We Hereby Excommunicate JUUL Labs

(Editor's Note:  Twenty-One Debunked has never been affiliated in any way, shape or form with JUUL Labs or any other vaping, tobacco, alcohol, or cannabis company.  And we never will be, either.)

Dear JUUL Labs,

Since you were founded in 2015 as a spinoff from Pax Labs, you have always presented yourselves, at least publicly, as the underdog saving the world in the fight against the evil Big Tobacco.  Little did America know that you were about to pull the wool over everyone's eyes and make fools, and then cynics, of us all.

Why do we hate thee, JUUL?  Let us count the ways:

• You loudly proclaimed yourselves as the enemy of Big Tobacco, but you began to copy their playbook awfully quickly in terms of advertising to young people and cynically attempting to implement your own "anti-vaping" progams in schools. (You claimed that was just an oversight.)
• You chose a much higher nicotine level for your products than other vape brands, by far.  That was most likely to try to edge out the competition, and it worked--at the expense of a new generation of nicotine addicts, that is.
• You lowered your nicotine content when selling in the European Union and Israel (who by law set the maximum allowable nicotine content of vape products much lower than the American version of your products), but curiously still do not offer such reduced-nicotine products in the USA, or any nicotine-free products.
• Until very recently, you failed to adequately warn users that your products contain nicotine and are addictive.  Many young people did not even know that all JUULs contain nicotine, let alone such a high level of it.
• When the FDA finally blew the whistle on you, you responded in the most cowardly way possible.  You decided to throw young adults under the bus by calling for the age limit for vaping products to be raised from 18 to 21, and you banned 18-20 year olds from your website.  And you still made no significant changes to your highly-addictive products, save for the removal of a few flavors.
• And worst of all, you literally SOLD OUT to Altria Group (aka Philip Morris), whose name is literally synonymous with Big Tobacco.  You know, the evil industry you once claimed to be fighting against?  Your deal with the devil may have made you richer and bought you some temporary protection, but everything comes with a price, and your day will come very soon.

Thus, in light of the above grievances, we hereby excommunicate you.  Here is your bell, book, and candle, you cowardly quislings.  Now go take your crack nicotine and shove it!

Say It Ain't So, Governor Cuomo! New York State To Raise Smoking/Vaping Age To 21

No, this is NOT an April Fool's Day joke.  New York State is now set to become the eighth (or ninth?) state to raise the age limit for tobacco and vaping products to 21.  The legislature passed it, and Governor Cuomo is expected to sign it.  If (really, when) he does, it will take effect in 120 days.  Which is very, very soon.

Many counties and cities in the state, including NYC and most of its "backyard", already set the age limit at 21.  That of course includes my home county of Westchester, which raised it from 18 to 21 last year.

The only silver lining is that the new age limit of 21, like the old age limit of 18, will only apply to vendors, as it will still not be illegal for "underage" people to possess or consume tobacco or vaping products.   But that still does NOT mean we should support it one bit!

With the "bookend" states of California and New York now down, plus several other populous and not-so-populous states, not to mention hundreds of localities across the country, and even our nation's capital, is our movement lost for good?  We sure hope not.  It looked like the Tobacco 21 movement had stagnated last year, but now with New York, Utah, and possibly Washington State next to jump on the bandwagon, perhaps we got too complacent last year.  It certainly does NOT bode well for any near-future attempt to lower the drinking and toking ages to 18!

Hindsight is 2020, both the year and the vision.

What's The Best Way To Reduce Teen Vaping? Teens Already Know The Answer

As bewildered chronological adults wring their hands and scratch their heads on how to best fight the teen vaping "epidemic", a recent article came out in Utah that actually asked teens themselves how to do it.  The answer was simple:  tax the hell out of it to make it more expensive.  Gee, who woulda thunk it?

Notice they did not say anything about raising the age limit, by the way.   America's experience with combustible cigarettes has shown that raising the price, via taxes or otherwise, seems to be the most effective and cost-effective way to do it.  And while it works for all ages, the effect size is larger for young people since they are more price-sensitive overall.

Of course, if vape taxes are raised, care must be taken to also raise combustible tobacco taxes so as not to inadvertently steer young people back to smoking.   And as long as vaping remains an available alternative, cigarette taxes can go much higher than they are now (except New York) without creating too much of a black market.   Thus vape taxes should go up, and cigarette taxes should be even higher still.  And only nicotine-containing vape juices and pods should be taxed significantly, ideally proportional to nicotine content.  (Hardware devices themselves should only be taxed modestly, if at all.)

