FDA to restrict sale of flavored Juul pods to fight teen vaping

Flavored pods make getting into Juuling easier for teens.
Image: scott olson/Getty Images

It’s like taking candy away from a baby.

The FDA will move to ban Juul’s fun flavors from most convenience stores to fight teen use of the product, reports the New York Times. The agency will also require stricter age verification measures for buying Juuls online.

The new policies are part of the FDA’s investigation into teens’ love of the product, and whether Juul itself is to blame. In September, the FDA gave JUUL 60 days to introduce new initiatives to fight teen use. Now that time has expired, the FDA is taking action themselves. The restrictions will also apply to other big tobacco companies that sell flavored nicotine pods. The FDA will reportedly share further details of the plan the week of November 12. 

Juul pods come in mango, cucumber, fruit, and creme, in addition to mint, menthol, Virginia tobacco, and classic tobacco. The FDA won’t allow gas stations and convenience stores to sell the more teen-friendly flavors: mango, cucumber, fruit, and creme. Vape shops and other “specialty retailers” will still be able to sell all the flavors, according to Reuters.

There aren’t details yet about how the stricter age verifications will work. Juul already restricts all online sales of its products to its own website, and is fighting counterfeiters who sell fake Juuls all over the internet. This is part of their push to curb teen vaping, because the Juul site already requires shoppers to verify their age with their social security number.

Juul’s age verification page.

Image: screenshot: rachel kraus/mashable/juul

Juul’s age verification page.

Image: SCREENSHOT: RACHEL KRAUS/MASHABLE/JUUL

Juul bills itself as a way to help adult smokers quit; it says that if you have never smoked, you should never start Juuling. But Juul has 70 percent of the market share of vaping devices. And Juuls in particular are the beloved e-cig brand of the high school set; “Juuling” is all over teenage social media, and a University of Michigan survey even found that 1 in 4 high school seniors said they vaped in 2017.

Going after flavored pods may be a good step in fighting teen use. The Campaign for Tobacco Free Kids reported that flavored pods might be easing the runway into vaping: 81 percent of 12-17 year olds “who had ever used e-cigarettes had used a flavored e-cigarette the first time they tried the product,” their report reads. And flavored pods remain popular even after the first time: “81.5 percent of current youth e-cigarette users said they used e-cigarettes “because they come in flavors I like.”

Given that research, restricting sales of the flavors might deter some first time Juulers. Although, plenty of companies sell other flavored pods that still work with Juuls.

However, the Campaign — and anyone who has eyes — first attributes the rise of Juul to the “sleek design” and easy ability to hide the activity from adults. That is, like so many other trends, it’s the rebellious, aesthetic cool-factor of Juul that has made it so popular with teenagers — not just fun flavors. 

Juuling is also a verb all its own that specifically does not look like smoking; it’s a necessarily nonchalant action in the same way smoking was, but with an under the radar swagger all its own.

That aura is something harder for the FDA to regulate. The cool factor (and subsequent use) of cigarettes has only ebbed as the adverse health effects and stigma have taken precedence over the James Dean look. Teens also reportedly don’t view vapes as being that bad for them, despite current research indicating that vaping comes with health risks all its own. 

Juul and the FDA have a long road ahead of them if they’re both committed, together, to getting teens to stop Juuling. Making mango pods slightly harder to buy isn’t the end of the road.

Read more: http://mashable.com/

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FDA expands investigation of illegal e-cigarette marketing to kids

(CNN)The US Food and Drug Administration pressed forward with its investigation of e-cigarette companies Friday, sending letters to 21 companies in an effort to uncover whether they are marketing products illegally and outside the agency’s compliance policy.

This latest phase of the investigation addresses more than 40 e-cigarette products and is part of the agency’s ongoing efforts to combat e-cigarette use among youth. It also comes less than two weeks after the agency conducted a surprise inspection of e-cigarette maker Juul’s corporate headquarters in San Francisco, seizing thousand of documents, many of which relate to its sales and marketing practices.
“Companies are on notice,” FDA Commissioner Dr. Scott Gottlieb said in a statement Friday. “The FDA will not allow the proliferation of e-cigarettes or other tobacco products potentially being marketed illegally and outside of the agency’s compliance policy, and we will take swift action when companies are skirting the law.”
    In September, Gottlieb called the increasing teen use of e-cigarettes “an epidemic,” adding that teen nicotine use is dangerous to young people’s health and brains.
    Federal law prohibits the sale of e-cigarettes to people under the age of 18, but more than 2 million middle and high school students were current users of e-cigarettes in 2017, according to the FDA. The US Centers for Disease Control and Prevention says it’s the most common nicotine product used by middle and high schoolers.
    Also last month, the FDA requested that five major e-cigarette manufacturers, including Juul, explain how they plan to combat the use of their products by minors. The agency said it was looking into steps to eliminate the sale of flavored products and unveiled a public education campaign about e-cigarettes.
    The FDA said it’s considering civil and criminal avenues to enforce these regulations, including fines, seizures and injunctions, according to Friday’s announcement.
    CNN reached out to some of the companies that received letters for comment but did not immediately receive a response.

