Carol A. Jahn, RDH, MS | firstname.lastname@example.org | 708-899-1886
In the fall of 2015, I attended a conference where the general session speaker was a tobacco cessation specialist. At the time, I was a neutral on the subject. I didn’t think – wow, I can’t wait to hear this, but neither did I think it wouldn’t be worth my time. I have a sense that a lot of my colleagues felt similarly. However, when the speaker made his opening statement, the room grew quiet, and he had our undivided attention.
What did he say that was so compelling? He opened with:
“Tobacco is the only legal consumer product that kills at least 1 out of 2 of its regular users when used as intended by the manufacturer.”1
During my clinical dental hygiene years, I was no stranger to the detriments of tobacco on oral and general health. I had worked in a periodontal office in the 1980’s where every day six or seven of my eight patients either used or had used cigarettes. I had also been in a general practice during the early 1990’s and had shockingly witnessed the resurgence of cigarettes among teens and young adults. But by 2015, like many, I had naively thought, we were on the upside of the battle with cigarettes.
Little did I know how I wrong I was. Little did I know that earlier in 2015, a new type of e-cigarette called JUUL had been introduced. Little did any of us know the enormous impact and influence it would have among youth.
In 2016, JUUL garnered about 5% of all e-cigarette sales. By the end of 2017, it was the leading e-cigarette brand, and at its peak in late 2018-2019, it had more than 70% of the market. The JUUL brand’s popularity with youth helped drive a 135% surge in youth vaping between 2017 (11.7%) and 2019 (27.5%).2
Three things helped drive its popularity with youth. It has a sleek compact design resembling a USB device making it easy to use discreetly and conceal at school and home. The nicotine formulation in JUUL is made from nicotine salts instead of free-base nicotine. This does two things. It provides the user with a better experience and more nicotine. One JUUL pod has the nicotine equivalent of a pack of cigarettes. When introduced, JUUL pods came in numerous different, youth appealing flavors. Flavored nicotine is preferred by over 80% of youth vapers.2
Today’s JUUL popularity has declined to about 40%.2 The 2021 Monitoring the Future Study found that student vaping rates are declining nearly showing 1 in 5 high school students vaped in the past month. However, vaping is still the predominate method for nicotine consumption in youth. Rates of smoking for traditional cigarettes fell to an all-time low of 4.1% among high school seniors.3
What are the effects of vaping products on oral and general health? While the long-term effects of vaping are unknown, nicotine is highly addictive. Research has shown that teens who vape are six times more likely to begin using traditional cigarettes.4 Nicotine can harm the developing brain including affecting the parts of the brain that impact attention, learning, mood, and impulse control.5
E-cigarettes have been promoted as means for tobacco cessation. In the United Kingdom (UK), vaping is considered an effective tool to help people stop smoking. The European Union regulates vaping differently from the US; for example, JUUL vaping pods have half as much nicotine in the UK as the US. Importantly, far fewer teens vape in the UK with 1.6% reporting weekly use.6
Smoking rates are down not just among teens but adults as well. Yet the emergence of new products like e-cigarettes mean this is a subject we cannot take for granted. A recent study conducted with Southern California teens found that while vaping is still the most popular nicotine product, flavored oral nicotine products such as gums, lozenges, and gummies are ranked second.7 As dental professionals, we need to be aware of the products beyond cigarettes and be able to talk knowledgeably about them with patients.
- Els C. Interrupting the disease of tobacco addiction. J Dent Hyg, 2015, 89(Suppl 1.): 16-19
- Campaign for Tobacco Free Kids: JUUL and Youth: Rising e-cigarette popularity. Accessed Aug 9, 2022. Available at: https://www.tobaccofreekids.org/assets/factsheets/0394.pdf
- Campaign for Tobacco Free Kids: 2021 Monitoring the future study shows youth e-cigarette use remains a serious problem. Accessed on Aug 9, 2022. Available at: https://www.tobaccofreekids.org/assets/factsheets/0394.pdf
- Barrington-Trimis JL, UrmanR, Berhane K, Unger J et a. E-cigarettes and future cigarette use. Pediatrics, 2016; 138(!):e20160379
- Centers for Disease Control and Prevention. Quick facts on the risks of e-cigarettes for kids, teens, and young adults. Accessed on Aug 9, 2022. Available at: https://www.tobaccofreekids.org/assets/factsheets/0394.pdf
- The US and UK see vaping very differently. Here’s why. CNN Health. Access on Aug 9, 2022. Available at: https://www.tobaccofreekids.org/assets/factsheets/0394.pdf
- Harlow AF, Vogel EA, Tackett AP, Cho J et al. Adolescent use of flavored non-tobacco oral nicotine products. Pediatrics 2022; Aug 8; e2022056586
About the author: Carol Jahn, RDH, MS is the Director of Professional Relations & Education for Water Pik, Inc. She has been providing continuing education courses for more than 25 years. Carol is an author, speaker, and industry leader and has published numerous articles and contributed to several textbooks.