WATERTOWN — The Youth Alliance of Jefferson County says a marketing denial for Juul won’t ease the vaping epidemic among youth.
In 2020, Juul Labs had voluntarily discontinued sales of its fruity and other flavored products after backlash over a rise in youth vaping rates. But the company had submitted four tobacco- and menthol-flavored products for Food and Drug Administration authorization. After a roughly two-year review of the applications, the FDA on June 23 ordered Juul to remove its remaining products from the market, contending that the company gave insufficient or conflicting data about the potential risks of using its products.
Juul Labs has been granted a temporary stay on the order banning its products and is seeking an extension in court. Juul argues the FDA overlooked company data in the review of its applications.
Tammie J. Nabywaniec, director at the Youth Alliance of Jefferson County, said a removal of Juul products from the market is not likely to curb vaping as there are other types of highly addictive “disposable” devices with high nicotine content, flavors, colorful packaging and much larger puff counts — all for a relatively low price.
In a recent spring take back campaign with four local school districts, 160 devices were collected and turned over to the Youth Alliance. Of those, 133 were nicotine devices. Only 21 were Juul devices. Nineteen contained some form of marijuana and eight were not manufactured devices, which are referred to as “homebrews.”
“I think that’s important for people to realize is that Juul is just not the most-used device anymore,” Mrs. Nabywaniec said. “Kids made adjustments very quickly because they have access to social media, which tells them what the best and cheapest devices are. They moved to it faster than parents, community members — before we could even prepare ourselves.”
With Juul devices, the liquid cartridges can be removed and disposed separately. With the new vaping products that are being marketed as “disposable,” that is not an option as they are just one piece with no removable parts, which Mrs. Nabywaniec called a huge environmental concern. While Juuls generally have about 200 puffs per cartridge, these supposedly “disposable” devices have puff counts of 2,500 to 5,000, and come in a variety of flavors.
Mrs. Nabywaniec said she and the Youth Alliance have presented on youth vaping to local and state officials, Jefferson County’s attorney, the county’s district attorney and representatives of the Substance Abuse and Mental Health Services Administration.
On Wednesday, Mrs. Nabywaniec hosted a Zoom meeting with local, regional and state organizations for a conversation about how to address youth vaping.
North country participants in Wednesday’s Zoom included representatives from Pivot, the Watertown Police Department, the Watertown regional office of the state attorney general, the Alliance for Better Communities, Watertown City Council, public health representatives from Jefferson and St. Lawrence counties, the Jefferson County Board of Legislators, the Fort Drum Army Volunteer Corps, Jefferson County Probation, the Watertown Family YMCA and local school districts. Members of SAMHSA and representatives from health departments and communities out of state also participated.
The groups are focusing on disposal methods; addressing the ease of purchasing online and in person; addressing the illegal shipping of devices through the U.S. Postal Service; and continued movement by the FDA to regulate other products. This includes oversight of nicotine salts, flavored vape juice, and nicotine or other substance concentrations available on the market.
“I think talking to everybody, what I would see is moving forward a monthly meeting where we can kind of give an update of where we are in our own individual communities, but also dividing up,” Mrs. Nabywaniec said. “It’ll allow us to kind of move forward in different communities and then be able to identify who wants to work on the environmental side who wants to work on the underage side in those components. This may be something that we work on for months, maybe longer.”
The latest vapes are referred to as disposable or “single use” and cannot be refilled after all the puffs are gone. As they are the primary devices used by youth and young adults, the local committee is concentrating on the regulation and enforcement of single-use devices.
Sending any electronic nicotine devices through the mail carries a misdemeanor charge and fine of up to $5,000, or $100 per vapor product. Devices are primarily being sent through the U.S. Postal Service, Mrs. Nabywaniec said.
She said she meets with local school resource officers once a month and will begin inventorying what they’ve collected and put out a summary of findings every quarter.
The goal is to enforce restrictions and make vaping devices inaccessible to youth. Mrs. Nabywaniec said her group at the Youth Alliance will be working this summer to develop support programs and information about how to handle withdrawals to share in the fall with parents, youth, schools and community members.
“If our kids are telling us anything, it’s that taking the product away is not working, that they really need some cessation help and some assistance,” she said. “So that will be another avenue that we are working through on our end.”
Online companies, like Hyde, promote a rewards system, discrete and free shipping, a flavor menu and other incentives, with only one click required for a website visitor to claim they are at least 21 years old. But flavored vapes are also sold in stores despite their sale being illegal in New York.
Mrs. Nabywaniec said one of the concerning characteristics of single-use vapes is that they cannot be recycled because, unlike the Juul devices, the liquid cartridges cannot be safely removed for disposal. Yet they’re popular for a variety of reasons, including puffs compared to price. A Juul has around 200 puffs per cartridge, which may run $5 to $7 apiece. Devices labeled as “disposable” have 2,500 to 5,000 puffs and run between $10 and $20.
“There’s no legislation in place right now for this, and there is no legal disposal,” Mrs. Nabywaniec said. “They’re paying attention to Juuls, and things like that. Nobody’s paying attention to what our kids are actually using.”
According to the Centers for Disease Control and Prevention, the most common reason for trying e-cigarettes given by middle and high school students in the U.S. is “a friend used them.” The most common reason youth give for continuing to use e-cigarettes is “I am feeling anxious, stressed or depressed.” In 2021, most young people who reported using e-cigarettes used flavored varieties, 84.7%. Among middle and high school students who used any type of flavored e-cigarette in 2021, the most common flavors were fruit at 71.6%, candy, desserts, or other sweets at 34.1%, mint at 30.2%, and menthol at 28.8%.
The CDC states that e-cigarette vapor that users breathe from the device and exhale can contain harmful and potentially harmful substances including nicotine; ultrafine particles that can be inhaled deep into the lungs; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds; cancer-causing chemicals; and heavy metals such as nickel, tin and lead. It can be difficult to determine what e-cigarette products contain. For example, some e-cigarettes marketed as containing no nicotine have been found to contain nicotine.
In May 2020, the New York State Department of Health announced that two signature pieces of Gov. Andrew M. Cuomo’s Comprehensive Tobacco Control Policy had taken effect. The first law prohibited the sale of flavored nicotine vapor products, and the second banned the sale of all tobacco and nicotine vapor products in pharmacies. According to the Department of Health, flavors are largely responsible for the dramatic increase in use of e-cigarettes by youth over recent years and are a principal reason that youth initiate and maintain e-cigarette use.
“Unfortunately, we know that the flavor devices are in most of our vape and smoke shops here locally,” Mrs. Nabywaniec said. “And from our focus group work, we know that there are a lot of kids who are purchasing them under 21 years old. I do believe one of our biggest things that we’re hearing back in focus groups is that our kids are buying in local smoke and vape shops, and providing IDs is not being as enforced as it should be.”