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      “We’re going to address issues related to the access kids have to e-cigarettes, as well as the youth appeal of these products,” Gottlieb said Friday. “We know flavors are one of the principal drivers of the youth appeal of e-cigarettes and we’re looking carefully at this.
      “No reasonable person wants to see these products reaching epidemic use among kids,” he said.

      Read more: http://edition.cnn.com/

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      Cannabis capitalism: who is making money in the marijuana industry?

      Marginalized groups that championed legalization struggle to compete with corporate refugees jumping on the bandwagon

      Two hours north of San Francisco, in Mendocino county, orderly roadside vineyards give way to the rugged forests and misty coast of the Emerald Triangle, Americas most celebrated marijuana growing region. In June, more than 300 cannabis industry insiders gathered there for a weekend of bonfires, starlit hikes and river swims.

      It was a lovely setting to discuss why none of them seemed to be making money.

      Americans spend roughly $40bn annually on legal and illegal marijuana. Their appetite is almost certain to increase as it becomes easier to legally access the drug and the industry continues to promote pot as compatible with a healthy adult life.

      In California alone, tens of thousands of farms grow the plant, which is increasingly processed into gorgeously packaged vape pens and edibles marketed to customers outside the core stoner demographic of young men. Today, seniors are the fastest-growing group of marijuana users in the US.

      The future looks very green indeed. But since New Years Day 2014, when Colorado opened the worlds first regulated recreational marijuana market, the business climate for weed companies has proven immensely difficult for a range of reasons, including high taxes, rapidly changing regulations and a still robust illicit market.

      Besides the business challenges, Americas legal marijuana industry also has to reckon with an unavoidable moral dimension. The US has been engaged in a war on drugs since Richard Nixon declared it in 1971. While white Americans use marijuana and other drugs at roughly equal rates to African Americans and Latinos, in virtually every respect, racial minorities have been disproportionately incarcerated and otherwise punished for involvement with drugs, including selling marijuana.

      In addition, marginalized groups Aids patients, disabled people, veterans who championed legalization when it was far riskier to do so now find themselves ill-equipped to compete against well-capitalized corporate refugees looking to jump on the bandwagon.

      One company, Acreage Holdings, which closed on $119m in investment capital this summer, has enlisted the former Republican speaker of the House John Boehner to help it navigate the market. Boehner has never smoked pot he hasnt felt the need or inclination, according to a spokesperson and he declared himself unalterably opposed to legalization when he was in office.

      With legal marijuana now one of the countrys fastest-growing industries, who profits is as much of a civil rights question as who gets punished.

      The industrys moral challenge is to ensure the groups who have suffered the most under the drug war can participate in the green rush and enjoy the spoils of legalization.

      A classic story of gentrification

      The story of Amber Senter, a businesswoman and activist who attended the weekend campout, dubbed Meadow Lands, goes some way to explain why racial equity will be as difficult to achieve in cannabis as it is in the rest of American life.

      Senter moved to Oakland, California, in 2014. A coast guard veteran with a background in corporate marketing and graphic design, she worked as an executive at Magnolia, a dispensary, and became a prominent advocate for women of color like herself in the industry.

      california
      If Amber Senter cant make it, who can? Illustration: George Wylesol for the Guardian

      Oakland, the birthplace of the Black Panther party, is known for radical politics and racial tensions. It was among the first US jurisdictions to recognize legalization as an economic opportunity and has sanctioned dispensaries since 2004. More recently, it became one of the first places to create an equity program to support marijuana entrepreneurs who were locked up for pot-related offenses or who come from neighborhoods considered disproportionately affected by the war on drugs.

      Senter didnt qualify for an equity permit. But in November 2017, her business partner signed a memorandum of understanding to open a dispensary with Marshall Crosby, a personal trainer in his 50s who did qualify.

      A native of Oaklands impoverished east side, Crosby has lived a hard life. One of eight children, he said he had several bullets lodged in him and had served stints in jail. I became a statistic in the drug life a long time ago, he said.

      On 31 January, Crosby had some good luck. Oakland put the names of a few dozen equity hopefuls into a lottery and pulled names to see who could pursue a dispensary license. Crosby was among the four winners.

      A few weeks later he wrote to Senters partner: I have decided not to work with you. Went another route. Rather than work with his local partners, Crosby had decided to partner with Have a Heart, a dispensary chain based 800 miles away in Seattle eyeing expansion in Oakland.

      In an interview, Crosby said he felt abandoned after he had signed the memorandum with Senters partner. And he felt an affinity for Have a Hearts COO, Ed Mitchell, who grew up in another rough part of the Bay Area. With Have a Heart, Mitchell said Crosby would also receive a payment of an undisclosed amount once they secured the license.

      Oaklands equity program had been laboriously developed over years to maximize not just jobs for Oaklanders but local ownership of marijuana companies. But the policy didnt stop Crosby from partnering with an outside company.

