A tobacco replacement designed to help grown-ups quit smoking has landed in the hands of children with potentially harmful consequences, new USC research shows.

Jon-Patrick Allem, PhD, MA, research scientist at the Keck School of Medicine of USC, explores the intersection of social media and public health. His study of 80,000 tweets shows the JUUL vaporizer, a discreet gadget a little bigger than a pack of gum, is widely used among high school, middle school and even elementary school students in the U.S.

“We found young people talking about using JUUL on school grounds, in classrooms, in bathrooms, in the library, at recess and during gym,” Allem said. “JUUL vapors dissipate quickly, unlike the telltale cloud of previous e-cigarette ‘vaping’ devices, so it’s a way for kids to use nicotine undetected.”

Allem is lead author of the paper, a collaboration among scientists in the Keck School’s Department of Preventive Medicine and the USC Viterbi School of Engineering’s Department of Computer Science. It was published in the June 26 issue of the journal Drug and Alcohol Dependence.


Smoking substitute JUUL consists of a flash drive

The JUUL device, a new type of e-cigarette developed by San Francisco-based PAX Labs, consists of a USB flash drive-powered vaporizer that is easily concealed. Users insert cartridges called JUUL pods containing nicotine salts found in tobacco leaves. The device converts nicotine into steam that delivers a wallop; one JUUL pod delivers about as much nicotine as a pack of cigarettes.

Pax Labs markets the device as a smoking alternative for adults trying to quit, but Twitter posts show that minors use it to vape at school without being caught.

JUUL sales have been estimated at more than half of the U.S. e-cigarette market. PAX Labs, responding to early criticism from health advocacy groups, has positioned JUUL in its marketing campaigns and website as a product to help adults quit smoking tobacco; website visitors must confirm they are 21 years or older.


Twitter posts on JUUL

Nicotine use is known to be addictive and harmful to adolescent brain development. Allem said that in a sample of more than 80,000 posts to Twitter, about 1 in 25 mentioned using JUUL at school. Some of the tweets even link to videos of kids using JUUL.

“Despite JUUL’s branding as a smoking alternative, very few Twitter users mentioned smoking cessation with JUUL,” the study reports, observing that roughly 1 in 350 Twitter posts mentioned using JUUL to quit smoking, far less than posts about use at school.

Allem’s research focuses on improving health surveillance using data from Twitter, Instagram, YouTube and Google web search. Other authors of the study include Likhit Dhampuri, a doctoral student in computer science at USC; Jennifer B. Unger, PhD, a professor of preventive medicine at the Keck School; and Tess Boley Cruz, PhD, MPH, assistant professor of clinical preventive medicine at the Keck School.

The study was funded by a $40,000 grant (P50CA180905) from the National Cancer Institute and the Food and Drug Administration’s Center for Tobacco Products to determine the public’s early experience with JUUL and the social and environmental context of its use. The findings offer a cautionary note for parents, school administrators and teachers. The study suggests educators might need to learn how to spot JUUL use while administrators may consider installing vaping detectors on campuses.

— Gary Polakovic