SICK NEW WAY TO GET THE YOUNG HOOKED ON NICOTINE THIS
As cigarette sales plummet, the tobacco giants are investing BILLIONS in vaping – and it’s teenagers who are taking up the habit, with disturbing implications for their health
HARRY GREEN started vaping about six months ago. Now it’s a daily ritual. He and his friends nip out of school at lunchtime to puff away, surrounded by clouds of sickly-sweet vapour. His favourite vape flavours are cherry and vanilla.
Harry is 17 and shouldn’t be vaping. Like tobacco smoking, the habit is restricted by UK law to people aged 18 or over. But he bought his vape kit online, circumventing sales restrictions, and his mother has conceded defeat — for the time being.
‘I ask him not to do it in the house because I hate the odour of synthetic chemicals and it gets everywhere,’ says Mrs Green, a PA from Berkshire. ‘We are battling with it.’
She adds: ‘My son was very anti-smoking and not a partygoer, but that has changed since he began vaping.’
Sarah Livingstone, a marketing director from Somerset, says vaping is endemic in her 13-year-old daughter frankie’s year.
‘It’s the “cool kid” thing to do,’ she says. ‘Some parents seem to think it’s just about the sweet flavours, but I’ve been told by older
children that they are all choosing vaping liquids which contain nicotine.
‘The rules are useless — they all shop online, get older friends to buy it for them or buy it themselves from shops that don’t care.’
Such fears are shared by thousands of parents nationwide. Nicotine had been on the retreat in Britain for years as the relentless campaign against cigarette smoking gradually yielded results. In 1974, 45 per cent of Britons smoked; today the figure is 15 per cent.
But this highly addictive drug is making a comeback, repackaged as e- cigarettes — originally developed to wean smokers off tobacco and aggressively promoted by the NHS as a safer alternative to smoking.
E- cigs are hand-held, battery- operated devices that simulate the experience of smoking a cigarette by heating liquid (in a refillable tank or sealed pod) that usually contains nicotine (nicotine-free products are available) to generate a ‘vapour’, which is then inhaled.
Now the catch-all phrase ‘vaping’ is used to describe a habit that is being embraced by youngsters, rather than adults, at an alarming rate. Public Health England says that, while numbers are still small, the proportion of 11 to 18-year-olds using e-cig products has doubled in the past five years (from 8.1 per cent in 2014 to 16 per cent in 2018), with almost one in six admitting they have tried one.
By contrast, vaping among adults in Britain has remained stable since 2015, at about 6 per cent (three million have used them in the decade since e-cigs became available).
And as leading vape brand Juul — its elegant e-cigs in a range of colours have been stocked by Boots, Sainsbury’s and ‘vape shops’ since last summer — announces plans to expand its British market to 55,000 outlets, the number of young users may be set to rise, despite Juul’s insistence that it actively seeks to dissuade UK youngsters from using its products and has a strict age-verification system in place. In the age of social media, advertising restrictions can be circumvented by ‘influencers’ who portray vaping as ‘cool’, and cartoons have been used on Instagram to promote the products to children as young as 13, according to one national newspaper investigation. Then, of course, there is peer pressure from older siblings and friends.
There is a real risk vaping could ensnare a new generation in nicotine addiction, with serious health consequences. E-cigs are also a possible ‘gateway’ to conventional cigarettes.
This week, Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine and a long-time critic of e-cigs, pointed to evidence of short-term effects on lung and cardiovascular function and said ‘we should be very, very careful’ because the long-term effects are unknown.
He is also highly critical of government health organisations that recommend e- cigs should be prescribed on the NHS because they are ‘ 95 per cent less harmful than cigarette smoking’, and campaign for smokers to switch to vaping.
‘It’s not whether e- cigarettes are safer than cigarettes, it’s whether they are actually safe,’ he says.
