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Blowing on Juul pods is just as effective in reducing tobacco-related biomarkers as total smoking abstinence. This is the conclusion of the data from the historical study published Saturday at the 2019 annual meeting of the American Society for Research on Nicotine and Tobacco.
Juul Pines for FDA approval
This small clinical study is the first company of Juul Labs, manufacturer of popular nicotine sprays. The former Silicon Valley start-up has three other studies underway and hopes to compile enough positive data to convince the FDA to approve Juul before 2022.
Juul's earnings took a hit (heh) at the end of last year with the decision to limit pod sales in certain flavors. but the company expects a turnover of 3.4 billion dollars in 2019 (!) https://t.co/gWqryXd0Zw – from @OliviaZaleski and me
– Ellen Huet (@ellenhuet) February 22, 2019
Juul Labs argued that Juul is safer than cigarettes and is an effective helper to quit smoking. The latter was demonstrated in a study of the New England Journal of Medicine published last month. Sprays have been shown to be almost twice as effective at quitting smoking as aids such as nicotine gums and patches.
Juul Labs now seems to have taken the first step to prove its safety against cigarettes by publishing data showing a massive decrease in several cancer-related biomarkers a few days after the cigarette was passed to Juul.
The study was sponsored by Juul Labs but conducted by the third party research laboratory Celerion Inc.
The sample size of the study is small and there are still several health problems to be resolved with regard to flavored nicotine pods, which are very popular among adolescents. But this is a necessary start in society's quest to bring regulators to its side.
What show the data of the Juul study
The study of 90 adult cigarette smokers looked for changes from the baseline values of nine short-term, specific cancer-related biomarkers, which are a by-product of the consumption of combustible cigarettes.
The study participants were divided into six randomized groups of 15 for the five-day hospital. Members of four of these groups switched cigarettes to one of four different juul flavors with 5% nicotine. Of the two remaining groups, one continued to smoke, while the other had nothing at all, forced to exercise caution.
The data obtained was conclusive. There was an 85% reduction from the baseline values of the nine biomarkers selected from the abstinence group and the Juul combined groups. These biomarkers increased by 14% among cigarette smokers.
Juul reduced some of the biomarkers of cancer a little less than stopping smoking. (Source: PRNewsfoto / JUUL Labs, Inc.)
"The equivalent reductions in these cigarette-specific biomarkers in the non-smoking groups and those who used the JUUL products reaffirm the role that vapor-based products can have for the adult smoker," said Kevin. Burns, president of Juul Labs, in a press release.
Although the results are good, they were not totally unexpected. The biomarkers studied are all related to tobacco, a substance that Juul does not contain. Nevertheless, there is now a small sample of clinical data proving Juul's ability to significantly reduce carcinogenic biomarkers in former cigarette smokers.
How do tobacco stocks react to the results of the Juul study?
Tobacco stocks Philip Morris (red) and British American Tobacco (red) were relatively unaffected by the results of the study, although Altria – which is partly the owner of Juul – grew about 0.85 % this week.
Tobacco stocks have been pushed up because of lower prices at the end of last week, but this momentum is stalling this week. Altria Group (MO), which holds a partial stake of Juul Labs at 35%, is the best, with an increase of 0.85%. His rival, Philip Morris (PM), lost 0.2%, while British American Tobacco (BTI) lost 0.23%.
For now, the results of the study do not seem to influence investors, even if Altria seems to be gaining ground. Quoting positive clinical data will certainly enhance Juul Labs' marketing efforts and legitimacy as a cessation aid. This could in turn convince more people to switch from cigarette to steam.
However, it will take more than that for the FDA and doctors to recommend devices to smokers, which would be the real concern of investors in the tobacco industry. Given their effectiveness as helpers, tobacco companies want as few Juuls as possible to be in the hands of smokers.
Why regulators are worried about vaping
Juul Labs' small study does not address the most important concerns of regulators about vaping. Although vaporizers have been shown to be even more effective than approved cessation aids in getting people to quit smoking, they are also much more unhealthy than these options.
Previous studies have shown that potentially hazardous concentrations of toxic metals and other harmful substances such as arsenic and manganese can be trapped in the aerosol particles of electronic cigarettes. Heated coils that cook flavored liquid cartridges are to blame for the increased presence of toxic metals such as lead, chromium and nickel.
"[…] In the current state, these heating coils seem to release toxic metals, which then enter the aerosols inhaled by the vapors, "said Assistant Scientist Ana María Rule of the Department of Environmental Health and Engineering. Bloomberg School.
Juul uses "a standard wick and nichrome coil system" to heat his liquid cartridges.
The long-term inhalation of toxic metals increases the risk of adverse effects on the health of the lungs, liver, brain and cardiovascular systems. Nicotine itself has also been associated with several major health problems and is highly addictive.
Thus, although vaping may very well be safer than smoking, it is not a feat in itself. This is not even relevant at all in some cases, as not everyone who takes vapors does so to stop smoking. Many begin with vaping, including people who may never have smoked. And this has clearly been the case in adolescents.
Why Vaping is so popular among teenagers
The use of vaping in adolescents has become an "epidemic," according to the Surgeon General, who specifically cited Juul in a report last year. There was a 900% increase in e-cigarette consumption among teens between 2011 and 2015, before the two years of decline. The growing popularity of Juul, however, has led to a resumption of its use in 2018. In a single year, the number of vapers among high school students jumped by 78% to represent more than 20% of all students.
Sprays like Juul are particularly popular among teenagers for their compact size and technological cachet. They can be refilled in less than an hour and, in the case of Juul, the cartridges are offered in a variety of flavors particularly appealing to younger users. Some of these flavored brands have been shown to contain more harmful chemicals than standard packaging.
30.7% of e-cigs users started to smoke within 6 months, while 8.1% of non-users started to smoke. | Source: National Institute for Combating Drug Abuse
The Juul study also showed slight variations in nicotine levels depending on the flavor. The mango flavor increased nicotine levels by 25.3% from baseline, slightly less than the regular smoker group (26.1%). The taste of Virginia Tobacco was much less powerful, lowering nicotine levels by 6.5% compared to baseline levels.
A study published last week by UNC at Chapel Hill concluded that attractive flavors encouraged children to take steam. He suggested banning all the likes of electronic cigarettes.
Juul Labs began recalling its own flavors on store shelves at the end of last year as a result of FDA pressure to limit vaping among young people. The company has also removed its social media platforms. Flavored pods are still on sale on Juul's website, with age verification checks in place.
"Our intention was never to have young people use Juul products. But the intention is not enough, it is the numbers that matter and these figures tell us that the use of electronic cigarette products by minors is a problem. We have to solve it, "said CEO Burns at the time of the announcement.
In the meantime, Juul Labs has taken a step in legitimizing as a smoking cessation aid for adults. More steps are still needed though.
Featured image of EVA HAMBACH / AFP
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