A Stanford study found that most young people who use e-cigarettes are unaware of what is in the products or even what brand of e-cigarettes they are using. Researchers conducted the study, published in the Journal of Adolescent Health, to better understand the growing number of young people addicted to nicotine vape pens. Specifically the research indicates that young adults are unaware of the nicotine content of their vapes, and choose their products based less on content and more on how they look.

The study, conducted by scientists at the Stanford University School of Medicine, was published online on March 16. The researchers asked 445 young adults in California about their perceptions of tobacco and e-cigarette use. Researchers compared the study participants’ information, gathered in 2019, with data collected in 2013 and 2014 from the same people.

The researchers recruited the participants in 2013 and 2014, when they were high school freshman and high school seniors. Last year, they revisited the same participants, now young adults between the ages of 17 and 24.

The overarching goal of the six-year study was to examine young adults’ perception of and susceptibility to tobacco marketing, as well as their perceptions of the products. The study also aimed to examine if the study participants’ perceptions or use changed over time, depending on the type of product used. 

The most recent data showed that more than a quarter — 26.3 percent — of the young people used JUUL, a popular brand of pod-based e-cigarettes. Slightly fewer had smoked traditional cigarettes and nonpod-based e-cigarettes, 24 percent and 23 percent, respectively.

Other brands of pod-based e-cigarettes are notably less popular than JUUL and non-pod based cigarettes.

Critics of e-cigarettes have claimed that e-cig companies intentionally market to teens in an effort to recruit new smokers. These critics also charge that e-cigarette makers are not trying to convert people who smoke traditonal cigarettes — a market already cornered by Big Tobacco companies. Some critics have also expressed concern that e-cigarette companies are designing their products to be attractive to teens, a strategy that if successful would result in getting young people addicted to vape pens.

To curb the growing popularity of flavored e-cigarettes, the federal government implemented a nationwide ban on many flavored pod-based e-cigarettes in February. The ban still allows menthol and tobacco-flavored pod-based e-cigarettes to be sold, but prohibits other flavors that may be more attractive to young users, explains NBC.

The results of the Stanford study support this worry. Some 58 percent of those who said they preferred pod-based e-cigarettes over other kinds said they chose the product because it was easier to hide than others. And 55.6 percent of pod-based e-cigarette users said they preferred pods because the smell is “less obvious” than that of other e-cigarettes. 

The study’s senior author, Bonnie Halpern-Felsher, Ph.D., a professor of pediatrics at Stanford, summarized these responses, saying “this ability to ‘stealth use’ is concerning.”

The study not only asked about the participants’ e-cigarette preferences, but also aimed to understand their knowledge of the products. The young adults reportedly found the labeling of the pod-based products confusing, and were unable to consistently identify the nicotine content of the product, or put that content in context with the amount of nicotine in other products on the market.

Further indicating a lack of awareness about how much of a product could or should be safely used, Halpern-Felsher noted that about half of the study participants could not identify how long it took them to finish a pod. To Halpern-Felsher, the disregard for dosage was further evidence of the young adults’ ignorance about the nicotine content.

User perception of e-cigarettes’ nicotine content has been a topic of discussion, as experts and critics examine whether e-cigarette companies are being truthful about their products, or if they are targeting teens, who may be particularly vulnerable to becoming addicted to nicotine vape products. 

Though vaping products are often advertised as harmless, as well as smoking cessation tools, they may be more damaging that many consumers believe. Vox explains that experts worry that e-cigarette companies try to appeal to young users by offering its products in flavors that mimic candy or food. Additionally, the products often have less of a burn, or a characteristic smell, like other tobacco products, as the Stanford study illustrates.

Truth Initiative explains that these marketing tactics can mask the reality that some e-cigarette products contain high levels of nicotine. According to TruthInitiative.org, nearly all e-cigarettes contain nicotine. Those containing 5 percent nicotine represent 67.2 percent of the e-cigarette market, and by comparison, e-cigarette products without nicotine account for less than 1 percent of the market.

According to a joint study by Truth Initiative and the Centers for Disease Control and Prevention (CDC), the average nicotine concentration in vapes sold in the United States more than doubled between 2013 and 2018.

The U.S. Food and Drug Administration (FDA) explains that young people are particularly vulnerable to nicotine addiction. Nicotine exposure while a brain is still forming can “rewire” a young person’s brain, causing them to become addicted to the chemical and result in “long-lasting effects on attention, learning, and memory.”

While cigarette smoking has plateaued among teenagers, e-cigarette use has become an “exploding epidemic,” according to FDA Commissioner Scott Gottlieb.

The Centers for Disease Control and Prevention (CDC) has reported that there was an increase in 1.5 million e-cigarette youth users in 2018 compared to 2017.

While the CDC saw an increase in e-cigarette use among high school and middle school students from 2017 to 2018, it found no change in all other tobacco products during the same time period.

Electronic cigarettes are marketed as a safer alternative to traditional cigarettes. While e-cigarettes do not contain tobacco, they do contain a high concentration of nicotine and other potentially harmful chemicals.

In fact, the most common causes of nicotine poisoning are vaping and liquid nicotine, according to Medical News Today.

Some of the companies that have been accused of marketing their vaping products to teens include:

• JUUL
• Vuse
• Blu
• Logic
• MarkTen XL
• Others

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This article is not legal advice. It is presented
for informational purposes only.