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No One Needs a Vape With a Screen

The Atlantic

www.theatlantic.com › health › archive › 2024 › 10 › vape-screen-teens-nicotine-addiction › 680455

When a friend pulled out her vape at a playoff-baseball watch party earlier this month, it immediately caught my eye. I had grown accustomed to marveling at the different disposable vapes she’d purchase each time her last one ran out of nicotine—the strange flavors, the seemingly endless number of brands—but this product was different. It had a screen. While she vaped, the device played a silly little animation that reminded me of a rudimentary version of Pacman.

In the name of journalism, I went to my local smoke shop this week, and sure enough, vapes with screens were ubiquitous. One product on the shelves, a Geek Bar Pulse X, featured a screen that wraps around the device, displaying a constellation of stars when you inhale. Another, the Watermelon Ice Raz vape, displayed a rudimentary animation of moving flames. Vapes with screens first began to hit the market late last year, and only recently have become widely accessible. Online retailers sell vapes with screens that display what appear to be planets, rockets, and cars driving in outer space. The screens are small—just a few inches wide at most—and they are cheap: These products run as little as $25, and can last for several months.

The Watermelon Ice Raz vape that I spotted in the store reminded me of the loading screens on an old Game Boy Color. I could see how adults like me might be enticed by the nostalgia of it all. The problem is that these vapes might also appeal to kids. It’s illegal for anyone under 21 to buy a vape, but the gadgets have been popular among teens since they were first popularized by Juul. Although youth vaping rates have dropped in recent years thanks in part to public-service campaigns that have warned kids about the dangers of vaping and nicotine addiction, the inclusion of a screen risks backtracking the progress that has been made. A screen full of animations sends the message that an e-cigarette is “something for fun and games and recreation,” Robert Jackler, an expert on tobacco marketing at Stanford University, told me. Just imagine you’re in eighth grade and the cool kid in your class has a vape with a screen of moving flames. You’re going to want one.

These gadgets are new enough that it’s unclear to what degree kids are using them, but they have all the warning signs. Vape companies are notorious for selling products in kid-friendly flavors such as Banana Taffy Freeze and Cherry Bomb, and screen vapes may be the next ploy to hook kids. The vaping industry “will do anything that it takes to bring in novel features to attract new users, and this is just another example of that,” Laura Struik, an assistant professor at the University of British Columbia at Okanagan who has studied youth use of e-cigarettes, told me. One of the most popular vape brands among teens, Mr. Fog, has already launched a screen vape.

Screen vapes run the risk of becoming a fad, and fads spread among kids because someone they look up to uses them, Emily Moorlock, a senior lecturer in marketing at Sheffield Hallam University who has written about youth vaping, told me. That was certainly my experience as a kid. I remember begging my parents for a Game Boy because other kids in my elementary school had them. Vaping is similar: When the government asks kids to explain the reason they tried vaping, the top explanation is because a friend does it.

Screens might also make vapes more addictive. Even the simplest visuals, such as retro video games, have been shown to cause the brain to release dopamine, a neurotransmitter responsible for feelings of pleasure and reward. Even the rudimentary vapes I encountered—those that just play little animations on a loop—could spike dopamine, and thus increase users’ desire for these products, three experts told me.

Tony Abboud, the head of the Vapor Technology Association, a lobbying group, described them to me as a technological advancement. Besides the animations, many of these screens tend to display how much battery and vapable nicotine juice is left in the device. Abboud said that public-health groups are trying to brand screen vapes as “the next bad example” of how the industry is marketing to kids, despite youth vape rates dropping. “Just because a new technology has a new feature doesn’t mean that feature was designed to allow the product to be marketed to kids,” he said.

Abboud and other vaping defenders have a point that e-cigarettes aren’t just an enticement for kids to get addicted to nicotine, but are also a tool to help smokers quit smoking. Vapes can benefit public health because they are safer than cigarettes and as effective, or more effective, than other anti-smoking products on the market. Even flavored vapes—which do attract kids—also can help entice adults to switch out their cigarettes for a vape.

