Medical Effects of JUUL Vaping

As soon as the public became aware of the grave dangers of smoking cigarettes a few decades ago, many people realized that voluntarily giving up their smoking habit is hard. To cash in on the desire to stop smoking, companies kept innovating and manufacturing smoking cessation products for many years. From nicotine patches to gums, the market was soon flooded with tons of products that guaranteed an escape from cigarette dependence. However, most of these products were either impractical or ineffective or just too expensive. And this is where e-cigarettes came in.

When battery-operated e-cigarettes were first introduced back in the late 2000s, they were marketed as a ‘safer’ alternative to regular cigarettes. After all, they were a sleek, discreet technology that could supposedly help adult smokers kick a potentially life-threatening habit. They were designed to look and feel like real cigarettes, even down to emitting artificial smoke; however, they did not actually contain any tobacco. Users could inhale vapor which looks like smoke without any of the carcinogens found in tobacco smoke which are harmful to the smoker and others around them. No doubt, people soon became very optimistic about e-cigarettes. However, a growing body of evidence indicates that e-cigarettes may not be safe after all. Various researchers and studies have proven that the use of e-cigarettes, especially among young people, has more risks than benefits. Let’s take a look at the medical dangers and risks from vaping or e-cigarettes.


Yale School of Medicine discovers that Juul vape pens emit dangerous chemicals that are not listed on the product's label.  Click for more information.


Teens using vaping devices in record numbers

Electronic smoking devices, more commonly known as e-cigarettes, have been around for a little more than a decade. However, it is only in the last few years that the use of e-cigarettes (vaping) has really skyrocketed, especially among teenagers. According to the Monitoring the Future (MTF) 2018 survey conducted by the researchers at the Institute of Social Research at the University of Michigan and funded by the National Institute on Drug Abuse (NIDA), about 37.3 percent of high school seniors, 32.3 percent of sophomores and 17.6 percent of middle school students have reported vaping at least once in 2019, compared to just 27.8 percent of high school seniors, 23.9 percent of sophomores and 13.3 percent of middle school students in 2017, just two short years ago. 

The findings from the MTF survey clearly show that teenage e-cigarette user numbers have hit record levels in 2018 and this should warrant concern for public health officials, parents, and communities responsible for raising healthy children. Vaping can have negative effects on the physical and psychological health of teenagers as well as act as a gateway to regular smoking (Even though it was originated as a smoking cessation aid.) No wonder why U.S. Surgeon General Jerome M. Adams officially declared e-cigarette use among youth an “epidemic” during a press conference.

What is vaping?

Vaping is the act of inhaling and exhaling the aerosol or vapor produced by the heated e-liquid of an e-cigarette. This e-liquid typically contains potentially harmful ingredients, including, Propylene Glycol (PG) or Vegetable Glycerin (VG) based liquid with nicotine (intended to provide a similar sensation to inhaling tobacco smoke), flavoring chemicals such as diacetyl, heavy metals (such as nickel, tin, and lead) and other volatile organic compounds such as benzene, which is found in car exhaust. Some e-liquids also contain cannabinoids such as marijuana and other drugs. From vape pens to e-hookahs to advanced personal vaporizers (also known as ‘MODS’), there are many types of e-cigarettes available in the market currently. Most e-cigarettes, however, have four common components:

  • A rechargeable, lithium-ion battery that powers the device
  • An atomizer that heats the e-liquid into an aerosol
  • A refillable or replaceable cartridge that stores the e-liquid and
  • A mouthpiece that allows the user to inhale the aerosol solution

Why are e-cigarettes so popular?

The global e-cigarette market is set to reach $53.4 billion in the next five years.  This means that the e-cigarette industry is most likely investing hundreds of millions every year into advertising their products. Even though e-cigarette companies strongly deny that they are marketing their products to young people, features targeted to youth can be noticed in their advertising. These features may consist of:

  • Youthful product design and packaging
  • Tempting flavors such as mango, mint, coffee and crème
  • Celebrities positively portraying e-cigarettes on the Internet and in TV and movies
  • Suggestions that vaping makes you happier and improves your social status

This aggressive marketing is one of the factors that tempt the youth to get in on the vaping craze.