ProfESSorMcKEE’s particular concern is the appeal to young people. He says vape marketing, with its range of child- friendly, sweet flavours, reminds him of the alcopops craze of yesteryear which introduced a generation to alcohol.
His may be a lone voice here, but vaping has reached epidemic proportions in U.S. high schools, leading to calls from politicians for tighter controls and a threat by authorities to withdraw e-cigs from sale unless more is done to curb the rise in their use by teenagers — again because of fears about the long-term effects.
Indeed, vaping has become the new front line in the never-ending battle with Big Tobacco — as the powerful global cigarette companies are known collectively — and the industry is investing billions in vaping and other new nicotine-delivery systems.
Philip Morris International (PMI), the maker of Marlboro cigarettes, has invested in Vivid vape and Iqos heated tobacco devices, while British American Tobacco is behind the Vype vapour and Glo heated tobacco e-cigarettes. Imperial Brands makes the Blu vaping device.
In a bizarre and cynical twist, the tobacco giants are even trying to portray themselves as champions of a ‘smokeless’ world — free of the conventional killer combustible cigarettes they currently supply to the planet’s 1.1 billion smokers.
Note, though, that this is not a ‘nicotine-free’ world. Big Tobacco has no intention of quitting the addiction business. Tobacco multinationals see vaping as an insurance policy against falling sales in developed countries that are increasingly hostile to smoking, where health campaigns, advertising bans and
packaging restrictions have turned smoking into a pariah activity.
This month, PMI has been pushing its e-cigarette products under cover of a campaign called ‘Unsmoke’. It took out full-page advertisements in the UK offering smokers support in quitting altogether. But it was also promoting the idea that if people cannot kick cigarettes, they should embrace ‘change’ by switching to vaping or ‘heated tobacco’ products.
‘our paramount business strategy is to replace cigarettes with less harmful, smoke-free alternatives. That’s what we call a smoke-free future,’ says PMI’s chief executive, Andre Calantzopoulos.
In pushing vaping, the tobacco
multinationals have unlikely allies — including Public Health England and Action on Smoking and Health (ASH), as these organisations see it as so much safer than smoking.
Yet even when the toxins in tobacco smoke are no longer being ingested, nicotine itself poses a risk. Research suggests the young brain — which continues to develop until the age of 25 — is particularly vulnerable to nicotine and adapts to cope with any influx of it.
Over time, as the brain learns to tolerate nicotine, it requires more of the drug to produce the same ‘high’. Effects of this deepening addiction can include loss of concentration, anxiety and a greater tendency to act impulsively.
As well as Professor McKee’s concerns about lung and heart function, researchers at Birmingham University have linked vaping with chronic respiratory diseases such as bronchitis and emphysema. According to Dr Aaron Scott, who led the study: ‘[Vaping] is cytotoxic [toxic to cells] and pro-inflammatory, just like cigarette smoke in the short term.’
Other studies have linked e-cigs to certain cancers and heart disease, while Harvard University reported this week that one e-cig product in four is contaminated by lung- damaging bacterial and fungal toxins.
The American scientists also found that the sweet, fruity flavours popular with teenagers were most likely to be contaminated.
Until 2016, when the substance was banned by the EU, some of these ‘ child- friendly’ liquids contained a chemical, diacetyl, that can cause ‘popcorn lung’ — a build-up of scar tissue that reduces the efficiency of the lungs.
An addiction to nicotine also, of course, raises the possibility that youngsters in search of a stronger hit may graduate to conventional cigarettes.
Linda Bauld, Professor of Public Health at Edinburgh University, says that, as with conventional cigarettes, youngsters will always find ways to get hold of vaping liquid, which is cheaper than tobacco. But she argues that the public health benefits of vaping far outweigh the risks to youngsters.
Tobacco remains the leading cause of preventable illness in this country, killing about 100,000 people a year and costing the country an estimated £12 billion in medical bills and lost work.