      Its a classic story of gentrification, Senter said following Meadow Lands. The dispensary chain was taking advantage of opportunities that were not made for them. In addition to boxing her out, the new store, she said, would compete with, and potentially undersell, existing locally owned dispensaries.

      Have a Heart said it would hire Oaklanders for 90% of its jobs in the city and would invest in cleaning up the area of Chinatown where it hopes to open. We believed Oakland was a place where we could really do some good, Mitchell said.

      Even if this is true, the situation anticipates similar deals which may reward a few local individuals but extract profit out of the city for large corporations.

      Someone was just able to swoop in and sabotage fair business dealings; thats wrong, said Anne Kelson, an Oakland cannabis attorney who is not professionally involved in the case.

      Kelson said the incident had shaken Oaklands cannabis community. More than one business operator has come to me and said: If Amber Senter cant make it, who can?

      Across the bay in San Francisco, another ambitious dispensary chain, MedMen, is pursuing partnerships with equity applicants. Compared with less sophisticated operators, MedMen brings a certain guarantee of execution, its spokesman, Daniel Yi, said. At the end of the day a business thats not successful wouldnt help anyone.

      Marijuana farming in California

      Most attendees at the campout in June belonged to the industrys craft cohort. Many of them have been professionally involved in cannabis for decades.

      Marijuana farming in California has never been easy. Those who succeed are skilled, cunning and well-versed in the law.

      Today theyve applied their intelligence to the endless intricacies of the California market. It both conforms to and departs from stoner stereotypesthat most conversations at Meadow Lands dug into riveting topics like zoning variances, building materials and water use rules.

      Of the state legalization experiments, California is, by far, the largest and most complex. For growers who operated in Californias gray and illegal markets and now want to transition into the legal market,the economics can be brutal. In the illegal market, an Emerald Triangle farmer might have sold a pound for $3,000 tax-free. Now the price is more like $600, before taxes and compliance-related costs.

      Ive never seen a craft cannabis brand work out, because its not cost effective, Hilary Bricken, a Los Angeles cannabis attorney with Harris Bricken said.

      Presently, no one in legalized marijuana is getting rich, Steve Schain, a senior attorney with the cannabis-focused Hoban Law Group, said.

      In Schains view, even the largest and most professionally run companies are being built to be acquired when major agriculture, alcohol and pharmaceutical companies consider it safe to profit. Already, immense grow projects, hundreds of thousands of square feet, are coming online in the desert east of Los Angeles, and across Canada.

      The difficulties small farmers face were anticipated. In the lead-up to legalization, Californias small growers had expected a provision which would prohibit farms larger than about an acre (43,560 sq feet) until 2023, giving small growers time to adapt.

      But when the rules came out last November, a new loophole allowed mega farms immediately. The California Growers Association, which has roughly 1,000 members, is suing the state.

      At Meadow Lands, a French-born hashmaker known as Frenchy Cannoli argued craft cannabis should follow Frances wine model and create a hierarchy of quality based on the concept of terroir,the idea that environmental factors like soil and climate contribute to a plants ultimate yield. Today, he said, many places produce great wine, but because France established the standard in the 1800s, they will always be the center of the wine industry.

      At night, Frenchy, who at 62 has a high broad forehead and harlequin smile,stood on a picnic tablecackling as he tended a many-armed hookah.

      Initiatives to create French-style appellations for northern California cannabis are under way, but they may not do much if the growers still have to immediately compete against big industrial farms.

      While Californias small growers are struggling, they also have clout. Which explains why one of the visitors to Meadow Lands that weekend was the California state senator Kevin de Len, an underdog US Senate candidate running to the left of his fellow Democrat, Senator Dianne Feinstein.

      While some Democrats, such as Feinstein, have made their peace with legalization, De Len gives it a full-throated endorsement. For many underemployed workers and the unemployed, cannabis is the future, De Len said, speaking at a campsite one morning. Dressed in pressed slacks and a crisp white shirt, he joked: Im not a narc.

      The audience laughed. After a night of camping, it was 8.30am and they were passing joints.

      Cannabis space

      Canada, true to form, has moved to legalize marijuana in a more orderly fashion than the US, with legalization day set for 17 October. The industry there perhaps gives their counterparts in the US a vision of the future.

      In Canada, a handful of companies already dominate the cannabis market. And a few weeks after Meadow Lands, a very different marijuana industry gathering took place at a big glass hotel in central Vancouver.

      The opening party took place in a smoke-free ballroom. The keynote speaker was Henry Rollins, the legendary punk rocker known for his association with the straight edge culture, who doesnt consume cannabis himself. His message to the International Cannabis Business Conference was that the industry shouldnt be too greedy. But he wasnt fooling anybody.

      Its the suits taking over, Carolyn Cudmore, the founder of the Vancouver craft company the Preroll Factory, said.

      Read more: http://www.theguardian.com/us

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      What parents should know about the ‘huge epidemic’ of vaping

      (CNN)With the news from the US Food and Drug Administration that vaping is skyrocketing among American youth, parents might be wondering how concerned they should be and what they should do if they catch their child using an e-cigarette.