Then there is the concern of how easy it is to buy an e-cigarette. Despite the fact that the U.S. Food and Drug Administration (FDA) subjects e-cigarettes to the same rules as tobacco products, middle and high school students can still go to any e-cigarette website, click a button that says they are at least 18 or 21 years old (depending on the state), and get their hands on an e-cigarette.

About JUUL

A research by the Centers for Disease Control and Prevention concluded that JUUL (Pronounced: jewel) is the most popular and successful e-cigarette brand in the market today.  In only three years since it was introduced, this small and sleek USB shaped device has laid hold of the entire e-cigarette market and currently accounts for over three-quarters of all e-cigarette sales in the United States, Yahoo Finance reported. JUUL’s quick rise in popularity even prompted an American daily newspaper, the Boston Globe, to call it “the most widespread phenomenon you have likely never heard of.” 

Health risks of vaping

No matter what chemical substance or in what quantity you introduce into your body (whether by inhaling, ingesting or even just touching), if your body is not accustomed to it, there will likely be certain side effects. E-liquids used in e-cigarettes are no exception as the ingredients in e-liquid (VG/PG base, nicotine, and flavoring) are either chemicals or substances derived through chemical processes. This means that while the health risks of vaping are different from those of regular cigarettes, they are still there and can be much more acute.

Some of the potential health risks of vaping are:

  • Irritation

When vaporized, the substances in e-liquid may potentially form cancer-causing or carcinogenic compounds. As a matter of fact, a study on the potentially harmful health effects of inhaling nicotine-free shisha-pen vapor found that just one puff from the pen contained more than enough propylene glycol and glycerol to cause skin irritation.

  • Inflammation

Not just skin irritation, nicotine-free vaping is also known to trigger an immune system response. One in-vitro study on the pro-inflammatory effects of e-cigarette vapor condensate on human alveolar macrophages found that exposure to e-juice flavoring compounds can cause an inflammatory response in immune system cells throughout the body (Especially within the lungs and throat.) Similarly, a different in-vitro study on the inflammatory and oxidative responses induced by exposure to commonly used e-cigarette flavoring chemicals and flavored e-liquids without nicotine concluded that exposure to vaping may activate an inflammatory response in certain types of white blood cells as well. This can affect how these cells work within your immune system.

  • Toxicity

In addition to skin and immune system, nicotine-free e-cigarette liquid may be toxic to cells. A study on the relation between flavorings in tobacco products and endothelial cell dysfunction concluded that exposure to e-cigarette vapor led to cell death in the lungs (which defend the body against toxins, infectious particles, and allergens in the air you breathe) and harm blood vessel cells in the heart as well (which are known to play a role in long-term heart health) even when nicotine is not present in the e-cigarette. The death of these cells leads to vascular conditions, such as high blood pressure, diabetes, and heart disease.

Negative effects of Nicotine

Most e-cigarettes (especially the notorious Juul) contain high levels of nicotine. Because of these high nicotine levels, vaping is extremely addictive and can have severe negative effects on the health of an individual. Nicotine usage is commonly associated with chronic obstructive pulmonary diseases (COPD) like bronchitis and emphysema and cancer of lungs, larynx, oral cavity, esophagus, pharynx, etc. Furthermore, prolonged usage of e-cigarettes with nicotine can develop into addiction over a period of time and cause heart diseases, high blood pressure and loss of appetite. Nicotine usage has several long-term and short-term harmful physiological effects on:

  • Lung Damage

Nicotine is detrimental to the healthy functioning of the lungs. Once the nicotine reaches the blood through the lungs, it increases the blood pressure and narrows the arteries restricting the amount of blood circulated in the body. Restricting the blood flow decreases the capacity of lungs to circulate oxygen in the blood. Other substances like carbon monoxide that enter the bloodstream along with nicotine further reduce the level of oxygen in the blood. Lack of oxygen further affects the functioning of lungs. Nicotine also increases the risk of lung cancer and prolonged exposure can promote the growth and development of tumors in the lungs. 

