8 Ways Juuls Can Cause Lung Cancer
The popular electronic cigarettes are promoted as a safer alternative to traditional cigarettes or a good way to wean yourself off smoking, but experts say not so fast.
What is a Juul?
Juuls are a type of battery-powered, electronic cigarette that contains a heating element and a refillable cartridge of "e-liquid," which is a mixture of nicotine, chemicals, and artificial flavorings. Pressing a button and inhaling (or sometimes simply inhaling) heats the liquid, creating an aerosol that can be inhaled the same way tobacco smoke from a regular cigarette is inhaled.
Juuls were introduced to American consumers in 2015, well after other brands of electronic cigarettes. But Juuls quickly became very popular, due to their small size; the cartridges are not much bigger than a typical USB flash drive. Their compact size makes concealing the devices easier, and this—along with fruity flavors—may help explain why Juuls and vaping (another name for smoking e-cigarettes) have become so popular with kids.
You may have seen marketing claims that Juuls are safer than cigarettes, but health experts aren't so sure. Indeed, research suggests that e-cigarettes can be potentially toxic and dangerous for your lungs.
The liquid contains toxic substances
Cigarettes are much maligned because of the thousands of chemicals in each puff. E-cigarettes may not have as high a number of ingredients, but they do contain chemicals that are not considered safe and nontoxic. "Vaping contains nicotine but also propylene glycol, flavored chemicals, glycerin, and byproducts including formaldehyde, which is toxic to the lungs," says Janette Nesheiwat, MD, family and emergency physician.
Each Juul pod contains a nicotine dose similar to a pack of cigarettes. Research suggests e-cigarettes contain at least 70 chemicals—lower than regular cigarettes, but still a significant amount. The concern for parents is that only one in three teenagers realizes that e-cigarettes such as Juul contain nicotine.
The risks grow the longer you vape
A study in the journal Oral Oncology linked e-cigarettes to cancer-related cell damage. With each puff, you're inhaling two primary e-cigarette ingredients—propylene glycol and vegetable glycerin—which contain a high level of toxins. What's more, toxicity from these ingredients increases the more you vape. And that's not the only risk—check out 8 silent ways e-cigarettes harm your body.
Heating releases potentially toxic chemicals
"Although e-cigarettes are noncombustible, the heating process does release chemicals such as formaldehyde, which are known carcinogens," says Amy M. Ahasic, MD, MPH, section chief, pulmonary and critical care medicine at Norwalk Hospital, WCHN.
"While the individual components of e-liquids—propylene glycol, vegetable glycerin, flavoring, nicotine—are safe and approved for consumption, [a National Institutes of Health study found that] when they are heated, as they are with the Juul device, they create carbonyls—acrolein and formaldehyde—as well as polycyclic aromatic hydrocarbons (PAH)," Dr. Nesheiwat says. "All of these can cause irritation and even irreversible lung damage. Acrolein, when inhaled, has been linked to lung cancer. PAHs are carcinogenic as well."
Juuls irritate and inflame the lungs
"[Some e-cigarette] ingredients are known to cause irritation and inflammation in the lungs; prolonged exposure can result in damage to the DNA of the cells, which then results in cancer after prolonged exposure," Dr. Nesheiwat says. "It can also cause what's called 'wet lung,'" Wet lung is basically irritation in the lung that inflames the tissue and mimics pneumonia. "It can be life-threatening as well and results in sudden life-threatening respiratory distress."
Flavorings contain known toxic substances
Juul pods come in eight flavors, with options like mango, mint, and cucumber. Many e-cigarette flavors often contain diacetyl, a chemical that has been shown to irritate and damage airways. The chemical is often used to create "buttery" flavors—it's the ingredient in microwave popcorn that makes it one of the 12 foods you think are healthy but are not and is a reason microwave popcorn is a food that cancer docs won't eat. Research has shown that workers at factories producing the chemical have developed a specific type of lung disease—referred to as "popcorn worker's lung." Indeed, diacetyl vapors are considered a workplace hazard.
"The flavors themselves are chemicals that are known to cause chronic lung disease," says Dr. Ahasic, who is also the chair of the occupational and environmental health network of the American College of Chest Physicians. "While we haven't really seen that with e-cigarettes yet, it's the same chemical. The type of lung disease that we see with flavorings-related lung disease is quite serious. In some cases, it can be lethal."
E-cigarettes may not help you stop smoking
E-cigarettes in general, and Juuls in particular, are marketed as a safer alternative to cigarettes and a tool to help people give up tobacco products. However, research the research is mixed on this claim: Some data suggests e-cigarettes are as effective as other smoking reduction methods (such as nicotine gum), while other research suggests they may have more addictive potential than standard cigarettes.
"When people are trying to break the habit and then they are using something that looks and feels similar to a cigarette and are inhaling similar to a cigarette, they are really enforcing the smoking behavior," Dr. Ahasic says. "That can make it not a very good smoking cessation tool."
Heat can damage airways
"The heat itself can be an irritant," Dr. Ahasic says. "It can cause inflammation of the airways... That can cause cough and mucus and shortness of breath in some people. There can be pretty immediate effects on the airways from the irritant factors of all the fine particulate matter you're inhaling—and that's true of e-cigarettes, aerosols, as well as traditional cigarettes."
Irritation overtime can lead to inflammation, which may be a risk factor for lung diseases, including lung cancer. Thinking e-cigarettes are a healthy alternative to cigarettes is one of the 50 health mistakes people make every day.
Juuls may cause secondhand smoke damage
We're all aware of some of the dangers of secondhand smoke; unfortunately, no one considers the dangers of secondhand e-smoke. "There is less in an e-cigarettes aerosol that's bad, but it's still there," Dr. Ahasic says. "When it's in a lower concentration, how much longer might it take for us to see the effects because the intensity of the exposure may be less?"
We simply don't know enough yet
"The problem is we really don't have any long-term health data, Dr. Ahasic says. "E-cigarettes have been on the market for less than 15 years," she points out. "If we think about lung cancer, the majority of patients diagnosed with lung cancer are aged 65 or greater, and many of those people started smoking when they were in their teens and 20s."
In 2016, the U.S. Surgeon General, Vivek H. Murthy, MD, MBA, released a report on the use of e-cigarettes among youth and young adults, warning: "Although e-cigarettes generally emit fewer toxicants than combustible tobacco products, we know that aerosol from e-cigarettes is not harmless." If you've heard enough and are ready to quit, here are the 23 best ways to stop smoking.