      Health experts say behavior changes are keys to look for, as more and more children and young adults become addicted to nicotine, causing physiological changes to their brain.
      “It’s just this huge epidemic,” said Marcella Bianco, the program director for CATCH My Breath, which works to prevent the spread of e-cigarette use.
        Steven Kelder, a professor of epidemiology with the University of Texas Health Science Center at Houston who also serves as a lead investigator for CATCH, said every parent needs to be aware of the dangers of vaping.
        “Kids have a hard time quitting or even wanting to quit, thus causing family disturbances,” he said. “Nicotine interferes with parental relationships and pushes children towards delinquent behavior. Raising a teen is hard enough without nicotine addiction.”
        Here are important takeaways for parents raising teens.

        What is vaping?

        E-cigarettes, or vaping, work by heating a liquid containing nicotine until it vaporizes. Experts say the huge increase in teen use is the result of a single company, Juul, which they say grabbed up market share with an assortment of flavors, high nicotine content and devices that look like USB drives.
        Juul gives users a flavored nicotine fix without the smell and smoke of combustible cigarettes.
        “I think parents should be proactive and talk to their kids about vaping,” Kelder said.
        Kelder said most of the flavors marketed by Juul contain 5% nicotine — “a very high dose of nicotine.”
        Juul vowed this week to halt most retail sales of flavor products while restricting flavor sales to adults 21 and older on its secure website. The company also announced that it was shutting down some of its social media accounts.
        Juul has said that it designed its products for adult smokers trying to switch from combustible cigarettes. Ashley Gould, the chief administrative officer for Juul Labs, previously told CNN its popularity among youth has been “devastating to us.”
        “This is not a product for youth. It’s a product for adult smokers,” Gould said.
        If you catch your child vaping, Kelder said, you’ll need to wean them off slowly, bringing them down to a vape with 3% nicotine.
        “If their child has been using 5% [nicotine] for any length of time, they are probably addicted and will be resistant to quitting. The withdrawals at that high level will be too strong,” he said. “Normalizing their blood nicotine content to a lower dose is a big first step towards quitting. Once at 3%, then quitting altogether will be much easier.”

        How do I know if my child is vaping?

        Teens are very good at hiding vaping from parents, coaches and school administrators, experts say.
        Bianco said parents need to check to make sure USB drives really are USB drives. Many times, they’re actually Juuls, with kids taking them to school and using them in bathrooms and locker rooms.
        “Parents need to take a look at what’s being charged: Is it a USB drive or not?” she said. “Unfortunately, that’s where we are [as a society].”
        Other signs to look out for: Has your child been asking for more money than usual? Does he or she have dry mouth and/or nosebleeds?
        “Nearly all teens vape fruit or candy flavors,” Kelder added. “You may notice a sweet scent on your child.”

        What are the health effects of vaping?

        Nicotine changes the brain, interfering with development up to the age of 26. So, experts say, the skyrocketing use of vaping among America’s youth should be concerning not to just parents but to public health officials across the country.
        The outcome of nicotine addiction, Kelder said, is “mild reductions in cognitive function in the prefrontal cortex, leading to poor decision-making, reduced impulse control, increased mood disorders such as anxiety and depression.”
        Pregnant women could also unknowingly harm their fetuses by vaping, because “nicotine is neurotoxic to a developing fetus.”
        “Sudden infant death syndrome, SIDS, is a real worry,” Kelder added.
        Bianco said parents frequently complain of behavior problems with their children who vape. “They’re having a hard time sleeping,” she said, “because they’re doing Juul so much in schools and throughout the day.
        “We know what nicotine does, and 99% of the e-cigarettes have nicotine. We know how nicotine changes the brain, especially for developing youth,” Bianco said.
        Another key point: the many unknowns from chemicals like glycerin and propylene glycol in some vapes.
        “That’s the scary part,” she said. “We don’t know the long-term health effects these kids are going to have in future years.”

        How did this happen?

        Juul’s rapid rise in the past year shocked public health officials, Bianco said. It’s easy to buy online, she said, resulting in astronomical sales and skyrocketing use among youth.

        Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

          “It took us all by surprise,” Bianco said. “I wish we knew ahead of time that this was coming aboard. We have a huge epidemic on our hands.”
          Kelder said simply, “Juul delivers the highest level of nicotine available. I believe that is the reason why the rates are rising so quickly. The addiction potential with Juul is much higher than with previous e-cig versions.”

          Read more: http://edition.cnn.com/

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          FDA threatens stores that sell Juul and flavored e-cigarettes to kids

          (CNN)The head of the US Food and Drug Administration took aim Wednesday at Juul and other e-cigarette manufacturers, warning that they must show in the next two months how they’ll keep the devices out of the hands of young people.