In addition, other chemicals that enter the body along with nicotine have the potential to damage the cell structure of the lung tissue. One such chemical is diacetyl, which can cause a severe and irreversible lung disease called bronchiolitis obliterans or "popcorn lung.” Bronchiolitis obliterans is characterized by severe symptoms that are persistent and include Wheezing (a dry cough that does not produce any phlegm) and shortness of breath that can be debilitating.

As soon as the nicotine enters the bloodstream, it reaches the brain and alters its functioning. Nicotine has the property to mimic the activity of a specific neurotransmitter in the body by binding to a particular receptor. Once nicotine binds to the specific receptor, it imbalances the neurotransmitter activity in body and affects your muscle movement, increases heart rate and breathing problems and makes it difficult for you to concentrate. 

Nicotine also results in the release of dopamine in the pleasure pathway of the brain, which gives a feeling of well-being and euphoria. But if used regularly, the brain will start finding ways to diminish the sensitivity of neurons to dopamine to normalize the levels. This means that if a person suddenly stops using that artificial stimulant – in this case, the nicotine from e-cigarettes – the dopamine levels will fall to unnaturally low levels because the brain is no longer as receptive to the neurotransmitter as it used to. Low dopamine levels can also trigger mood disorders such as depression. Eventually, the body will readapt, and dopamine levels return to normal, but only if the person is able to resist the cravings to restart their habit.

Nicotine increases the blood pressure by narrowing the size of blood vessels. Narrow blood vessels mean less supply of oxygenated blood flow to vital organs of the body that can further cause medical complications. Narrowing down of blood vessels can also result in many cardiovascular diseases such as cardiac arrest. Less circulation of blood in vessels in the brain can result in the formation of clots or leaks that can cause a stroke. This narrowing down of blood vessels can increase pressure on its weakened areas thus causing aneurysms. An aneurysm is the swelling in the walls of blood vessels especially arteries. The swelling and widening of blood vessels cause them to weaken over time, and they can rupture. An aneurysm is usually classified by shape, size, and location of the bulge. It is most common in arteries at the base of the brain referred to as brain or cerebral aneurysm, and in aortic arteries known as an abdominal aortic aneurysm.

  • Central Nervous System

Once the Nicotine enters the bloodstream, it reaches the brain quickly and affects the working of the Central Nervous System (CNS) by stimulating the activity of neurotransmitters. Nicotine stimulates the CNS that results in increased blood pressure, increased heart rate, faster respiration, and narrowing of blood vessels. Prolonged exposure to usage of Nicotine can be harmful to CNS and can lead to conditions like muscular sclerosis.

  • Seizures

FDA’s ongoing scientific investigation of potential safety issue related to seizures reported following e-cigarette use, particularly in youth and young adults have warned that seizures induced by nicotine could be a side effect of vaping. Here are a few types of seizers the heightened risk of which may be linked to the use of e-cigarettes with nicotine.

