Last month, a U.S. House of Representatives committee heard testimony that the multibillion-dollar nicotine-delivery company Juul has found new and insidious ways to market nicotine to our kids, even reaching into elementary schools to entice them.

Scientists and educators testified that Juul reps met “with students — with no teachers present — and told them the company’s e-cigarettes were ‘totally safe,’ ” The New York Times reported. Juul paid a charter school network to design a curriculum for a student summer camp that would “teach children healthy lifestyles.” The company has built an army of thousands of “social influencers” to market vaping to kids. Juul now controls three-quarters of the youth e-cigarette market, and has been rewarded with a $13 billion investment and noncompete agreement with Altria, the company behind Marlboro. The notion that Juul is positioned to support “healthy lifestyles” invites the fox to build the henhouse.

Nicotine is a toxic pesticide produced by the tobacco plant. It kills off insect predators by mimicking neurotransmitters. For humans, one of those neurotransmitters is dopamine, which in smaller doses gives a temporary sensation of pleasure. So every inhalation from a Juul pod reinforces the addiction, up to 200 times from a single pod.

That’s “brain education” for you. Juul and vape pods also contain goodies such as carcinogenic flavor compounds (e.g., mint, crème and mango) designed to get youths with a sweet tooth hooked.

Nicotine also poses immediate dangers. If your dog or baby chews on the small Juul “flash drive,” they will ingest the equivalent of nicotine in 20 cigarettes, potentially with lethal impact. Nicotine even can be directly absorbed into the blood through a baby’s skin.

As pediatricians and public-health experts, we know that addictive behaviors start in childhood. Juul knows this, too. They’re banking on it. The rise in vaping has reversed decades of progress in reducing youth smoking. In the 2018 Washington State Healthy Youth Survey, nearly one in three high school students had used vaping products in the past month. This translates to a future revenue stream for Juul, whose products represent over half of the nicotine vaping market.


The increase in youth nicotine use, in great measure, is due to the introduction of Juul and other e-cigarettes. How can parents and pediatricians protect kids from the insidious new face of an old addiction?

We need strong and enforceable laws to restrict youth access. Kudos to Washington state lawmakers who raised the e-cigarette/vape purchase age to 21, effective in January 2020. Vape sales and marketing tools need tight regulation and scrutiny for online and storefront sales, which are still effortlessly accessible to kids. IDs should be electronically scanned, rather than relying on a shop owner to calculate age/date based on a driver’s license. Sting operations and hefty fines are needed to ensure compliance. Many states have banned kid-focused flavoring like mango and cotton candy; some cities have moved to ban e-cigarettes entirely.

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Schools and educators can do their part by developing ethical guidelines for banning corporate “contributions” and curricula from companies that sell nicotine and other addictive products. The Food and Drug Administration could tighten regulations on e-cigarettes. If a Juul sale required a prescription that named the prescribing physician and the patient, as is necessary with opioids and ADHD medications, we could quickly identify products that are being diverted to youth.

Parents and kids are recognizing that vaping products are designed to develop a lifetime nicotine addiction, for company profits, and at the expense of our kids — right under our noses.