          Noting an “epidemic” surge in teen use of e-cigarettes, FDA Commissioner Dr. Scott Gottlieb warned the FDA might require companies to change their sales and marketing practices; stop distributing products to retailers who sell to kids; and remove flavored e-cigarette products from the market.
          “I use the word epidemic with great care,” Gottlieb said. “E-cigs have become an almost ubiquitous — and dangerous — trend among teens. The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable.”
            Juul, MarkTen, Vuse, Blu and Logic control 97% of the e-cigarette market, the FDA said. In the next 60 days, the FDA plans to investigate the five e-cigarette companies’ marketing and sales practices, with possible “boots on the ground inspections,” Gottlieb said.
            The agency will also be increasing federal enforcement actions on e-cig sales to minors in convenience stores and other retail sites, Gottlieb said. On Wednesday, it announced “historic action” against more than 1,300 retailers who illegally sold Juul and other e-cigarettes to minors during a crack down on retailers this summer. Gottlieb called the action the largest coordinated enforcement effort in the agency’s history.
            The FDA will also look closely at “straw purchases,” in which adults visit web-based stores and buy in bulk to resell to minors. Federal law prohibits the sale of e-cigarettes to people younger than 18.
            “If young adults go online and buy 100 units of a product to sell to teens, that activity ought to be easy for a product manufacturer to identify,” said Gottlieb. If manufacturers aren’t willing to do the research, he said, the FDA will do it for them, with appropriate consequences.
            “Let me be clear: Everything is on the table,” said Gottlieb. “This includes the resources of our civil and criminal enforcement tools.”

            A generation addicted?

            E-cigarette makers argue the devices help adult smokers give up cigarettes — potentially saving them from related illnesses — by giving a nicotine fix without the smoke and smell of combustible cigarettes. The scientific consensus, however, is still out on the long-term health effects of vaping.
            The FDA recognized the impact its actions might have on adults trying to stop smoking, Gottlieb said, but emerging research on how flavored products encourage excessive use by young people shows action must be taken.
            More than 2 million middle and high school students were current users of e-cigarettes in 2017, the FDA said, and e-cigarettes were the most commonly used tobacco product by youth. Youths are more likely than adults to vape, according to the US Centers for Disease Control and Prevention.
            “I’ll be clear. The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine as a tradeoff for enabling adults to have unfettered access to these same products,” Gottlieb said Wednesday.
            “We’re especially focused on the flavored e-cigarettes. And we’re seriously considering a policy change that would lead to the immediate removal of these flavored products from the market.”
            Juul Labs, which controls about 70% of the market, said in its statement that “appropriate flavors” play a role in adults changing their smoking habits, but added that they “are committed to preventing underage use of our product, and we want to be part of the solution in keeping e-cigarettes out of the hands of young people.”
            Several other manufacturers targeted by the FDA — MarkTen, Vuse, Blu and Logic — also issued statements agreeing with the need to limit access to minors and announcing their willingness to work with the FDA to reach a solution.
            The Vapor Technology Association, which says it represents over 600 vaping manufacturers and distributors, also supports limiting teen access, but added that the new actions by the FDA ventured “into dangerous territory” by not being in the best interest of public health.
            In a statement, VTA Executive Director Tony Abboud asked: “Does FDA really want millions of Americans to return to smoking cigarettes?”

            A change of plan

            Last year, the FDA announced that it would delay regulations that could have halted the sales of many e-cigarettes. Instead, the agency gave extensions till August 2022 to new and existing vaping products. The agency said it allowed the extra time to strike an appropriate balance between regulation and encouraging the development of innovative tobacco products that may help older smokers quit.
            At that time of the extension, Gottlieb said Wednesday, the agency didn’t foresee the “epidemic'”of adolescent use that has become one of the plan’s biggest challenges.
            “Today we can see that this epidemic of addiction was emerging when we first announced our plan last summer,” said Gottlieb. “Hindsight, and the data now available to us, reveal these trends.”

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            Since Wednesday’s action did not change the current 2022 timeline for regulatory review, some said the agency’s action fell short.
            “We need to go further,” said Michael Bloomberg, the billionaire philanthropist who has worked for years to reduce tobacco use.
            “The FDA should immediately move to regulate flavored e-cigarettes, instead of waiting until 2022, as it is currently planning to do,” Bloomberg said in a statement.
            The Campaign for Tobacco-Free Kids also called for stronger action.
            In a statement, Matthew Myers, the campaign’s president, said the FDA’s action would only represent a turning point if it “reverses its policy and requires that all of these products undergo agency review now, not four years from now.”
            The American Medical Association’s Dr. Barbara McAneny also said the FDA could do much more, pledging that the association would “continue to advocate for more stringent policies.”
            U.S. Senate Democratic Whip Dick Durbin and Republican Sen. Lisa Murkowski also asked the FDA to end delays. In a statement, they called for support for their bipartisan legislation, introduced in July, which would ban flavored cigars and place stringent controls on e-juice flavorings.

