What rules for e-cig?

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Earlier this month, the U.S. Food and Drug Administration proposed new rulesthat would restrict  flavored e-cigarettes and tobacco products that have lured young people into vaping and smoking.Fast Company, a media outlet that “chronicles how changing companies create and compete”, recently published a profileof  Juul, a company founded in 2017 to make and sell  e-cigarettes.   Juul is now valued at more than $16 billion and controls 72% of the U.S. e-cigarette market.   It’s also hooking teens on nicotine and drawing scrutiny from the FDA. Can the company innovate its way out of a crisis it helped create, asks Fast Company?

Another story last week, this one in The New York Times, describes how Matt Murphy, a high school senior then 17 years old in Reading , Massachusetts, become addicted to Juul.  “It was love at first puff,” said Matt, now 19.  As the United States debates what rules will govern the marketing of e-cigarettes, public health researchers and advocates will have to digest and synthesize a growing body of literature — and misleading claims.   Two recent reviews, cited  below, can help readers to begin to sort through this evidence.

Breitbarth AK, Morgan J, Jones AL. E-cigarettes-An unintended illicit drug delivery system. Drug and alcohol dependence. 2019(88): 144-149.

Unger M, Unger DW. E-cigarettes/electronic nicotine delivery systems: a word of caution on health and new product development. Journal of thoracic disease. 2018;10(Suppl 22):S2588.

E-cigarette maker Juul targeted teens with false claims of safety, lawsuit says

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A Juul in the hand…(credit)

When a San Diego-based mother posted an emergency alert on Nextdoor, a community discussion app, she hoped a Good Samaritan could help, according to court filings, reports The Washington Post.  Her son was hysterical after losing a flash drive with his homework near the local McDonald’s, she wrote, uploading a photo along with the message. A neighbor quickly replied, explaining that the chewing-gum-sized object in the picture was not a flash drive: It was a Juul vaping device. “That’s just an indication of how quickly Juuls became prevalent,” recounted Esfand Nafisi, a lawyer who is handling two of three lawsuits initiated against Juul Labs last month. “You blinked your eye, and suddenly they were all over the place.”

“I think Juul has been insincere from the very beginning in saying it’s only for adult smokers,” said Robert Jackler, principal investigator at a Stanford University School of Medicine program that studies the impact of tobacco advertising. He noted that Juul Labs executives have boasted that they run “the most educated company, the most diligent, the most well-researched.”

Two recent court cases challenge Juul’s practices.

Read the complaintfiled against Juul in United States District Court Southern District of New York in June 2018.

Read the complaintfiled in United States District Court District of Northern California in April 2018.

Juul: Does new e-cigarette save or cost lives?

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The rapid growth of a new brand of e-cigarette known as Juul has attracted media and public health advocates’ attention.  According to The New York Times, school officials, struggling to control an explosion of vaping among high school and middle school students across the country, fear that the devices are creating a new generation of nicotine addicts.

Since launching about two years ago, reports BuzzFeed News, Juul has become one of the hottest e-cigarettes on the market. It’s been called “the iPhone of e-cigs” and it has gained somewhat of a cult following among young adults. Shaped like a USB device and easy to conceal, Juul is made by a San Francisco-based company that has received venture capital money.

Following the playbook of cigarette and alcohol manufacturers, who long ago learned that the best way to market their products to children and young people was to claim they were only for adults, Ashley Gould, the chief administrative officer of Juul, told the Times that the company’s products are intended solely for adults who want to quit smoking. Among the flavors Juul markets are fruit medley and crème brulee.

A new study published in PLOS One assesses the net gains and losses from the spread of  vaping.  The authors calculated the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers and transition to long-term cigarette smoking among never smokers for the 2014 US population cohort.  Their conclusion: “e-cigarette use currently represents more population-level harm than benefit. Effective national, state, and local efforts are needed to reduce e-cigarette use among youth and young adults if e-cigarettes are to confer a net population-level benefit in the future.”

To counteract the rapid spread of e-cigarettes, seven public health and medical groups, and several individual pediatricians, filed suit in federal court in Maryland challenging a U.S. Food and Drug Administration (FDA) decision that allows electronic cigarettes and cigars – including candy-flavored products that appeal to kids – to stay on the market for years without being reviewed by the agency. According to Industrial Safety and Hygiene News,  The lawsuit was filed by the American Academy of Pediatrics and its Maryland chapter, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, Truth Initiative and five individual pediatricians.

Although the groups strongly support the FDA’s new efforts to reduce nicotine levels in cigarettes to minimally or non-addictive levels, they also believe that the FDA’s August 2017 decision to exempt e-cigarettes and cigars from agency review for years to come is unlawful and harms public health.