  1. Tonic-Clonic: known as the "grand mal", this is what people think of when they hear the word seizure. In this, the person will drop to the floor and almost every muscle will stiffen while the person jerks. It usually lasts 1-3 minutes and the person can easily injure themselves.
  2. Absence: This is when a person blanks out anywhere from a couple of seconds to 30 seconds and is unaware of their surroundings. They may blink their eyes repetitively and their eyes may roll up into the back of their head as well. People who have these types of seizures could have them up to sixty times a day.
  3. Atonic: In this seizure, people lose all muscle strength and just drop to the ground. However, they stay conscious and aware during this type of seizure, but that does not mean it is not hard on their body.
  4. Myoclonic: Most people would not even see these as seizures because they are so simple. They are very brief jerks of a muscle or a group of muscles. They only last for a second or two. It is like a sudden jerk you may feel that wakes you up when falling asleep.
  5. Tonic: Causes a person's body to stiffen up and lasts for about 20 seconds. The person does not always fall but can lose balance when muscles stiffen or if they have multiple seizures in a row. This particular seizure often happens while a person is sleeping.
  6. Clonic: It is not often seen alone and only consists of repeated jerking. The jerking cannot be stopped even if someone tries to restrain the person having the seizure. This type of seizure usually only happens with the body stiffening part or "grand mal."
  7. Simple Partial: The one thing different about the simple partial is that people remain alert and can recall the whole thing. But the way it occurs varies from person to person. It can be anything from a pain in ones stomach, a feeling of déjà vu, or the sound of ringing. There is a whole list of things that happen to people who have these. They only last up to two minutes.
  8. Complex Partial: If you see somebody experiencing one of these, you may think they are just crazy. People become unaware of everything going on around them. The person will normally repeat actions things like picking at clothing, making noises, swiping at the air etc. The person may also do embarrassing things such as start taking off their clothing or get themselves into a dangerous situation. They do not last very long, but the person is normally confused from 15 minutes to hours afterwards and does not remember a thing.
  • Withdrawal Symptoms

Sudden cessation of nicotine usage can cause withdrawal symptoms and although these symptoms are only temporary, they can cause very unpleasant feelings. Several symptoms that most often arise are: 

  1. Insomnia 
  2. Food cravings
  3. A strong urge to vape
  4. Coughing
  5. Sore throat
  6. Severe headaches
  7. Tightness or pain in the chest
  8. Poor concentration and retention
  9. Irritability

These are some of the most commonly reported symptoms of nicotine withdrawal. Most people have some of these, but rarely all of them. While each person will go through this process a little differently, for most people, these discomforts are short-lived.

Health risks of vaping CBD

CBD or cannabidiol is an essential component of medical marijuana. While vaping CBD is much safer than vaping nicotine, there are still side effects that you may experience. Some reported side effects of using e-cigarettes with CBD oil include:

  1. Impaired coordination
  2. Impaired memory
  3. Difficulties in problem-solving
  4. Nausea and vomiting
  5. Increased heart rate
  6. Dependence in the long term
  7. Fatigue
  8. Irritability
  9. Nausea

E-cigarettes containing CBD also contain other chemicals found in nicotine-free e-cigarettes, so they may cause similar side-effects as well.

Risks of secondhand exposure

Secondhand exposure to aerosol produced by e-cigarettes is potentially less toxic than secondhand exposure to cigarette smoke, but it is still a form of air pollution and poses health risks. A report on the effects of e-cigarettes among youth and young adults prepared by the Surgeon General concluded that secondhand emissions contain toxic substances at concentrations that are above recommended levels and linked to serious lung diseases.

Why should parents be concerned?

The biggest problem with the use of e-cigarettes is that most teens hold favorable views toward e-cigarettes and do not consider vaping to be bad for their health (some even think that the smoke from e-cigarettes is just water), as reported by an article on the adolescents' attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation reported. Another study on e-cigarette use as a predictor of cigarette smoking found that 12th graders who used e-cigarettes were more than four times as likely to start smoking cigarettes. (16)

What’s the bottom-line?

Even if vaping can serve as an aid for people quitting smoking and is less toxic than tobacco – still the leading (and avoidable) cause of death in the United States – FDA has not certified it as safe and effective. After all, nicotine, regardless of how it is delivered, can never be safe. The negatives of vaping far outweigh its positives – at least, with regular cigarettes, the health risks are well-documented, and the large, graphic warnings on every pack are obvious.

Join us in fighting the epidemic.  If you or a loved one has fallen victim to JUUL, whether by addiction, medical injury, or otherwise, use the form on this page to contact us.  If you need to talk to someone immediately, you can call or text us at 469-466-2600.

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