But a screen serves no purpose except for some cheap entertainment. If adult vapers want a signal that their product is low on battery, that could be solved by a little power light, like on a smoke detector. The flames and constellations simply aren’t necessary. After years of panic over youth vaping rates, it seems like kids are finally understanding that they shouldn’t vape. Why risk messing that up because of a tiny screen?

Public Health Has a Blueberry-Banana Problem

The Atlantic

www.theatlantic.com › health › archive › 2024 › 10 › vaping-quit-smoking-trump › 680215

These days, you can easily find vapes in flavors that include “Lush Ice,” “Blueberry Banana,” “Mango Lychee,” “Hot Fudge,” and “Fcuking Fab” (whatever that is). No matter which one you choose, it’s almost certainly illegal. The tiny battery-powered devices that produce a mist of nicotine when you inhale, first popularized by Juul, are not outright banned—at least not for adults—but only a few flavored vapes have gotten the FDA authorization required before they hit the market. That hasn’t stopped hundreds of shadowy companies, many based abroad, from effectively hawking contraband. Vapes are sold to Americans online for as little as $5, and are well-stocked in convenience stores, smoke shops, and even vending machines.

With such little oversight, it’s no wonder that about 1.6 million American kids are regularly vaping, leading to panic that they are getting duped into a lifetime of nicotine addiction. The FDA has levied fines, filed lawsuits, and even seized products to keep vapes off of shelves, and the agency has pledged a major escalation in its efforts. Politicians across the political spectrum, including Senators Mitt Romney and Chuck Schumer, have advocated for a vaping crackdown. But not Donald Trump.

In 2020, Trump abruptly abandoned a plan to ban flavored vapes, much to the chagrin of public-health officials. Late last month, Trump posted on Truth Social that, if elected, he would “save Vaping again!” The former president may be a deeply flawed messenger, and the vaping industry hardly deserves any sympathy. Many of these companies flagrantly violate the law and overtly market to kids. Even so, Trump has a point. Vapes—as a replacement for cigarettes, anyway—are actually worth saving.

Trump said in that Truth Social post that vapes have “greatly helped people get off smoking.” It’s easy to dismiss that as spin. After all, he had received a personal visit from the head of the vaping industry’s lobbying group that same day. However, vapes are indeed a revelation for the 28 million adults in the United States who smoke cigarettes. They work as well, or even better, than all of the conventional products designed to help wean people off of cigarettes.

Gum, lozenges, and patches simply deliver nicotine, the addictive chemical that keeps smokers smoking, in a safer way. These so-called nicotine-replacement therapies don’t contain any of the harmful ingredients in tobacco products such as cigarettes. Whenever you might feel an itch to smoke, you can instead use one of these replacements to satiate your craving.

But nicotine-replacement therapies don’t work well. Less than 20 percent of people who try to quit smoking using these therapies in clinical trials are actually successful; one study found they aren’t any better than attempting to quit cold turkey. That’s because, for smokers, nicotine gums and lozenges never deliver anything close to the euphoric feelings of puffing on a cigarette. Your average cigarette is just tobacco leaves wrapped in paper with a filter on the end, but it is exquisitely efficient at delivering nicotine to the body. When burned, tobacco creates nicotine particles that hit receptors in the brain within 10 to 20 seconds. Nicotine-replacement therapies deliver nicotine much more slowly—from minutes to several hours—because the drug is absorbed by the mouth or through the skin.

But you know what can get close to the experience of smoking? Vapes. They generate an aerosol that can reach deep into the lungs, allowing nicotine to hit the bloodstream at a speed that is “almost identical” to cigarettes, Maciej Goniewicz, an expert on nicotine pharmacology at the Roswell Park Comprehensive Cancer Center, told me. Part of what makes vapes so effective is that they look and work like cigarettes. “People who are addicted to smoking are not just physiologically addicted to the nicotine; they’re also behaviorally addicted to the process of smoking,” Ken Warner, an emeritus professor of public health at the University of Michigan, told me.

