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Children's Health

December 2018

Juuling: The Newest Tobacco Trend Aimed at Youth

While cigarettes have long been a concern for parents of teens, there’s a new tobacco threat in town—and it doesn’t look like tobacco at all.

Woman exhaling smoke

“Juuling” has been around since 2015, when the Juul brand of electronic cigarettes was introduced. These products look like a USB flash drive and can be charged in a USB port. Inside is a cartridge with liquid that comes in various appealing flavors, from fruit and dessert-inspired to coffee and mint. Each cartridge holds about the same amount of nicotine that you’d find in a pack of cigarettes.

Understanding the appeal

Juuling is exploding in popularity. U.S. retail sales in the fourth quarter of 2017 reached $150 million. And a recent survey given to more than 1,000 youth found that 18% of middle and high school students have seen the devices used in school. The brand focuses much of its advertising efforts on social media and uses images that catch the eye of adolescents.

The flavors are a big part of the appeal—most youth who use e-cigarettes start with a flavored product. Recognizing that flavors entice this younger population, manufacturer JUUL Labs has stopped selling mango, fruit, creme, and cucumber flavor cartridges in retail stores in an effort to reduce the number of teens using nicotine products. These flavors are now only available to adults ages 21 and older through their website.

The packaging matters, too. Some companies make skins to decorate these devices. This is just one way young people can disguise them—and it makes them seem like fun accessories. While a lit cigarette is hard not to notice, juuling is much easier to hide from parents and teachers. It’s not difficult for someone underage to buy these products, especially online.

The health effects

Because Juul and other e-cigarettes are so new, there aren’t long-term studies on their health effects yet. But it’s important to remember that they contain nicotine, just like cigarettes. There’s also evidence that they serve as a gateway into nicotine products that have been proven harmful. A study published in the journal Pediatrics found that use of e-cigarettes makes youth more likely to say that tobacco isn’t dangerous. Those who used e-cigarettes were also more likely to say they planned to smoke cigarettes in the future. In addition, e-cigarette use has been associated with future marijuana use.

Many young people don’t realize Juul products have nicotine inside. They may think it’s just harmless flavored water vapor. In reality, Juul pods are reported to contain high levels of nicotine.

For those who argue that juuling isn’t so bad, a report from the U.S. Surgeon General says that using e-cigarettes during adolescence can cause addiction and harm the developing brain. Given that about 3 million adolescents “vape”—that is, use e-cigarettes—this is a real public health concern.

Make sure you talk with your kids about the health dangers of juuling. If you notice them using e-cigarettes, encourage them to quit. While they may seem fun and harmless, they’re a potent nicotine product in disguise. 


Online Medical Reviewer: Lazebnik, Rina, MD
Date Last Reviewed: 9/21/2018
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