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Information on JUUL and E-Cigarettes

101 on E-Cigarette Infographic

JUULing Fact Sheet

JUUL and other e-cigarettes are addicting a new generation of kids and threaten the decades-long progress our nation has made in reducing youth tobacco use. Youth e-cigarette use in the United States has skyrocketed to what the U.S. Surgeon General and the Food and Drug Administration (FDA) have called “epidemic” levels. According to the National Youth Tobacco Survey, in 2018 alone, e-cigarette use among high school students rose by 78% to 20.8% of students. Altogether, more than 3.6 million middle and high school students used e-cigarettes and that is an increase of 1.5 million in one year.

The main cause of this epidemic is JUUL, the most commonly sold e-cigarette in the United States that makes up more than 70 percent of the U.S. e-cigarette market. Introduced in 2015, JUUL e-cigarettes have skyrocketed in popularity among youth across the United States. JUUL is a discreet device small enough to fit in a closed fist and has a sleek, tech-inspired design that resembles a USB flash drive. JUUL devices heat up a cartridge containing oils vaporizing a liquid that contains nicotine salts through e-liquid “pods,” which quickly dissolves into the air. JUUL delivers higher doses of nicotine than other e-cigarettes, putting youth users at greater risk of addiction. Each pod contains as much nicotine as at least one pack of 20 regular cigarettes, and its nicotine salts are absorbed into the body at almost the same speed as nicotine in regular cigarettes. This speed of absorption worries health officials concerned that JUUL may be more addictive than other e-cigarettes. However, research by Truth Initiative has found that many young JUUL users don’t know the product always contains nicotine, and many teens call use of the product “juuling,” indicating they may not realize it is an e-cigarette or tobacco product.

From previous school years in 2017 when they were introduced through 2019, educators and students have reported an alarming level of JUUL use in middle and high schools across the country. There is widespread use of JUUL devices by students in schools, including classrooms and bathrooms. This may be attributed to JUUL being small and easy to hide, it comes in sweet flavors that entice kids and delivers a powerful nicotine hit. Research shows that flavors play a key role in youth use of tobacco products, including e-cigarettes. Over 80% of kids who have used tobacco started with a flavored product, and 97% of current youth e-cigarette users have used a flavored e-cigarette in the past month. JUUL is sold in flavors that appeal to youth, including mint, menthol, fruit, crème, mango and cucumber. In addition to JUUL, e-cigarettes are sold in over 15,000 flavors, including many flavors like cotton candy, gummy bear and cherry crush that clearly appeal to kids.

Another factor for JUUL’s increased use is the marketing strategy employed by the company that manufactures JUUL products. JUUL’s popularity was fueled by the company’s social media marketing that featured attractive young people in fun, trendy settings. A report by Stanford University researchers concluded that JUUL’s launch marketing was “patently youth oriented” and “subsequently JUUL’s principal advertising themes have been closely aligned with that of traditional tobacco advertising.” According to former Food and Drug Administration (FDA) Commissioner Scott Gottlieb, “There’s no question the JUUL product drove a lot of the youth use.”

JUUL’s success prompted Altria, maker of the best-selling Marlboro cigarette, to pay $12.8 billion for a 35% stake in JUUL. The December 2018 deal brought together the companies that sell the most popular e-cigarette and cigarette brands among kids in JUUL and Marlboro.

JUUL and other e-cigarettes pose serious risks to the health of young people. Most e-cigarettes contain nicotine which is the addictive drug in regular cigarettes, cigars, and other tobacco products. A 2016 Surgeon General’s report concluded that youth use of nicotine in any form, including e-cigarettes, is unsafe, causes addiction and can harm adolescent brain development. Nicotine can harm the developing adolescent brain that keeps developing until about age 25. Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control. Using nicotine in adolescence may also increase risk for future addiction to other drugs. In addition to nicotine, e-cigarette devices can be used to deliver marijuana and other drugs.

E-cigarette aerosol is NOT harmless “water vapor.” The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, that include nicotine, ultrafine particles that can be inhaled deep into the lungs, flavoring such as diacetyl, a chemical linked to a serious lung disease, volatile organic compounds, cancer-causing chemicals such as formaldehyde and heavy metals such as nickel, tin, and lead. Some of the ingredients in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs. Scientists are still learning about the long-term health effects of e-cigarettes.

Another risk factor for the use of JUUL and other e-cigarette brands is that youth who use e-cigarettes may be more likely to go on to smoke conventional cigarettes. Many are low-risk youth who would not have otherwise smoked cigarettes. A January 2018 report by the National Academies of Sciences, Engineering and Medicine concluded, “There is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults.”

Attached are fact sheets on JUUL and other e-cigarettes to post/network to your personal and professional contacts, particularly parents of middle and high school students.

The Campaign for Tobacco-Free Kids is the leading advocacy organization working to reduce tobacco use and its deadly consequences in the United States and around the world. Through strategic communications and policy advocacy campaigns, they promote the adoption of proven solutions that are most effective at reducing tobacco use and save the most lives.

For more information from the Campaign for Tobacco-Free Kids on JUUL, visit

The Bergen-Hudson Chronic Disease Coalition, administered by the Bergen County Department of Health Services from a grant funded by the New Jersey Department of Health Office of Cancer Control and Prevention (OCCP), encourages parents, teachers, school nurses and other adults to learn about the health risks of JUUL and other e-cigarette products and convey that they are not a safe alternative to conventional tobacco products.

The youth e-cigarette epidemic is a public health emergency.

Information for this media release was secured from research of the website of the Campaign for Tobacco-Free Kids.