Everybody hates Juul, a “bad company run by bad people,” according to Gizmodo’s increasingly difficult-to-dispute analysis, and an outfit possessed with a remarkable ability to continuously out-bad itself. Worse than knowingly hooking teens on nicotine, as Juul appears to have done, is destroying an entire concept—one known to save lives. And Juul appears to have done that as well.
Juuls are highly addictive by design. That’s not necessarily entirely bad: highly addictive nicotine vaporizers have real value in compelling adult humans to stop smoking worse-for-you conventional cigarettes, as recently published research from Italy and the Netherlands shows. But good luck making that argument in the United States, where, even if the pods aren’t actually contaminated, e-cigarettes are now scandal-tainted toxic properties.
As Scott Gottlieb, the Trump administration’s former Food and Drug Administration (FDA) commissioner (and pharmaceutical company board member) observed on Tuesday: “One company, bent on pursuing top line growth at almost any cost, may have wrecked the entire concept of harm reduction in the U.S.” And so people, like the 480,000 Americans who die from tobacco use or secondhand smoke every year, will continue to die.
“Harm reduction” is a broad concept that generally involves replacing something that will kill you with something that won’t, or at least not right away. Allowing alcoholics to live in a “wet house” is harm reduction. So are replacement therapies.
The notion that e-cigarettes are a harm reduction tool, less dangerous than conventional smokes, is old, and by now quite basic. In adult smokers, e-cigarettes are almost twice as effective as nicotine-replacement therapies, like nicotine gum or nicotine patches, research published earlier this year in the British Medical Journal and New England Journal of Medicine found.
These findings are supported by more recent research, conducted in Italy, the UK and the United States and published last month in the journal Tobacco Use Insights, that found “nonstandard electronic nicotine delivery systems, such as an electronic cigarette, ensure a greater chance of cessation success” (although it’s necessary to note that American researchers, most notably at the University of California, San Francisco’s Center for Tobacco Control, don’t quite buy this).
One reason why nicotine-addicted smokers pick up vapes rather than cigarettes is the same reason why Juuls are so good at rewiring the reward centers of teens’ brains: e-cigarettes—and specifically Juuls—kick like mules.
As Juul’s first hire, Kurt Sonderegger, told Vice this week, Juul worked very hard to find a “satisfying nicotine” formula. More important than the maligned and now-banned fruity and minty flavors in the pods are the nicotine salts that enter the bloodstream almost as quickly as a cigarette.
In “the first direct assessment of brain uptake of nicotine from e-cig use,” researchers working on a National Institutes of Health (NIH) grant—and one who also accepted a research grant from Juul Labs—found that, yes, “e-cigs can deliver nicotine to the brain with similar rapidity as” conventional cigarettes.
There are more factors at play than the e-liquid’s chemical makeup, but it seems increasingly obvious that e-cigarettes “work” because they are just enough like cigarettes, but different. “Duh,” you might say, but this wasn’t a “fact” you could print in a peer-reviewed journal until recently—just as Juul’s value is cratering with investors and as any goodwill the company, or e-cigarettes in general, might have enjoyed is vanishing.
In the United Kingdom, vaporizers and e-cigarettes are considered “95%” less dangerous than conventional smokes and are an accepted part of anti-smoking campaigns and cessation treatments. Here in the U.S.—where a 2017 study suggested that vapes are, at worse, 40% as bad as smokes—they’re toxic commodities. Thanks mostly to teens finding themselves addicted to e-cigarettes “within two months” rather than the two to three years it takes to become habituated to smokes, as Susanne Tanski told Reuters, vaporizers like Juul are worse every day.
In Wyoming, a 19-year-old will likely face felony charges for recently breaking into a convenience store—in order to allegedly steal JuuL “devices and pods,” which police reportedly found strewn abut his house, according Casper-based Oil City News. Anecdotes like this make it harder to deny that Juul hasn’t created a generation of fiends, who will remain among us even as the minty vape clouds disappear. American exceptionalism lives on in the e-cigarette, where profit lust dealt a death blow to a life-saving medical concept, and Americans will likely die because of it.