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Juul may have pushed rival e-cigarette brands to compete in a 'nicotine arms race,' study says

  • According to a new study, Juul’s entrance into the e-cigarette marketplace in June 2015 caused other e-cigarette brands to increase their nicotine content to match or surpass Juul’s 59 mg/mL levels.
  • Juul created a patented nicotine salt technology that reduces the bitter taste of nicotine, allowing the company to add higher levels of nicotine to its vapes while maintaining a palatable flavor.
  • In an interview with INSIDER, a Juul representative said some e-cigarettes that existed before Juul already had high nicotine levels.
  • But Dr. Robert Jackler, lead author of the study, told INSIDER that based on his research the majority of pre-Juul era e-cigarettes had 1% to 2% nicotine per volume.

As e-cigarette use continues to skyrocket in the United States, the Food and Drug Administration (FDA) has pointed to Juul, a popular e-cigarette brand, as a major contributor to the vaping epidemic, especially among teenagers, Business Insider previously reported. Now, a new study from Stanford University suggests Juul’s 59 mg/mL (5.9% by volume) nicotine products may have lead other e-cigarette companies to increase their nicotine content, starting a “nicotine arms race.”

“Following Juul’s lead, many purveyors of nicotine salt-based e-liquids offer nicotine concentrations at the 5%, 6%, and even 7% [per volume] level,” Dr. Robert Jackler, lead author of the study and a professor of head and neck surgery at Stanford University, wrote.

Jackler’s research team has been following the vaping industry for almost a decade and believes that “simply put, Juul transformed the market by more than doubling the nicotine concentration in the e-liquid consumer markets.”

More e-cigarette brands are selling devices with higher nicotine levels than in previous years, according to the study

For the study, Jackler and his team conducted an online search for Juul look-a-likes that offered more than 5% nicotine salt e-liquid by volume. Experts estimate that a 5% e-cigarette pod can deliver the same amount of nicotine as a pack of cigarettes.

They searched terms like “nicotine salts,” “high nicotine,” “nicotine e-liquid,” and “nicotine e-juice” to pinpoint these brands, and found that 14 brands were selling 15 types of Juul-compatible e-liquid pods that had nicotine concentrations as high as 6.5% by volume.

They also found 39 pod-based e-cigarettes, some which resembled Juul, that were introduced to the market after 2015. All of these devices were able to hold more than 0.7 mL of vape liquid, which is the capacity of Juul devices. In some cases, these “Juul-a-like” devices could hold up to 2 mL of vape liquid.

The additional capacity of these devices puts more nicotine at users’ disposal, which could, in turn, cause consumers to become dependent on nicotine. Nicotine dependence can lead to health problems like diabetes, infertility, teeth and gum disease, eye problems, and more, according to the Mayo Clinic.

A number of e-cigarette brands appear to have mimicked Juul’s design, the study points out.
Stanford Research Into the Impact of Tobacco Advertising

Jackler’s team also found 71 American brands that sell vape liquids with high nicotine levels in bulk, which is defined as more than 30 mL of liquid. This makes it easy for consumers to obtain and use large quantities of nicotine at once, which Jackler believes could lead to nicotine overdoses, child poisoning, and more nicotine addiction overall.

Nicotine can also be absorbed through the skin, which is especially dangerous for children. In 2012, there were 659 reported children poisonings due to e-liquids, but according to the American Academy of Pediatrics (AAP) that number rose to 3,353 in 2014, the year before Juul came on the scene. According to Jackler, a 0.7 mL Juul pod with 41 mg of nicotine is “theoretically potent enough to kill 25 toddlers,” so a 30 mL bottle of nicotine salt e-liquid that contains about 1,770 mg of nicotine could do even more potentially fatal damage.

Bulk e-liquid sales also decrease the cost of vaping, creating one less barrier to entry for users, Jackler noted in his paper.

Juul’s patented nicotine salt technology allows it to create 59 mg/mL nicotine e-cigarettes

Juul uses nicotine salts in its vapes, which lessens the bitter taste of traditional nicotine.
Hollis Johnson/INSIDER

The rise in high nicotine e-cigarettes and e-liquids is due in part to Juul’s use of nicotine salts, a type of technology the company patented in 2013.

Read more: Regulators will ban menthol cigarettes and chip away at flavored e-cigs to combat teen vaping — but experts say their plans fall short

Nicotine salts contain more benzoic acid, an ingredient that masks the unpleasant bitter taste of nicotine, than other nicotine products, according to the National Center for Health Research. As a result, people who use devices with nicotine salts can inhale higher levels of nicotine with less irritation, according to the Centers for Disease Control and Prevention (CDC).

Juul said Jackler’s paper misrepresents the brand and its products

In response to Jackler’s study, a representative for Juul told INSIDER that other e-cigarette brands like Vuse and NJOY offered vaping products in the 4% to 5% nicotine by volume range before Juul existed.

Read more: The head of the FDA is planning to meet with more e-cig CEOs and blamed ‘manufacturers and management’ for the devices’ skyrocketing popularity among young people

But Jackler said his team has been monitoring the e-cigarette space for nearly a decade, and that the majority of these high nicotine vapes appeared on the market after Juul did.

“We have a very large collection of advertisements from e-liquid providers both before and after Juul’s introduction,” Jackler told INSIDER. “The vast majority of e-cigarettes were 1% or 2% nicotine [by volume] and maybe some were a little more, but by and large, what was high nicotine at that time was much lower than what Juul put on the market.”

Higher nicotine e-cigarettes could be just as dangerous as traditional cigarettes

Jackler also asserted that higher nicotine levels, when coupled with the vape method of tobacco consumption, make e-cigarettes just as harmful as traditional cigarettes.

“While first-generation cig-a-like devices did not deliver comparable nicotine levels to a cigarette, advanced personal vaporizers, with their larger aerosol volumes, may achieve similar absorption curves to combustible cigarettes,” Jackler wrote.

He explained that when a person smokes a traditional cigarette, some nicotine burns into the air, some is exhaled, and some is absorbed into the bloodstream from the lungs. But with e-cigarettes, there is no nicotine that burns off, which means that e-cigarettes “can have less nicotine but still deliver the same amount [to the body],” Jackler said.

Countries like Israel and the UK even have regulations that prohibit people from purchasing high-nicotine e-liquids. As a result, Juul markets 1.7% nicotine e-liquids in these places rather than the 5.9% nicotine e-liquids it sells in the states, according to CBS News.

The Food and Drug Administration has shown concern about Juul in the past

E-cigarettes’ detrimental health effects and rising popularity have lead the FDA to call out Juul, suggesting that the brand and other high-nicotine e-cigarettes have contributed to the teenage vaping epidemic, Business Insider previously reported. But Juul says otherwise.

“Juul Labs is committed to preventing youth access of Juul products. As part of our commitment to prevent underage use, we are taking swift and decisive action against counterfeit and infringing products,” Juul said in a statement to INSIDER.

The FDA is also reviewing all tobacco and e-cigarette products with the hopes of lowering nicotine content in the coming years. In a 2017 press announcement, the FDA said it would allow any high-nicotine products that were on the market before August 2016 (like Juul) to stay on shelves until 2022 without pre-market review, leading some to believe the agency isn’t doing enough to prevent the sale of high-nicotine products.

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