Seacoast experts call vaping 'gateway' to smoking for teens as FDA seeks Juul ban

EXETER — The FDA wants to ban Juul vaping products and Juul is fighting back, but many in the medical community applaud the effort.

On June 23, the U.S. Food and Drug Administration issued marketing denial orders to JUUL Labs Inc. for all of its products currently marketed in the United States. The company was ordered to stop selling and distributing its products, and to remove products currently in retail operations.

The products included in the marketing denial order are Juul devices and four types of Juul pods: Virginia tobacco flavored pods at nicotine concentrations of 5% and 3% and menthol flavored pods at nicotine concentrations of 5% and 3%.

On Monday, June 27, Juul appealed the ban. While the appeal is in process, the company can continue to market its products. The FDA must file a response by July 7.

In 2018, the American Cancer Society Cancer Action Network joined public health and medical groups and pediatricians to successfully sue the FDA after the agency sought to extend its deadline to August 2022 for e-cigarette manufacturers to apply to the agency and demonstrate their products are “appropriate for the protection of the public health” in order to market their products. This delay would have left these products on store shelves unregulated until at least that time.

In the meantime, the medical community supports the ban. They have been criticizing vaping for years, calling its use a gateway to smoking, particularly for young people. Vape flavors like fruit and mint considered kid-friendly were banned in 2020.

Christine Wyrsch, RN, manager of the Wentworth-Douglass Hospital Patient & Family Learning Center, said she has been following the FDA news about Juul.

"It is incredibly interesting to me," Wyrsch said. "I know that multiple states have filed lawsuits in relation to vaping. Initially they were part of a harm reduction to smokers status, but they soon became that the flavors were being marketed, successfully, to teens."

Noting e-cigarettes satisfy a nicotine craving, are sleek and high-tech and do not have a significant odor, Wyrsch said, "They were being marketed as safer than cigarettes, which I don't think is true. That correlates to the risk-taking behavior of teens."

Wyrsch said that even though the carcinogens are removed from vape products, medical professionals are still seeing addictions to them.

"It's hard to quit, cigarettes and vape products," she said. "Schools are addressing it by taking them away on school grounds, but that's not addressing the issue. It doesn't take a lot to get addicted."

Wyrsch said Wentworth-Douglass plans to offer a freedom from smoking program this fall.

"We hope to reach out to schools and get teens involved," she said. "High schoolers have a daily habit. Juul is bringing smoking back, creating a new generation of smokers."

Retailers will feel the pinch if Juul and potentially other vape products are removed from the market.

"I feel bad for them," said Wyrsch. "But I also feel this is necessary. I believe this is a gateway to smoking and now you can vape marijuana, THC products. This was linked to lung injuries in teens a few years ago and thankfully this seems to have subsided a bit. Vaping can affect brain development, too."

Dr. Karen E. Knudsen, CEO of American Cancer Society Cancer Action Network, said, “ACS CAN strongly supports the FDA’s decision to issue a marketing denial order to Juul for the company’s e-cigarette products, including menthol-flavored e-cigarettes. This decision sends a strong message that public health is paramount when regulating tobacco products, especially a product which is proven to be the chief driver behind the impact Juul products have had on public health."

"In the time Juul products were on the market unregulated, these products and Juul’s marketing strategies significantly contributed to the youth e-cigarette crisis we currently face in this nation and led to new, previously unimaginable, levels of addiction among youth," Knudsen said. "Given research shows youth who use e-cigarettes are more likely to use combustible cigarettes, preventing youth addiction to these products is critical to preventing tobacco-related cancers."

Knudsen said the tobacco industry has long used flavors to hook kids and e-cigarette manufacturers have taken that strategy and run with it, unregulated for far too long.

"FDA’s decision to deny authorization of the sale of Juul products, including menthol products, is an important step that will protect our kids from an industry built on luring people into a lifetime of addiction," she said. "It blunts the potential for future generations to become addicted to tobacco and suffering from tobacco-related diseases like cancer."

Wyrsch said she would like to see more legislation to keep other companies from attempting to take up the slack left by the removal of Juul products.

"I know North Carolina settled a lawsuit," she said. "I believe there are still 12 to 13 states with lawsuits pending. This has created a public health problem now, and I have to think we might see more health problems down the road."

This article originally appeared on Fosters Daily Democrat: Seacoast experts on dangers of vaping by teens as FDA seeks Juul ban