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Posted on: January 5, 2018 at 2:48 pm
Last updated: May 8, 2018 at 10:33 am

Remember that Dr. Scholl’s TV commercial where all those supposedly cool people were asking everyone else: “Are you gellin’?” Well, years later (and years younger), kids are asking a very similar question sounding question… Are you JUULing?

What Is JUULing?

According to JUUL, it’s “the satisfying alternative to cigarettes.” If you’re familiar with vaping, JUULing is proving to be a dangerous form of that ‘smoking’ method. While more studies are needed to really confirm or deny the adverse health effects of vaping, what makes it so dangerous is the sheer number of children and youth who are JUULing!

The Truth Initiative web panel surveyed 1,018 15-24-year-olds in the United States and, as reported by Reader’s Digest, it “revealed that 37 percent of teens were uncertain that they were inhaling nicotine, although it clearly states on the JUUL website that each pod is equal to 200 cigarette puffs. That’s like smoking a pack a day.”[20]

Some of the reasons why countless youth are flocking to JUUL products is because they’re sleek, taste and smell great, and are more attractive than cigarettes. It actually seems that youth are more in love with how they look JUULing as opposed to what they are JUULing. What’s worse is that many states do not yet have regulations or age restrictions for vape purchases.

“It’s extremely worrisome that teens and young adults do not know that when they JUUL, they are inhaling an addictive substance,” Truth Initiative CEO and President, Robin Koval.[21] “But it’s not surprising – many young people do not purchase their own vape products, and there will not be labeling requirements indicating that products contain nicotine until August 2018.”

A common argument is that it’s not actually smoke, it’s vapor, or that vaping is the lesser of two evils. However, that might not be true, at least that not what Brian King thinks.

“Safer is not the same as safe,” says King, the deputy director for research translation in the CDC’s Office on Smoking and Health.[25] “Nicotine is a prime ingredient in these devices [and] studies show nicotine is more addictive than heroin and cocaine. And there’s a growing body of evidence that nicotine can harm the developing adolescent brain… High school students are using e-cigarettes at a greater rate than adults.”

Know the Dangers of Cigarette Smoke (And the “Alternatives” On the Market)

Do you know what the leading cause of preventable disease and death in the United States? Cigarette Smoking which, every year, is responsible for 480,000 deaths or 1 of every 5 deaths. Let’s put this more into perspective. According to the Centers for Disease Control (CDC) most recent numbers, about 36,500,000 American adults currently smoke cigarettes. Additionally, around 16,000,000 Americans live with some type of smoking-related disease.[1,2]

This is beyond alarming. Especially when mountains of research and published studies continue to shine light on the devastating effects of cigarette chemicals and cigarette smoke. In a single cigarette, there are almost 600 ingredients. When burned, they collectively create over 7,000 chemicals, at least 69 of which are known to cause cancer.[3,4]

Just holding a cigarette between your fingers, it can be hard to believe there are that many chemicals in tobacco smoke. But, you can find those same ingredients in everyday products you wouldn’t ever choose to put inside your body…

11 Cancer-Linked or Cancer-Causing Chemicals Found in Tobacco Smoke

Here are just some of the chemicals and other places you can find them:[5]

  • Nicotine (the addictive component of cigarettes; used as insecticide)
  • Hydrogen cyanide
  • Formaldehyde (embalming fluid)
  • Lead (used in batteries)
  • Arsenic (found in rat poison)
  • Ammonia (a common household cleaner)
  • Radioactive elements, such as uranium
  • Benzene (found in rubber cement)
  • Carbon monoxide (released in car exhaust fumes)
  • Nitrosamines
  • Polycyclic aromatic hydrocarbons (PAHs)

Because of ingredients including the ones above, cigarettes are a regulated substance that come with countless warnings. In more recent years, however, cigarette “alternatives” have been gaining traction, minus the strict regulations cigarette manufacturers face. And that’s exactly why you need to know about them…

The Science Behind 5 Types of Smoking & Their Health Effects

Despite clear written warnings and graphic heart-wrenching images, different types of smokers are not ready to break their habit and leave the pack behind. But, in comparison to standard cigarettes, are these supposedly harmful alternatives truly worth the worry? Let’s take a look at the evidence.

1. E-Cigarettes

The electronic cigarette was created in hopes of helping traditional cigarette smokers kick the butt because of the attractiveness of replacing bitter smoke with aromatic vapor. However, the liquid put into e-cigarettes still contains varying levels of nicotine.

