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!