UCSF associate professor Jeremiah Mock holding a JUUL e-cigarette cartridge and a cigarette butt he found on a local high school campus (photo by Elisabeth Fall)
The use of electronic cigarettes, or e-cigarettes, by American youth has surged so dramatically in recent years that the U.S. Surgeon General has declared it an “epidemic.” According to the Centers for Disease Control and Prevention, e-cigarette use among middle school students increased by 48 percent (3.3 percent to 4.9 percent) and among high school students by 78 percent (11.7 percent to 20.8 percent) from 2017 to 2018. In 2018, about 3.6 million middle and high school students nationwide reported using e-cigarettes, according to the CDC.
Communities in the San Francisco Bay Area have not been immune to this epidemic. For example, in Marin County between 2016 and 2018, e-cigarette use among seventh-graders rose from 2 percent to 5 percent, and among 11th-graders from 11 percent to 28 percent, according to the California Healthy Kids Survey.
JUUL is the leader in the e-cigarette industry with a market share around 70 percent.
“A year ago, there were very few high school administrators and parents in Marin County who knew what JUUL was or how to pronounce it,” said Jeremiah Mock, a health anthropologist and associate professor in the UC San Francisco School of Nursing’s Institute for Health & Aging and member of UCSF’s Center for Tobacco Control Research and Education. “JUULing caught a large majority of parents and teachers flat-footed.”
In addition, the waste from e-cigarettes may pose negative environmental effects. Mock and other researchers at UCSF are investigating this potential risk, which has taken them from the parking lots of San Francisco Bay Area high schools to the beaches and national parks of the Pacific Rim.
12 High Schools, 893 Pieces of Tobacco Waste
First introduced in the U.S. in 2007, e-cigarettes were hailed by some as a healthier alternative to combustible cigarettes because users avoided inhaling some of the estimated 7,000 chemicals that are produced from burning tobacco.
But e-cigarettes, notably JUUL, have become increasingly popular with adolescents and teens — and with considerable dangers. Emerging evidence shows that the use of e-cigarettes can cause heart attacks, lung disease, and may cause seizures. E-cigarette aerosol can also contain cancer-causing chemicals, according to the American Cancer Society. Additionally, e-cigarettes contain nicotine, which is more damaging for younger users because brain development continues into one’s mid-20s. Studies have shown nicotine affects cell activity in the brain and negatively impacts the capacities for attention, learning and memory.