A 2014 study in Nicotine & Tobacco Research examined how the glycerin and propylene glycol nicotine solvent and battery output voltage affected carbonyls (i.e., bonded carbon monoxide molecules) in vapor. Researchers found that e-cigarette vapor does, in fact, contain toxic and carcinogenic carbonyl compounds.[6]

Although we need further studies before determining whether e-cigarettes are as toxic as traditional cigarettes, existing studies show that base ingredients in e-liquids (e.g., propylene glycol and glycerin) can cause eye and respiratory irritation and even potentially damage the central nervous system with this cessation stepping stone.[7]

2. Vaping

Just to clarify: traditional e-cigarettes heat (and, in effect, burn) the liquid before inhalation, whereas vaporizer e-cigarettes immediately vaporize the same liquid used in traditional e-cigarettes which skips the burning process. But does that make vaping any better?

As recent as a December 2016 study in Preventative Medicine Reports, the authors state that the “health risks associated with electronic cigarettes are largely unknown.” However, upon review of 26 case reports, researchers found that vaping did have some negative effects. Namely, inflammation in the respiratory and gastrointestinal systems, as well as nicotine poisoning.[8]

In a February 2017 article published by PubMed Health, researchers who conducted a landmark study deemed long-term vaping far safer than smoking. After studying 181 real-world smokers or ex-smokers, “researchers found significantly lower levels of toxic chemicals and cancer-causing substances (carcinogens) in the samples of those of former smokers who had been using e-cigarettes or nicotine replacement therapy (NRT) compared to current smokers.”[9]

3. JUUL

Two Major Health Risks of JUULing

(We’ve already talked about the dangers of JUULing, but here are a couple more reasons to keep the out of your home!They’re backed by science, too.[22-24] )

  • Diacetyl exposure, which can promote respiratory diseases (e.g., asthma and bronchitis)
  • Increases risk of smoking later in life[25]

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4. Hookah

Often used interchangeably with “shisha,” shisha actually refers to the practice of smoking a tobacco substance through a bowl pipe, AKA a hookah.[10] Either way, some people claim that because the smoke is ‘filtered’ by water, the tobacco smoke contains little to no nicotine, making hookah the least harmful way to smoke.

A March 2015 study published in Tobacco Control examined literature pertaining to waterpipe smoking (WPS) on three databases: PubMed, MEDLINE, and EMBASE. After reviewing all relevant clinical (human) studies, case reports and systematic reviews, researchers concluded that hookah smoking “acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and esophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems.”[11,12,13]

5. Standard Cigarettes

We touched on traditional cigarette smoking at the start of this article, but let’s go into a bit more detail… In 2004, the Surgeon General’s report concluded that there was indeed a causal relationship between smoking and several cancers – lung, larynx, oral cavity, pharynx, esophagus, pancreas, bladder, kidney, cervix, and stomach, colorectal, liver, and acute myeloid leukemia.[14]

A 2007 study published in The International Journal of Angiology, researchers linked cigarette smoking to numerous cardiovascular diseases including, atherosclerosis and coronary artery disease.[15]

Unfortunately, you don’t need to be a tobacco smoker to experience the adverse effects of cigarettes. This is made especially clear by a July 2000 study exploring the effects of husbands’ cigarette smoke on their non-smoking wives. Sadly, after the 14-year study, researchers found that non-smoking wives of heavy smokers had a statistically significant higher risk of developing lung cancer.[16] It may be time to evaluate nicotine cessation programs.

6. Marijuana

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The most topical of these types of smoking is marijuana.[17] In comparison to the cigarette alternatives above, it’s arguable that more positive news has been published about cannabis than negative. This is largely due to the push for medical cannabis and the potential benefits patients can reap for a number of health conditions.

In a patient survey published in 2014 in the Hawai’i Journal of Medicine and Public Health, researchers handed out surveys to 100 patients who were getting recertified for medical cannabis.[18] The results were astounding.

“The response rate was 94%. Mean and median ages were 49.3 and 51 years respectively. 97% of respondents used cannabis primarily for chronic pain. Average pain improvement on a 0–10 pain scale was 5.0 (from 7.8 to 2.8), which translates to a 64% relative decrease in average pain. Half of all respondents also noted relief from stress/anxiety, and nearly half (45%) reported relief from insomnia. Most patients (71%) reported no adverse effects, while 6% reported a cough or throat irritation.”

A May 2017 clinical review published in Cannabis and Cannabinoid Research acknowledged that more and more patients are turning to cannabis for pain relief. As a result, a surge in studies have started and even more are needed. However, researchers did “[find] modest evidence supporting the use of cannabinoid pharmacotherapy for pain. Recent epidemiological studies have provided initial evidence for a possible reduction in opioid pharmacotherapy for pain as a result of increased implementation of medical cannabis regimens.”[19]

Clearing the Smoke

For some people, kicking any type of smoking habit seems like a no-brainer. For others, the act of quitting itself is not as simple as it seems. However, it’s not hopeless. And, in the case of cannabis, the benefits seem to be outweighing the risks. Smoke cessation can lead to a happier and healthier life. Just see the links below.

