UPDATED: Oct. 17, 2018 at 11:25 p.m.

James Sprankle first stumbled upon Juul in 2016, when he went to a smoke shop looking for a small, discreet device he could use to get his nicotine fix while trying to quit smoking. For him, using a Juul ended up having the opposite effect, he said. 

Sprankle, a graduate photography student at Syracuse University, is more addicted to nicotine now than ever, he said. One Juul pod — which contains the same levels of nicotine as two packs of cigarettes — lasts him less than a day, he said. 

“What purpose does (Juul) serve other than feeding an addiction?” Sprankle asked. 

While Juul was invented as a tool for adult smokers to reduce their nicotine consumption, not every Juul user at SU is using the device for its intended purpose. In interviews with The Daily Orange, experts said the prevalence of Juul on college campuses is concerning, given the lack of knowledge about the health effects of e-cigarettes. 

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The Food and Drug Administration is currently investigating whether e-cigarette companies have introduced new devices and liquids to the market without agency approval. The FDA seized “thousands of pages of documents” in a surprise inspection of Juul’s San Francisco headquarters earlier this month, and sent letters to more than 20 other e-cigarette manufacturers on Friday requesting information similar to what they seized from Juul.  

Juuls heat a nicotine-containing liquid and produce an aerosol when inhaled, according to the Centers for Disease Control and Prevention. The device uses nicotine salts, which can allow high levels of nicotine to be inhaled more easily and with less irritation, according to the CDC.  

“Nicotine is being delivered in a different way, and … almost everyone assumes in a safer way, and that’s really the question that remains to be answered,” said Joseph Ditre, an assistant professor in SU’s psychology department. “But the long-term effects of taking vapor that deep into the lungs and nicotine that deep into the tissue (are) completely unknown.” 

Juul controls 72 percent of the e-cigarette market and is valued by investors at $16 billion, the New York Times reported. The sale of liquid nicotine to minors under 18 is illegal in Onondaga County, where SU is located. The legal age to buy tobacco products including liquid nicotine in Onondaga County will be 21 effective January 1, 2019. 

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SU became smoke- and tobacco-free in 2015, the same year Juul Labs first launched their product. It’s unclear what the Syracuse University Health Services plans to do about the recent uptick in e-cigarette popularity. Health Services did not respond to a request for comment on this story. 

More than two dozen stores sell Juul products within five miles of the SU campus, according to the company’s store locator. Sprankle said he has noticed an increase in the convenience of buying pods since he first came to Syracuse last summer — as Juul becomes more prevalent, it’s easier to find pods. 

At Student’s Choice Foods on Marshall Street, a four-pack of pods is priced between $16 and $17. In comparison, a pack of cigarettes costs between $10.95 and $11.35.  

Karis Felton, a sophomore in the David B. Falk College of Sport and Human Dynamics, doesn’t use Juul — and thinks Juuling is “overall, really bad.”  

“I really thought that my generation was going to be the one to kind of end this smoking epidemic,” she said. “I feel like Juuls have kind of restarted it … I just think it’s bad for people’s health.” 

Eashani Malhotra, a junior finance and management double major in the Martin J. Whitman School of Management, considers herself to be a casual Juul user, only vaping at parties. She said this allows her to have control over how often she uses it, and she doesn’t consider it an addiction, she said. 

“I don’t think people are taking it too seriously. We’re college students,” she said. 

Malhotra, an international student, added that using tobacco and nicotine products is a much more accepted practice in other parts of the world. For international students who come to SU from countries where it’s normalized, she said, they’ll likely continue with old habits. 

With pods unaffiliated with Juul Labs Inc., Juul users can vape cannabinoid substances. In an email to The Daily Orange, Victoria Davis, a spokeswoman at Juul Labs Inc, said Juul is only meant to be used as a “nicotine delivery system.” Scientists haven’t been able to assess what the safety of vaping cannabinoids is either, said Martin De Vita, a doctoral candidate in SU’s department of psychology who recently led a study investigating how cannabis affects pain. 

“All of these things are happening so fast that the science is having a hard time keeping up,” he said of the growing popularity of e-cigarettes. 

De Vita said using those substances without having a good understanding of them is risky because it’s not evident what’s really in them. An evidence base needs to be built before products like Juul can be determined clinically sound or not sound, he said.

 

In a study conducted by Juul in February, Juul measured the HPHC profile of aerosol generated by a pod, and found 89% of panel analytes were not detected or were below the level of quantification.

But some of the flavor additives used in products like Juul are known lung irritants, said David Ashley, a professor of public health at Georgia State University and former director of the Office of Science in the FDA’s Center for Tobacco Products. These flavors, which he called “an interesting conundrum,” were designed to be ingested, not inhaled. 

A lot of the “residual harm” in e-cigarettes comes from the flavors and from the nicotine, Ashley said. Some of the flavors may cause lung problems that wouldn’t happen if they were just ingested, he added.  

Ashley has done extensive research related to the impact of cigarette design and contents on emissions from tobacco products. The design features of each e-cigarette change the toxic exposure that people get from one product to another, and some deliver more nicotine than others, he said.

“The design of that product is very interesting, and the FDA’s activities around Juul in particular will be very interesting to see where that goes product-wise and design-wise,” Ashley said. 

He said the FDA has a “strong authority” over these products, and there are a number of things the agency can do to improve the situation. These could include stopping certain products from entering the market if they encourage continued smoking, doing more research and regulation around flavor additives and potentially eliminating the discrete nature of Juul that allows it to be so prevalent. 

“There’s a lot of addiction potential,” Ashley said. “Juul, for example, and some of the other, more advanced e-cigarettes deliver a lot of nicotine, and the levels (users are) getting are just going to be addictive.”

CORRECTION: In a previous version of this post, the number of Juul pods available at Choice Foods was misstated. Juul only has eight flavor pods available. The Daily Orange regrets this error. 

CORRECTION: In a previous version of this post, the ingredients in the aerosol of a Juul pod were misstated. The Daily Orange regrets this error. 

CLARIFICATION: Pods used to vape cannabinoids are not affiliated with Juul Labs, Inc. 

Published on October 14, 2018 at 9:53 pm

Contact Colleen: cefergus@syr.edu | @ColleenEFergus2