raises concerns about higher dependency rates among Juul users, Halpern said. Felsher. The answers to the validated questionnaire on the loss of autonomy in relation to nicotine consumption suggested similar levels of nicotine dependence between Juul users and those using other electronic cigarettes, she said. noted, although the relatively small number of participants limited the sensitivity of the questionnaire.

The findings of the study underscore the need for clear public health messages about the risks of new types of electronic cigarettes, including Juul, the researchers said. "The lack of clear messages is interpreted as a safety among teenagers," McKelvey said. Nicotine-containing products are particularly risky for teenagers, she added. "The sooner you are exposed to nicotine, the more likely you are to be dependent on your addiction throughout your life."

Teachers and parents also need better information, Halpern-Felsher said. "We need to identify and explain the new and different products containing nicotine to regulate them and prevent young people from using them," she said. "It took some time for teachers to realize that this product [Juul] existed and that what they saw in the classrooms were not USB sticks. "

Halpern-Felsher and his team have developed a free tobacco prevention toolkit, available online for educators, parents and others working with youth.

Mike Baiocchi, PhD, an assistant professor of medicine at the Stanford Prevention Research Center, was also an author of the article. Baiocchi is a member of Stanford Bio-X and Halpern-Felsher is a member of the Stanford Institute of Child Health Research and the Stanford Cancer Institute.

The research was funded by the National Cancer Institute (grant 1P50CA180890), the US Center for Tobacco Product Management for Food and Drugs, and the Institute for Research on Child Health.

The Stanford Pediatrics Department also supported the work

Other research on electronic cigarettes

On October 19th, Halpern-Felsher also published a comment on a smoking prevention program developed by Juul. The comment, which will appear in the Journal of Adolescent Health, worries about several aspects of Juul's curriculum. Juul provides schools with a $ 10,000 financial incentive to use his program and does not follow the best practices in teen smoking education, according to the commentary.

For example, the program does not discuss the role of the industry in marketing products containing tobacco or nicotine to young people, mentions little Juul and does not indicate why young people use the electronic cigarette or mentions that flavored products such as Juul can be particularly attractive to them. Jessica Liu, a graduate student at Yale University, did a summer internship at Halpern-Felsher's lab.

Earlier this month, researchers also published a study in Addictive Behaviors explore the perceptions that teens have of advertising for flavored electronic cigarette liquids. Manufacturers of electronic cigarettes, including Juul, claim that their flavors are not marketed to teenagers. Yet, when asked to view advertisements for flavored electronic cigarette fluids, most of the 255 teenagers participating in the study said they believed these ads were for their age group. . McKelvey is the principal author of this study and Halpern-Felsher is the main author. The other co-authors of Stanford are Baiocchi; research associate Divya Ramamurthi; and Sheila McLaughlin, Program Coordinator, Pediatric and Adolescent Medicine.