Other effective measures we have noted include capping and reducing the nicotine content of vape products down to European and Israeli levels (JUUL, we're looking at YOU), strictly enforcing the 18 age limit on vendors for all tobacco and nicotine products, and perhaps also removing kid-friendly fruity flavors of nicotine-containing vapes from the market.  But raising the age limit any higher than 18 should quite frankly not even be considered.   Too bad Utah is now the latest state to NOT heed that last bit of advice.

Israel's (and Europe's) Non-Ageist, Cool-Headed Response to Vaping

Unlike in the USA, it seems like cooler heads are prevailing in Israel and in the EU when it comes to vaping.  Rather than respond from a position of moral panic over teen use, which only fuels the deviancy amplification spiral, they instead took a much more measured public health response.  Israel recently banned JUUL due to its unusually high nicotine content, and almost immediately afterwards, JUUL began selling the same reduced-nicotine version there that they have already been selling in the UK and Europe to comply with EU regulations.  And interestingly, Israel doesn't even have an age limit for vaping.  (It varies in Europe, and is 18 in the UK.)

The kernel of truth to the concern about youth vaping in the USA has to do with the nicotine, which is hardly a benign substance.  It is a highly addictive drug as well as a known neurotoxin, especially for the early adolescent brain, and yet some teens apparently don't realize that vape juices and pods even contain nicotine at all.  And with JUUL's high nicotine content, by the time some young experimenters realize that it has nicotine, they may already be hooked.  That said, vaping is still safer than smoking, and it seems to be making a dent in reducing youth and adult smoking rates, which are currently at a record low, as well as increasing successful quit rates among adults.  That means that vaping is literally saving people's lives.

The best balancing act would probably be to stop panicking and to cap and reduce the maximum allowable nicotine levels for vape juices/pods to European and Israeli levels.  The FDA already has the authority to do this.  Alternatively, or in in addition, taxing vape juices/pods based on nicotine content would also be a good idea as well.

And stop panicking already!  Seriously, this moral panic is the best free advertising that JUUL and other vape companies could ever possibly dream of.

Oh, and by the way, there is zero evidence that raising the age limit to 21, as was done in several states and localities recently, has had any measurable impact on teen vaping OR smoking rates compared to states and localities that kept it at 18.  And since the apparent success of Needham, MA still has yet to be replicated anywhere, it would be most parsimonious to consider them an outlier, with factors other than raising the age limit being the real underlying causes of success.

Tempest in a Vape Pod: Let's Be Adult About This

Just a few months ago, we at Twenty-One Debunked posted an article about the latest moral panic to sweep the nation: teen vaping, particularly Juuling.  Well, that particular moral panic is now at (or approaching) its ultimate crescendo as we speak, with the FDA not only cracking down on retailers who sell to people under 18, but going so far as to give vendors an ultimatum of sorts:  either they come up with a plan within 60 days to tackle youth use of their vape products, or such products will be pulled from the market.  Such fighting words, aimed primarily at JUUL, have been prompted by largely unpublished data showing an alleged "epidemic" of teen vaping.

Wait, what? Oh, they must mean the "epidemic" where a whopping 2.4% of high school students in 2017 (2.0% in 2015) nationally reported daily vaping.  (And that is the total--keep in mind that among never-smokers, such figures are even lower still, at 0.3%)  Or maybe they mean the "epidemic" in which e-cigarettes have become more popular than combustible cigarettes in terms of experimentation and casual use, and regular vaping is making a dent in displacing regular smoking, but regular vaping among never-smokers still remains vanishingly low, and the use of combustible cigarettes has fallen to a record low.

Yes, you read that right.  A record low. Smoking cigarettes is decidedly "uncool" these days.  And by some measures, vaping has already crested and it too has also declined a bit as well since its 2015 peak.

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, we must repeat, is that combustible tobacco consumption is now at a record low among young people, and still falling.  And again, 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.

For currently addicted smokers of any age trying to quit, vaping can literally save their lives upon switching, and we must remember that no matter how much of a fever pitch the ridiculous moral panic over teen vaping ultimately reaches.  Seriously.

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 highly 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 lack 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
• Consider capping/reducing the maximum nicotine content in vape juice/pods, as is already the case in the EU and now in Israel as well.
• Educate the public, especially young people, on the truth about vaping, particularly with an eye towards preventing accidental addiction to something that 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.

And most ironically of all, this moral panic driven by irresponsible yellow journalism is literally the very best (not to mention free) advertising that JUUL and other vape companies could ever dream of.  Despite being founded in 2015, it is unlikely that very many young people (or anyone else for that matter) had ever even heard of JUUL until it became at the center of the scare stories that started in 2017 and especially 2018.  And if the alleged unpublished increase in teen vaping in 2018 relative to 2017 does turn out to be real, well, we really know who to thank for that!