‘We don’t want kids to vape,’ Professor Bauld says. ‘ These products can be addictive and we need schools to crack down. But at the end of the day, if you have a troubled teenager, often from a smoking family, then vaping is a far better alternative to smoking.
‘We need to protect kids, but also to make sure that the one adult in four who mistakenly believes vaping is just as bad as smoking doesn’t increase.’
Professor McKee disagrees with this approach and accuses the bodies that back vaping as an aid to quitting smoking of ‘gross complacency’. ‘There are other factors that work in cutting smoking in a population, like price, availability and marketing,’ he argues. ‘This idea that e-cigarettes are some wonder cure for smoking — they are not.
‘UK data on youth vaping is still at an early stage. We’ve seen what has happened in the U.S., and American kids aren’t different from ours. They have just been exposed to it for longer.’
Which brings us back to Juul. So dominant is its position in the teen market in the U.S. — although the minimum age to purchase Juul products is 21 — that users speak of ‘Juuling’ rather than vaping.
Easy to conceal, the product is also easy to reload with sealed liquid pods containing — in the U.S. version — nicotine equal to that in a pack of 20 cigarettes. (The British variant contains a third of that concentration of nicotine, to comply with EU restrictions.)
A starter kit with a Juul device and four pods, including ‘royal creme’ and ‘ mango nectar’, is currently selling in some vape shops for as little as £19.99.
A pod is intended to last for about a day and a pack of four is £9.99. So the average user can ‘Juul’ for £2.50 a day, as opposed to spending £11 on a packet of cigarettes.
Juul Labs, the device’s U. S. manufacturer, says the product was developed specifically to wean adult tobacco smokers off cigarettes. But it concedes that the company has been forced to change its marketing campaign in the U.S. — which had used images of stylish young people on social media sites such as Facebook and Instagram — to head off accusations that it targets the young.
Juul UK says it has learned from the American experience and made efforts to prevent youngsters buying its products online, with multiple security checks designed to deter underage buyers. Its limited marketing campaign in the UK portrays the device solely as a smoking cessation aid.
has not prevented its apparent infiltration into the UK independent education sector. ‘It’s all over the boarding schools in Britain,’ according to journalist Joanna Della-Ragione, a one-time Juul ‘addict’ herself. In the course of a magazine investigation she talked to Dan, in Year 11, who told her about 50 children at his boarding school had been suspended for vaping in the previous year.
‘ If you’re caught, it’s instant suspension.’ he said. ‘ But still, everyone does it. A sixth-former comes and takes orders for Juul once a week and deals them out to the younger kids.
‘A lot of my friends hit the Juul from the second they wake up. I have five or six friends in my house alone who are seriously addicted. They spend their entire allowance on Juul pods.’
Billy, 19, said lack of odour made it easier to vape with Juul than to smoke conventional cigarettes at his former boarding school.
‘I smoked cigarettes before, and another vape pen, but Juul was easier and more fun,’ he said.
Someone else is a fan of Juul — the American cigarette giant Altria. In 2007, the Philip Morris empire split into two listed companies: Philip Morris International (which sells brands outside the U.S.) and Altria, which manages domestic U.S. sales. Last year, Altria paid £9.8 billion for a 35 per cent share in Juul Labs. As part of the deal, Juul pods will be displayed in stores alongside Marlboro.
Critics say this poacher-turnedgamekeeper tactic is to be expected from an industry never short on cynicism. Indeed, is it too fanciful to believe that behind boardroom doors, Big Tobacco executives are intent on finding new ways to keep us hooked on nicotine?
One concerned parent has little doubt this is the intention.
‘Sometimes I tell myself this is a craze and will die out,’ says Sarah Livingstone, mother of Frankie, 13. ‘But then I remember that these kids are getting addicted to nicotine, as well as potentially harming their lungs.
‘At least with cigarettes, we know what we’re up against. With vaping, our children are at the mercy of the big companies again.’ Some names have been changed.