The Latest Moral Panic: Juuling in the Classroom

Those who are old enough to remember the 1973 song "Smokin' in the Boys' Room" by Brownsville Station (and/or it's 1985 Motley Crue cover version) would certainly remember that there was a whole lot of actual smoking going on in school or at least on school grounds back then.  Since then, in part because of the declining popularity of tobacco in general and in part due to today's stricter rules and laws governing smoking in and around schools, such conduct has declined considerably.

But now, there seems to be a new moral panic du jour taking hold lately:  Juuling.  What's that, you ask?  Well, JUUL is a fairly new brand of e-cigarette (vaping device) that was first launched in 2015 and really took off in 2017 in terms of popularity.  As for why it is so popular, it probably has something to do with the appealing fruity flavors and the fact that it is very easy to conceal since it literally looks just like a USB flash drive and doesn't smell like tobacco.  High school (and younger) students apparently even sometimes sneak using it in class, thus if one were to ever do an updated cover version of the aforementioned song for 2018, it might as well be called "Juuling in the Classroom".

So what should we make of all this?  First, don't panic, lest we continue to fuel a deviancy amplification spiral rather than let this fad burn out on its own.  The good news is that combustible tobacco consumption is now at a record low among young people, and still falling.  Vaping is actually rarely used by teens who have never also tried combustible cigarettes.  If anything, vaping in general (including, but not limited to, Juuling) is displacing combustible cigarettes on balance, and is significantly safer as well--perhaps even 95% safer by some estimates.  The bad news?  Vaping is, of course, not completely safe, as most vape juices (including all JUUL brand ones, even if its users don't realize it) do contain nicotine, which is highly addictive and is even a known neurotoxin, particularly for the developing early adolescent brain.  Other concerns include the relative lack of regulation as to how these things are made and what sort of contaminants may be lurking inside, but again, it still pales in comparison to the dangers of combustible tobacco cigarettes, which contain literally thousands of other nasty chemicals as well as nicotine, including many known carcinogens, mutagens, and teratogens.  So insofar as vaping displaces smoking, it is a net win for public health.

Secondly, we should note that this apparent fad exists even in states and localities where the age limit is 21 for both smoking and vaping (or at least for buying these things), including New Jersey.  Thus, raising the age limit is unlikely to solve anything in that regard compared with keeping it 18 and enforcing it on vendors the same as with combustible tobacco products.  Keep in mind that until fairly recently there was no age limit at all for vaping devices and liquids/pods in many states and localities.

And finally, there are practical ways of reducing any potential harm from all of this:

• Regulate vaping devices and juices/pods the same as combustible cigarettes (but no stricter), and require strong quality control standards and testing
• Warning labels alerting users about the fact that they contain the addictive drug nicotine
• Tax nicotine-containing vape juices/pods by weight or volume adjusted for nicotine content (but much lower than combustible cigarettes)
• Increase the number of nicotine-free vape juices, particularly for Juul brand ones which currently lacks such options 
• Consider banning or phasing out any vape juices/pods that have fruity, floral, or any other non-neutral or non-tobacco-style flavors unless they are completely nicotine-free ones
• Educate the public, especially young people, on the truth about vaping, particularly with an eye towards preventing accidental addiction to something they may not even realize contains nicotine at all
• Social norms marketing to help defuse any deviancy amplification spiral

Most importantly, we need to see the forest for the trees, and stop tilting at windmills already. 

Latest 2017 MTF Survey Results

The results of the annual Monitoring the Future survey for 2017 are in.  And here is a brief summary of the results:

• Alcohol use in general as well as "binge" drinking among all three grades (8, 10, 12) remains at the same record-low levels as 2016.  
• Tobacco use overall in all grades continued its long decline to a new record low in 2017, particularly for cigarettes, though vaping (e-cigarettes) did increase slightly in 2017 after decreasing a bit in 2016.
• Cannabis use went up slightly in 2017 from 2016 after declining for several years, though generally still remains below 2012 levels, and of course far below the peaks in both 1979 and 1997.  This dovetails with another recent study of legalization states which found no significant increase in teen use post-legalization.
• Opioids, including heroin, remain at very low levels among teens, while the opioid epidemic continues largely unabated among adults.
• Inhalant use went up slightly among 8th graders after a long decline, though still remains at low levels.
• All other substances decreased or saw no significant change either way in 2017.

So what can we conclude from all of this?  First, we can conclude that cannabis legalization did not increase teen cannabis use as the fearmongers claimed it would. Nor did the use of other substances increase as the "gateway" theory would have predicted--in fact, most other substances decreased.   So much for that theory.  Second, it would appear that e-cigarette vaping is to some extent displacing cigarette smoking, rather than exerting a "gateway" effect as was often feared--smoking would have increased along with vaping if those fears were true, and in fact the opposite has occured instead.  Which any way you slice it, is ultimately a net win for public health even if vaping is not completely harmless.  In fact, the drop in cigarette smoking was much faster from 2013-2015 than it was in the years before or since, coinciding with the period of greatest increase in e-cigarette use.   And finally, we can conclude that the kids are (mostly) alright, at least compared to the many adults around them who continue to drink themselves to death and/or rot and rust in opioids.