[1] Same as 2.

[2] Morbidity and Mortality Weekly Report (MMWR). (2017, August 17). Retrieved January 04, 2018, from https://www.cdc.gov/mmwr/volumes/65/wr/mm6544a2.htm?s_cid=mm6544a2_w

[3] What’s In a Cigarette? (n.d.). Retrieved January 04, 2018, from http://www.lung.org/stop-smoking/smoking-facts/whats-in-a-cigarette.html?referrer=https%3A%2F%2Fwww.google.ca%2F

[4] Centers for Disease Control and Prevention (US). (1970, January 01). Chemistry and Toxicology of Cigarette Smoke and Biomarkers of Exposure and Harm. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/books/NBK53014/

[5] Harmful Chemicals in Tobacco Products. (n.d.). Retrieved January 04, 2018, from https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/carcinogens-found-in-tobacco-products.html

[6] Kosmider, L., Sobczak, A., Fik, M., Knysak, J., Zaciera, M., Kurek, J., & Goniewicz, M. L. (2014, May 15). Carbonyl Compounds in Electronic Cigarette Vapors: Effects of Nicotine Solvent and Battery Output Voltage | Nicotine & Tobacco Research | Oxford Academic. Retrieved January 04, 2018, from https://academic.oup.com/ntr/article-abstract/16/10/1319/2509282?redirectedFrom=fulltext

[7] Grana, R., Benowitz, N., & Glantz, S. A. (2014, May 13). E-Cigarettes. Retrieved January 04, 2018, from http://circ.ahajournals.org/content/129/19/1972.full

[8] Hua, M., & Talbot, P. (2016, December). Potential health effects of electronic cigarettes: A systematic review of case reports. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929082/

[9] Long-term vaping ‘far safer than smoking’ says ‘landmark’ study – National Library of Medicine – PubMed Health. (n.d.). Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2017-02-07-long-term-vaping-far-safer-than-smoking-says-landmark-study/

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[10] What is the difference between Hookah and Sheeshah? (n.d.). Retrieved January 04, 2018, from https://www.quora.com/What-is-the-difference-between-Hookah-and-Sheeshah

[11] Aslam, H. M., Saleem, S., German, S., & Qureshi, W. A. (2014). Harmful effects of shisha: literature review. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003490/

[12] El-Zaatari, Z. M., Chami, H. A., & Zaatari, G. S. (2015, March). Health effects associated with waterpipe smoking. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345795/

[13] Ali, M., & Jawad, M. (2017). Health Effects of Waterpipe Tobacco Use: Getting the Public Health Message Just Right. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428225/

[14] Centers for Disease Control and Prevention (US). (1970, January 01). Cancer. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/books/NBK53010/

[15] Saha, S. P., Bhalla, D. K., Whayne, T. F., & Gairola, C. (2007). Cigarette smoke and adverse health effects: An overview of research trends and future needs. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733016/

[16] Hirayama, T. (2000, July 01). Non-smoking wives of heavy smokes have a higher risk of lung cancer: a study from Japan. Retrieved January 04, 2018, from https://scielosp.org/scielo.php?pid=S0042-96862000000700013&script=sci_arttext

[17] The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. (n.d.). Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/28182367

[18] Webb, C. W., & Webb, S. M. (2014, April). Therapeutic Benefits of Cannabis: A Patient Survey. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998228/

[19] Hill, K. P., Palastro, M. D., Johnson, B., & Ditre, J. W. (2017). Cannabis and Pain: A Clinical Review. Retrieved January 04, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549367/

[20] How many cigarettes = 1 pod? (n.d.). Retrieved April 09, 2018, from https://support.juulvapor.com/home/learn/faqs/juulpods-juice#cigarettes

[21] Roland, E. (2018, January 09). JUULing Could Be As Dangerous As Smoking a Pack a Day. Retrieved April 09, 2018, from https://www.rd.com/advice/parenting/juuling/

[22] Starek-Swiechowicz, B., & Starek, A. (n.d.). Diacetyl exposure as a pneumotoxic factor: A review. Retrieved April 09, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/25272573

[23] Kreiss, K. (2017, August 01). Recognizing occupational effects of diacetyl: What can we learn from this history? Retrieved April 09, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323392/

[24] Allen, J. G., Flanigan, S. S., LeBlanc, M., Vallarino, J., MacNaughton, P., Stewart, J. H., & Christiani, D. C. (2016, June). Flavoring Chemicals in E-Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail-Flavored E-Cigarettes. Retrieved April 09, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892929/

[25] Grillo, J. (n.d.). Teen Vaping: What You Should Know. Retrieved April 09, 2018, from https://www.webmd.com/smoking-cessation/features/teen-vaping

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