Vapes even hold their own against the one conventional treatment that’s more effective than the traditional gums and patches: a prescription drug called Chantix. Instead of replacing the nicotine in cigarettes, it blocks the pleasurable effects of nicotine on the brain. According to a recent clinical trial, roughly 40 percent of some 400 people given a vape or Chantix successfully quit smoking after six months. Vaping may be an easier transition for smokers: Chantix isn’t widely used, in large part because of its side effects, which include nausea and vivid dreams. It certainly doesn’t hurt that huffing on a “Fcuking Fab”–flavored gadget can also just be fun. That vapes come in so many flavors is often the reason people start vaping in the first place. It’s not that different from alcohol: Many drinkers would prefer a vodka cranberry over a shot of Tito’s.

Just like how it’s not just heavy drinkers who enjoy a vodka cranberry, the same is true of flavored vapes. The attractiveness of flavors is also why kids gravitate toward them, as do adults who have never smoked. Because kids overwhelmingly use flavors, banning them seems like an easy way to reduce vape use. But if public health is about managing trade-offs, the benefits of vapes seem to outweigh the negatives. Although no kids should be vaping, abusing these products is not deadly like cigarettes are. Amid rising public awareness about the dangers of youth vaping, even FDA’s top tobacco official has acknowledged publicly that youth vaping is no longer the epidemic it was a few years ago.

But there are other caveats to consider when it comes to the anti-smoking potential of vapes. They are regulated as consumer products and not medicines, so they have not gone through the same rigorous approval process that every other anti-smoking drug has gone through. We still don’t know alot about how effective vapes might be to help people quit smoking, or how often smokers need to use them to successfully quit. Because vapes are still relatively new, no one can say definitively that they do not carry some long-term risks we do not know yet. The current Wild West of vapes also adds to the potential pitfalls. Vapes also contain known carcinogens, likely because of the chemicals in e-liquids being heated to high temperatures. Some likely carry higher risks than others because of how little standardization there is in the chemicals used.

All of these risks have made public-health groups understandably reluctant to embrace their use. The FDA acknowledges that vapes are safer than cigarettes, though they do not endorse them as an anti-smoking treatment. Should the agency get its way, the majority of flavored vapes will eventually be off of store shelves. The head of the FDA’s tobacco center has said that “nothing is off the table.”

No matter who wins in November, some of the FDA’s decisions are likely out of the next president’s control: The agency’s decisions on which vapes to green-light doesn’t rest with the commander in chief or the FDA commissioner; rather, they are governed by FDA scientists who are following a legal standard. Still, having a president who embraces vaping could go a long way. Surveys show that a sizable proportion of smokers mistakenly think vapes are more dangerous than cigarettes. That likely keeps many smokers from trying them.

Kamala Harris has not weighed in on vaping since becoming the Democratic nominee. (Her campaign declined to comment on her position. And any single-issue vaping voters out there might do well to reconsider their priorities before voting for Trump.) His stance isn’t exactly academically rigorous, nor is it adequately nuanced. But if Trump acknowledges the benefits of vaping while also condemning the lawlessness of much of the current vaping industry, he could help legitimize a product that has been shunned by most of the medical establishment. For now, few reputable companies are willing to invest in making their own vapes, and few doctors are going to recommend them to patients.

This all might sound like public-health sacrilege. But given that the overwhelming majority of smokers who try to quit each year fail, “anything that we can add to the tool kit as a way that could help people transition away from smoking is something that is worth exploring,” Jamie Hartmann-Boyce, a professor at the University of Massachusetts at Amherst who has studied anti-smoking drugs, told me. You might cringe at the thought of anyone putting something called “Fcuking Fab” into their lungs, but consider that cigarettes still kill nearly 500,000 Americans each year. Vapes are deeply flawed. Unfortunately, so are the alternatives.