            FDA actions so far

            In April the agency launched a Youth Tobacco Prevention Plan, designed to address some of the known public health risks, such as flavors, that contribute to adolescent use of e-cigarettes.
            Shortly after the launch, the FDA cracked down on e-liquids marketed to resemble kid-friendly foods like juice boxes, candy and cookies. As part of today’s action, the agency sent an additional 12 warning letters to another 12 companies that continue to sell the products.
              The FDA also targeted Juul retailers this spring, issuing 56 warning letters and six civil monetary penalties. Today’s effort notches up that action, becoming, said Gottlieb, the “largest ever coordinated initiative against violative sales in the history of the FDA.”
              The agency said it plans to unveil a new e-cigarette public education campaign targeted to youth next week, and will soon announce wider access to new nicotine replacement therapies to help more adult smokers quit cigarettes.’

              Read more: http://edition.cnn.com/

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              Love and heroin don’t mix: how these newlyweds survived a harrowing romance

              Augusta, Georgia (CNN)There’s nothing sweet or adorable about the way newlyweds Brittany and Ryan Coleman first met — no “meet cute” like in rom-com movies or romance novels.

              It was 2015, and Brittany bought heroin from Ryan in a parking lot, and Ryan cheated her. Brittany called him some choice names, and Ryan shrugged his shoulders and walked off.
              Despite that inauspicious beginning, and the many years of drug abuse that precededit, the Colemans want to get out this message: There is life and love after drug addiction.
                They want to give hope to those whose lives have been ravaged by the opioid epidemic, which kills more than 115 people every day in the United States.
                “You just have to find the right people to get connected to to kind of show you the way out,” said Brittany, 29.

                Addiction, rehab and relapse

                When Brittany Hokrein was 11 years old, her parents divorced, and she and her brothers and mother moved from Georgia to Pennsylvania.
                She struggled emotionally, and at age 14 she started to use marijuana and alcohol so she wouldn’t feel the hurt. Soon, pain pills became her drug of choice, and by age 18 she was addicted.
                Ryan, now 37, was born into a military family, moving from Georgia to Germany to Texas and then back to Georgia. Like Brittany, he had a loving family, but as a teenager, he felt like he didn’t fit in, and he started to smoke pot at age 14.
                “I found that I could medicate that feeling. Life was great once I got high,” he said.
                By the time Ryan was 17, he was smoking pot every day, and he dropped out of high school senior year. He moved on to LSD and cocaine. By the time he was 20 he was hooked on painkillers.
                His father, an Army drill sergeant, and his mother, a high school teacher, begged him to go to recovery. They told him a recovery program had saved his mother from alcoholism when Ryan was a child. But he rebelled and rejected everything his parents stood for.
                By 22, he was strung out on heroin. “I had to have it,” he said.
                Over the next 10 years, Brittany and Ryan unknowingly led parallel lives. Hopping from city to city, they both used heroin, methamphetamines, prescription opioids, Xanax, cocaine and alcohol.
                Brittany overdosed three times, and Ryan overdosed five times. Ryan got arrested 16 times, mostly for stealing so he could get money to buy drugs. Brittany stole, too, and had a stint at prostitution.
                Their parents loved them and helped get them into rehab programs. Each stint ended in a relapse.
                By 2016, both Ryan and Brittany had moved back to Augusta, Georgia.
                They happened to end up at the same recovery group meeting. Eight months had passed since they’d met at that drug deal in the parking lot.

                A forbidden love (and with good reason)

                He’s cute, Brittany thought when she met him again at rehab.
                She’s beautiful, Ryan thought. Really beautiful. And she looked so familiar.
                He realized she was the woman he’d cheated in the drug deal.
                “I thought, ‘This was fate.’ I walked right up to her and told her I needed to apologize for ripping her off,” Ryan remembered. “I did want to make amends, but I also had an ulterior moment. I wanted to date her.”
                Dating was discouraged in their recovery program — and Brittany and Ryan found out why.
                As they fell in love, they spent all their time together and their lives became intertwined. At first they both stayed sober but then slowly, imperceptibly, Ryan slipped away, taking Brittany with him.
                After about four months of dating, one Friday morning Ryan told Brittany he was going down to a park by the Savannah River to think about his life.
                But instead, he drove two hours to Atlanta to buy heroin and cocaine.
                He called her on the way and told her the truth. Brittany stood there with her phone in her hand. She wrote out a text that she knew she shouldn’t send.
                It said that Ryan needed to bring back some drugs for her. She stared at the text for a while. Then she hit send.
                And everything fell apart.

