It’s 10 a.m. on a regular school day at the Josiah Quincy Upper School located on the edge of Chinatown. A 15-year-old male student asks his teacher to use the restroom, which she allows. The student walks earnestly to the toilet, whips out his Juul, a popular e-cigarette product, and takes a long pull from the tobacco pen that resembles a sleek USB stick.
Clouds of odorless smoke waft through the bathroom stalls. After a few minutes of blissful puffing, the student decides it’s time to hit the books again and walks out of the boy’s room, a cloud of vape smoke following him. A teacher in the hall realizes what’s occurred and notifies staff that the child vaped on school grounds.
This event illustrates a somewhat larger “Juuling” problem at JQUS, according to the school’s Operations Team Leader Donna Harris, who shared the information about the incident. Harris reports that school administration learned of other underage Juuling instances at the beginning of the school year and understands that other unidentified students have also picked up the unhealthy habit.
PAX Labs, the initial makers of Juul, created their first products in the beginning of June in 2015. Since then, Juul broke off from its initial parent company to create Juul Labs and has since gained tremendous popularity over the past few years. Juul is the most popular e-cigarette brand in the U.S. today and currently holds a market share worth over 70 percent, according to the Winston-Salem Journal.
Juul Labs promotes their product on their website as “a satisfying alternative to cigarettes.” The company claims the e-cigarette is meant to help conventional smokers quit their unhealthy habit by offering a less-detrimental option that still satisfies a smoker’s nicotine cravings.
Though Juul Labs insists they market to the adult demographic, teenagers have still picked up Juuls across the nation, spreading a new dangerous fad that the Food and Drug Administration calls an epidemic.
How big is the problem?
While a Juul presence exists at JQUS, some school administration officials declined to equate it to catastrophic proportions. Boston Public Schools Press Secretary Dan O’Brien said he believes JQUS represents a portion of the other BPS schools who address occasional vaping instances.
O’Brien provided a comment on Juul use in the BPS system through a letter from former Superintendent Tommy Chang, which was issued to all students and families last spring. The letter outlines BPS’s policy as well as connections to resources for students with substance use/abuse issues.
“In the Boston Public Schools, some high school administrators are reporting instances of students in possession of vaping devices at school,” the letter reads. “Even though a 2017 BPS Youth Risk Behavior Survey shows the overall percentage of district students who reported using electronic cigarettes declined by 9 percent, we are always concerned about students engaging in risky behaviors.”
“I would not say the Juul presence at JQUS is an epidemic,” shared JQUS Principal Sarah Chang. “It has not been reported that Juul use is affecting classroom learning in a significant way.
But Harris believes that while not every student at the school Juuls, the “odorless epidemic” exists within JQUS.
Easy appeal
Juuling easily trended with the younger generation due to several factors, including the sleekness of the device, its user-friendly appeal, and the tasty flavored nicotine pods that power the e-cigarettes. Critics, like the FDA, argue that while Juul Labs insists they don’t advertise to adolescents, their marketing strategies on social media platforms contradict this.
Once minors give in to Juul enticements, it proves difficult for them to quit. According to health professionals, the product has high addiction potential. This is because Juuls use nicotine salt, which absorbs into the bloodstream at a much faster rate than the nicotine formulation used in virtually all other electronic cigarettes. Juuls elicit a sharp nicotine spike and the level of nicotine in the blood drops rapidly, creating a craving for more puffs.
With a growing number of teens hooked on Juuls, the FDA ordered Juul Labs and other alike companies in September to prove their products could stay out of the lungs of minors, or risk facing consequences.
Local efforts
Community organizations like Boston Asian Youth Essential Services (YES) are also aiming to limit underage Juul use through smoking cessation efforts partially funded by the Tufts Medical Center Asian Health Initiative.
“We’re looking at early education as a main way of stopping the spread of Juuls,” said Boston Asian YES youth advocate Trinh Britton at a Chinatown Coalition meeting last month.
“We also have new swag that promotes our message,” Britton said, displaying a shirt with anti-smoking sentiments.
Though Britton plans to tackle underage Juul use in Chinatown through seminars and lectures, no specific anti-Juul events have happened yet.
“We have not worked with any community organizations around the topic of Juul smoking,” Principal Chang acknowledged. “We are open to working with community organizations to bring education and awareness to students, teachers, and families.”
Curbing teen use
Juul Labs has also done its part to meet the FDA halfway and face the underage Juuling problem. The company suspended the sale of most of its flavored e-cigarette pods in retail stores and terminated most of its marketing on social media last month in an effort to keep their products away from children.
“We want to be part of the solution in preventing underage use, and we believe it will take industry and regulators working together to restrict youth access,” stated Juul Labs Chief Communications Officer Matt David.
Unintended consequences
The steps to take Juul products off of retail shelves and out of youth Instagram feeds may be alleviating underage use issues, but these actions create an entirely new problem. Many critics believe that by limiting access to these products, individuals who are trying to quit conventional smoking may have a harder time doing so.
Boston University Community Health Sciences Professor Michael Siegel said he believes conventional smokers who are trying to quit may suffer as a result of FDA pressures on e-cigarettes. Siegel also reasons that current stringent e-cigarette sales rules should also apply to regular cigarettes.
“It doesn’t make sense to eliminate the sale of virtually all electronic cigarettes in retail stores but continue to allow the sale of real cigarettes,” said Siegel. “At the very least, e-cigarettes and tobacco cigarettes should be on a level playing field.”
Siegel suggested that schools create media campaigns revolving around the idea that Juuls can take away a student’s freedom, alluding to the consequences of addiction that youths can face.
The state is committed to keeping Juul products out of the hands of minors through law enforcement and legislation, Supervising Attorney for Tobacco Enforcement Daniel Less shared. Retailers found guilty of selling e-cigarette products to adolescents face prison sentences and fines.
Less also highlighted efforts to limit the sale of e-cigarette products on the municipal level. Boston, Needham, and Medway are among the cities and towns that have passed ordinances to limit the sale of tobacco products, which includes the flavored pods that reflect a major selling point for minors.
Many agree that schools, retailers and the government can do more to limit youth access to Juuls, but an overwhelming number of officials believe support from families can lead to healthier children. In the end, parents are the deciding factor between a child picking up a Juul or leaving it alone.
The 15-year-old caught vaping in the bathroom at Chinatown’s JQUS was suspended from school, and Harris recommended the student’s family seek substance abuse assistance for teens. The family was not interested.
