A Bunch of Smoke and Mirrors

There are still a lot of unanswered questions about the true health risks of vaping, but its unwavering popularity is scary. 

Popular culture has the ability to make anything mainstream. From certain fashion trends to the hoverboard, there are always new developments waiting to infiltrate the general public. Some of the trends, like the now fossilized hoverboard, have short lifespans and are quickly replaced with the newer and trendier. Other products can evolve into cultural staples and are pushed to the forefront of a new generation. 

Vaping has reached these heights. Vaping is the action of inhaling and exhaling the vapor produced by an electronic cigarette or a similar device that may look like a flash drive. Vapes are now most commonly associated with Generation Z, which is the demographic group of those born in the mid-1900s to early 2000s, because vape companies target younger age groups. It is impossible to walk around any major city without seeing at least someone 25 years or younger vaping to their heart’s desire. There is a lot of advertising by way of TV commercials and billboards that promote vaping as a tool to quit smoking cigarettes. A lot of these ads simply promote it as a cool thing to do, especially with the availability of all of the different flavors. The variety of flavors gives the vape a taste that will appeal to pre-teens or children who might view it more as a toy with  a sweet taste rather than something that could damage their lungs.

Juul Labs, a company established 2015 in San Francisco, is the face of the vaping movement. The company created and sold 17 million units of a vape fittingly called the juul. The juul is the most popular commercial vape, and the company has taken over the whole nicotine scene by being one of the first companies to target the youth rather than adults who are looking for an alternative source of nicotine. The branding of the juul as a modern cigarette alternative took the whole vaping industry to a higher status within party and popular culture. It isn’t just Juul Labs —  a variety of other vape companies like Suorin or Smoktech are benefiting from the popularity of e-cigarettes as well.

The start of the now-established vaping industry can be traced to a marketing campaign that began when Juul launched and ended in late 2018. It featured a social media heavy campaign to reel in the youth at the high school level. This campaign was described in a Vox article by Julia Belluz which stated that “Juul launched a “Vaporized” campaign. Again, its colorful ads — blasted out on billboards, in magazines, and on social media — featured happy, playful 20-something models.” The slogans that were featured in Juul marketing campaigns featured tag lines like “simple, smart, intensely satisfying” or promises to “improve the lives of the world’s 1 billion adult smokers by eliminating cigarettes.” By promoting the juul in a fashion that implies it carries less consequences than smoking a cigarette, Juul entered the mass market with more innocence than big tobacco companies, which are legally required to provide a health warning statement upon sale. Once the ball started to roll when it came to marketing, it led to the youth maintaining the marketing as it became cool to vape, especially to use a Juul. All that it takes for a nicotine product to stick is for some audience to use it. Following the start, people become hooked for life and the companies receive marketing from the people as they will promote the product themselves. This was the manner in which Juul Labs is able to sustain momentum in the marketplace. 

This targeting of a younger audience soon became apparent to regulators and it led to a response from the Food and Drug Administration. It issued the following statement on September 9, 2019.

“The U.S. Food and Drug Administration issued a warning letter to JUUL Labs Inc. for marketing unauthorized modified risk tobacco products by engaging in labeling, advertising, and/or other activities directed to consumers, including a presentation given to youth at a school.”

The warning did result in a halt of the marketing towards the younger audience as they toned down the social media usage. Still, the popularity established prevented the warning from affecting the sales. 

Many argue that only strict legal regulations will lead the product to losing steam. So far the states that have banned vaping sales or pursed policy for vaping regulations include New York, California, Washington, Massachusetts, Rhode Island, and Michigan. Most of these come as a response to the aftermath of the incidents related to vaping. With the recent media coverage, the politicians have felt the pressure to push some sort of policy. 

Their audience has reached high schools, college campuses, and even middle schools alike as stress and party culture has led it to uncharted popularity even on a smoke-free campus like UC San Diego.

The possible health risks are still up in the air, but there have been enough studies done in order to establish some risks that are known and others that are simply being projected by the stigma of smoking.

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According to the Center for Disease Control and Prevention, there have been 1,299 probable lung injury cases since 2016 that have been a result of vaping. Thirteen percent came from products that only contain nicotine and 58 percent came from nicotine products that have THC, the main ingredient in cannabis, in them. Fifty-four percent of these patients were 24 years or younger, the typical age of a college student. There have been 26 deaths from these cases. Although it appears to be that the cartridges with THC infused with nicotine have been the cause of most lung injuries, there some of the injuries have been caused by extreme usage of juuls. Introducing vaping into a young audience itself does contribute to the vaping injuries to some extent and Juul Labs can’t avoid the blame by pointing to the THC as the problem itself. The making of the vape mainstream does lend them liable to all of these injuries. 