                Giving up heroin — and each other

                For the next week, Brittany and Ryan went right back to heroin, right back to cocaine, right back to meth, sometimes all at the same time.
                “I even romanticized it, saying f*** all the rules, we’re going to be heroin junkies together, all that ‘Trainspotting’ bull****,” he said, referring to the 1996 film about young Britons on heroin. “Addicts have a sick way of romanticizing their drug use.”
                Then on October 3, 2016, they both overdosed on meth and heroin. Medics found Brittany lying on the floor of a gas station bathroom, and Ryan right outside, unconscious in his car.
                The medics gave them doses of Narcan, the drug that reverses overdoses. Brittany had done so much heroin she needed two doses.
                Ryan was wracked with guilt. He felt personally responsible for Brittany’s near death in that gas station bathroom. He was the one who’d driven to Atlanta to get drugs when they were both working so hard to be clean. He was the one who said ‘yes’ when she asked him to bring some back for her.
                “I had almost killed the person I loved the most,” he said.
                Brittany returned to Hope House, a treatment center for women in Augusta.
                Ryan visited here there. Surrounded by his sponsor from his recovery group and Brittany’s counselors, he got down on his knees — and apologized.
                “He held my hand and apologized to me in front of all those people,” Brittany said, crying at the memory of it. “He was shaking and I was shaking. He said how sorry he was for putting me through all this and how scared he was to almost lose me.”
                They then had to do something they describe as just as hard as giving up heroin: They had to give each other up. For a month, they had no contact at all.
                “The only way for us to survive was to focus only on our recovery, and not on each other,” Brittany said. “It was the only way it would work.”
                Brittany then left Hope House, and the two met up at their recovery group’s Thanksgiving dinner. They started back dating slowly, and then a year and a half later, on February 24, 2018, they were married.

                Two years sober

                Next month marks two years of sobriety for both Brittany and Ryan, and today they live in a small house with four cats in Augusta. Ryan works at a vape store, where he’s advanced from part-time clerk to assistant manager to manager. Brittany works at a rehab center, helping others overcome their addictions.
                They volunteer to help others in recovery and have also spoken at programs that train people how to use Narcan, the drug that saved both of them so many times.
                When asked how they survived addiction where so many have died, they say it was the grace of God and to a large degree luck — luck that those Narcan doses were available right when they needed them.
                They also say they let other people guide them: their families, who never gave up on them; the rehab counselors who stuck with them; and their recovery mentors who showed them the way, including that they needed to focus on their individual recoveries and not on each other in order to survive.

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                All of those people joined them on their wedding day.
                “It was really a culmination of all the good things going on in our lives finally really coming together,” Ryan said.
                Sometimes Brittany can’t believe she’s alive, much less in a loving, stable relationship.
                “It’s unbelievable. I don’t think that I would have ever imagined that I would be married and happy and just planning a future with another human,” she said. “I didn’t ever picture that for myself.”
                  They want people in the throes of addiction to see that despite the dire statistics, there can be hope.
                  “I want them to see people like us and realize that we were in that same place at one point in our lives — and we got out,” Ryan said.

                  Read more: http://edition.cnn.com/

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                  19-year-old dies after inhaling deodorant spray to get high

                  (CNN)A 19-year-old died after inhaling deodorant spray to get high, according to a new case report, and doctors who treated the man in the Netherlands are using the case to highlight the fatal consequences of inhaling chemicals.

                  Kramp explained that because deaths from deodorant inhalation are not common among the general population, the “consequences aren’t really known,” causing people to continue this dangerous behavior.
                  The patient, who had a history of psychotic symptoms, had been admitted to a rehabilitation center for cannabis and ketamine abuse and was taking antipsychotic drugs.

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                    During a relapse in July, he placed a towel over his head and inhaled deodorant spray to get high, according to the report, published Thursday in the BMJ. He became hyperactive, jumping up and down, before blood flow stopped suddenly, causing him to go into cardiac arrest and collapse, the report says. He was admitted to the hospital and placed in a medically induced coma when staff failed to revive him.
                    The “patient did not had enough brain function to sustain life,” Kramp said. Nine days after he was admitted, doctors withdrew care, and the man died.
                    There are three theories about what caused the cardiac arrest, Kramp said: The inhalant could have oversensitized the patient’s heart, which can make any subsequent stress, like getting caught by a parent, cause cardiac arrest. Also, inhalants decrease the strength of contraction of the heart muscle. Another possibility is that inhalants can cause spasm of the coronary arteries.
                    The patient’s hyperactivity could mean he was experiencing a “scary hallucination,” Kramp said, adding that if that was the case, the first theory would be applicable.
                    Solvent abuse is not a new phenomenon, the report points out, and is primarily found in “young and vulnerable people,” according to Kramp.
                    The group most affected by solvent abuseis 15- to 19-year-olds, studies show. People in rehabilitation centers or prisons are more likely to abuse household products, the report added, meaning there could be a greater risk of cardiac deaths in these environments.
                    In these secure environments, people have less access to other substances, and household products are easily available, explained Roz Gittins, director of pharmacy at the British drug charity Addaction, who was not involved in the report.
                    The toxic chemical butane, often used in sprayable household products, has a similar effect to alcohol, Kramp said. “The intention of abusers is to experience feelings of euphoria and disinhibition.”
                    Other health effects of inhalants include liver and kidney damage, hearing loss, delayed behavioral development and brain damage.
                    Chemicals like butane have a very quick and short-acting effect, which can make people want to take more, Gittins said.
                    The report’s authors hope increased awareness will help reduce further inhalant-related deaths, through education in schools around the fatal consequences of solvent abuse.
                    “To stop the abuse, we can only try to increase awareness about the possible dramatic consequences of inhalant abuse among youngsters, parents, medical personnel,” Kramp said.
                    Up to 125 deaths are caused by inhalant abuse every year in the United States, according to the report.

