The Tennessee Department of Health recently issued an updated advisory concerning electronic cigarettes. Margaret Cunningham, chief executive officer for the Coffee County Anti-Drug Coalition, said vaping is particularly popular among students and may be a new avenue for nicotine addiction.

The Tennessee Department of Health has issued an updated advisory concerning electronic cigarettes, the practice of “vaping,” “Juuling” and use of other electronic nicotine delivery systems (ENDS).

Since the first advisory on ENDS was issued in 2013, accumulating evidence has increased the level of concern regarding the risks posed by these products to the health of all individuals involved, especially children.

Margaret Cunningham, chief executive officer for the Coffee County Anti-Drug Coalition warns locals of the dangers related to Juuling, which is particularly popular among students.

Juul is an electronic cigarette that was introduced in 2015.

“The Juul product is a huge problem among vaping teens,” Cunningham said. “It creates a new generation of addictive issues for teens. Along with that are new health issues from the vaping public in relation to the dangers of the vaping products themselves.”

Cunningham said that people mistakenly think vaping is safe.

“That’s not the case,” she said.


Damaging the youth

According to the department of health, nicotine is especially harmful for youth. Nicotine is highly addictive and dangerous to the developing brain. Nearly 90 percent of adult smokers started before age 18.

There is now substantial evidence that use of ENDS by young people places them at increased risk of becoming future smokers of combustible products, according to the department of health. Teens who use ENDS are at higher risk for increasing the frequency and intensity of subsequent combustible tobacco smoking.

In Tennessee, 40 percent of high school students have used an ENDS product, and 11.5 percent report current use.

ENDS products continue to evolve in ways that are appealing to teens, and young people often fail to understand the dangers associated with their use.

Products such as Juul provide high-dose nicotine via devices that are similar in appearance to USB devices.

These devices combine attractive flavorings such as crème brulee and mango with minimal vapor production, making them attractive to youth and easy to conceal, even in school.

According to the 2018 National Youth Tobacco Survey, more than 3.6 million U.S. middle (one in 20) and high school (one in five) students had used an ENDS product in the 30 days prior to the survey. That represents a 78 percent increase in use among high school students and a 48 percent increase among middle school students.

The majority of these youths would never have used combustible tobacco products, according to the report.

Juul products have been banned in other nations, citing them as a danger to public health.

The Tennessee Department of Health supports the regulation of flavorings and further urges that no flavorings of any kind, including menthol, be used with tobacco and nicotine products.


ENDS do not help smokers quit

Individuals who use ENDS as cessation devices often continue to smoke cigarettes as well and may be less likely to quit using tobacco than those who do not use ENDS products.

While ENDS are promoted as smoking cessation devices, the safety and efficacy of these products has not been demonstrated.

ENDS expose users and bystanders to harmful chemicals and metals. As smoking cessation devices, ENDS do not provide clear benefit over the various other Food and Drug Administration-approved products available to smokers who would like to end their use of tobacco.


Urging caution

The department of health continues to urge caution to consumers using or considering the use of electronic nicotine delivery systems such as Juuls, electronic cigarettes, e-cigs, e-cigars, e-pipes, e-hookahs, personal vaporizers and similar emissions-producing devices.

Consumers should understand there are still significant unknown long- and short-term health effects upon individuals of any age who use these devices and for those exposed to second-hand emissions, in addition to the known increased risk to youth for the development of nicotine addiction and future chronic tobacco and substance use.

Elena Cawley may be reached via email at