These incidents have led to political measures being seriously considered. The city of Los Angeles is considering a ban of all e-cigarettes. 

“The city of Los Angeles is not content to wait and do nothing as the numbers of illnesses and even deaths associated with unregulated vaping devices increases daily,” Councilmember Paul Koretz stated in USA Today.

His announcement came a couple of days after President Donald Trump called for the banning of e-cigarettes. 

“We want to discuss the situation because not only is it a problem overall but, really, specifically, with respect to children, we’re getting some stories that we don’t want to hear,” he said at a White House hearing. “And we may very well have to do something very, very strong about it.” 

The recent activity from these politicians, especially Trump, symbolizes a murky future for Juul Lab and other companies, as they may have their products pulled until there is definitive proof that vapes do not cause significant harm. 

The solution to the vaping problem is not as simple as restricting vape sales. Some good has come from the rising popularity of vapes: e-cigarettes have helped cigarette smokers quit by knowing that there are other ways of receiving nicotine and they are even more accessible. The lack of long-term studies on vaping effects is concerning due to simply having a lack of information, but it is known that cigarettes are directly linked with lung cancer. A UCSD student who wished to remain anonymous explained how vaping helped him significantly cut back on his once-heavy cigarette use. 

“Vaping fills the need for nicotine that cigarettes created,” he said. “As a whole, it’s more pleasant and accessible at all times. With a cigarette, you have to smoke the whole thing at once, but with a vape you can pace yourself. It just became more practical and I am still getting nicotine.”

There is a lot of value in transitioning people away from cigarettes into an alternative method of receiving nicotine. For adults who struggle with smoking cigarettes, vaping provides a way to buy time until they can possibly quit smoking all together. A study done by the New England Journal of Medicine showed that e-cigarettes allowed for 18 percent of smokers to quit while other methods like nicotine gum only yielded 9.9 percent of people that stopped smoking. It concluded that, “E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support.” The demonization of vaping could potentially lead people who have transitioned to go back to cigarettes and erase some of their progress via bans on vapes.  

The question looming over the vaping industry is about the long-term effects of vaping and whether it is definitely better than smoking a cigarette. Although the chemicals and carcinogens are different when it comes to vaping, that doesn’t make them better. There is a lack of answers when it comes to this question as there are a lot of studies that contradict each other in different fashions. 

A now infamous study conducted by Public Health England concluded that “the results of the demonstration visually illustrate the stark contrast between the impacts of smoking and vaping. Research estimates that while not risk-free, vaping is at least 95 percent less harmful than smoking.” The results should be promising for vaping, but there was a lot of backlash based on these findings as they were commonly criticized. Dr. Albert Rizzo, Chief Medical Officer for the American Lung Association, told the New York Times that, “To say that something is safer than a product like cigarettes that kills seven million people in the world each year because of tobacco-related disease, and half a million people in this country, is not saying a lot.” Contracting findings like these are commonplace throughout the scientific community as there simply hasn’t been much time to analyze the effects that vaping has on people and their bodies. Making very extreme claims on either side would be unfair to the scientific method. 

On the other hand, a study by Dharma N. Bhatta, and Stanton A. Glantz published in the Journal of the American Heart Association concluded that the “Effect of e‐cigarettes are similar as conventional cigarette and dual use of e‐cigarettes and conventional cigarettes at the same time is riskier than using either product alone.” This finding would coincide with studies that show nicotine causes problems with blood pressure and the heart as a whole. Finding a direct link to lung cancer has not been cemented yet as it is early in the life of vaping, but there is risk of heart problems in the future via consumption of nicotine. The combination of these potential cardiovascular risks and the lurking threat of the chemicals found in vape leads to an alternative to cigarettes that can be potentially just as dangerous.

At the end of the day, vaping will remain as a prevalent feature of culture for our generation going forward. It has been normalized among Gen Z and has a good portion of teenagers already hooked. Significant evidence argues that e-cigarettes are not safe to use and that they actually provide detrimental health risks. The following steps of the government and other regulators will prove to be important as more studies are done into the health risk of vaping. Until then, there will be just as many questions about vaping as about the exact concerns for anyone who is already vaping or looking to start. There is potential for the marketing of vaping products to cause serious health problems for those that are already hooked, or it may end up being a legitimately viable tool for those looking to turn to a healthier way of smoking.

Illustration by Leanne Chen.

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