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                    Stephen Ream, director of UK-based charity Re-solv, said that in 2016, “there were 64 deaths associated with these products,” with butane gas accounting for at least a third of those.
                    “The breakdown by product is more difficult to establish, but we would suspect that about four or five deaths a year are associated with aerosol products,” he said.
                      “Solvent abuse is also more of a problem in the northern regions of the UK, with rates particularly higher in Scotland and the North East of England.”
                      According UK drug advice organization Talk to Frank, more 10- to 15-year-olds were killed from abusing glues, gases and aerosols than from illegal drugs combined between 2000 and 2008.

                      Read more: http://edition.cnn.com/

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                      Juul Labs sues Chinese counterfeiters illegally selling fake Juuls

                      Counterfeit or the real thing? Depends where you buy it.
                      Image: Brianna Soukup/Portland Press Herald via Getty Images

                      It’s a sue and be sued world out there!

                      In August, Juul Labs filed trademark claims against 30 entities in China selling counterfeit Juul products on Ebay. Now, the company has announced that a federal court granted the company a temporary restraining order over the accounts, and froze the counterfeiters’ PayPals. Take that, counterfeiters!

                      For Juul, this isn’t a simple matter of copyright infringement, though. The company is fighting to reduce teenage use of the product, especially in light of a FDA investigation into why teens love Juuls so much (and whether that’s Juul’s fault). And maintaining control over online sales that are age-verified is a crucial component of that campaign.

                      Legitimate Juul products are only available online through Juul’s website. However, as of this writing, there were over 2,000 listings for Juul or Juul-related products on Ebay. Any Juul device or pod you might see on Ebay or elsewhere that’s not Juul’s website directly comes from a counterfeiter, or an unauthorized seller. 

                      But selling Juul directly through the company’s own site isn’t just important to controlling the company’s cashflow, or even for verifying that the product is the real deal. Keeping Juul’s site as the sole online seller is crucial to ensuring that teens don’t purchase the e-cigs online. 

                      “Keeping JUUL out of the hands of young people is a priority for us,” Victoria Davis, a Juul Labs spokesperson told Mashable over email. “We have a strict and industry-leading age-verification process on our Web site so no one under the age of 21 can access JUUL. However, counterfeiters do not utilize the same type of age verification systems, which may enable minors to purchase products.” 

                      Juul’s site requires users to register with their social security numbers in order to verify that they’re over 21. So circumventing Juul’s commerce system means that the counterfeiters are actually undermining the company’s very intentional efforts to keep the cute lil’ vapes out of the hands of kids.

                      Juul is going after the counterfeiters through the legal system, as well as directly with sales platforms like Ebay and Amazon. But Davis described the hunt for counterfeiters as a “challenge” because the sellers can easily make new profiles. That isn’t deterring Juul, though, since more counterfeiters are popping up as the company grows.

                      “The prevalence of counterfeiters has increased dramatically over the last year consistent with JUUL’s rise in the marketplace,” Davis said. “The process of tracking and identifying the culprits of counterfeit products is time intensive. We have dedicated resources to this initiative to ensure these products stay off the market and out of hands of underage users.”

                      In other words, Juul’s attempts to go after counterfeiters is like USB-vape whack-a-mole. And the nicotine habits of kids are on the line. 

                      Read more: http://mashable.com/

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                      FDA to restrict sale of flavored Juul pods to fight teen vaping

                      Flavored pods make getting into Juuling easier for teens.
                      Image: scott olson/Getty Images

                      It’s like taking candy away from a baby.

                      The FDA will move to ban Juul’s fun flavors from most convenience stores to fight teen use of the product, reports the New York Times. The agency will also require stricter age verification measures for buying Juuls online.

                      The new policies are part of the FDA’s investigation into teens’ love of the product, and whether Juul itself is to blame. In September, the FDA gave JUUL 60 days to introduce new initiatives to fight teen use. Now that time has expired, the FDA is taking action themselves. The restrictions will also apply to other big tobacco companies that sell flavored nicotine pods. The FDA will reportedly share further details of the plan the week of November 12. 

                      Juul pods come in mango, cucumber, fruit, and creme, in addition to mint, menthol, Virginia tobacco, and classic tobacco. The FDA won’t allow gas stations and convenience stores to sell the more teen-friendly flavors: mango, cucumber, fruit, and creme. Vape shops and other “specialty retailers” will still be able to sell all the flavors, according to Reuters.

                      There aren’t details yet about how the stricter age verifications will work. Juul already restricts all online sales of its products to its own website, and is fighting counterfeiters who sell fake Juuls all over the internet. This is part of their push to curb teen vaping, because the Juul site already requires shoppers to verify their age with their social security number.

                      Juul’s age verification page.

                      Image: screenshot: rachel kraus/mashable/juul

                      Juul’s age verification page.

                      Image: SCREENSHOT: RACHEL KRAUS/MASHABLE/JUUL

                      Juul bills itself as a way to help adult smokers quit; it says that if you have never smoked, you should never start Juuling. But Juul has 70 percent of the market share of vaping devices. And Juuls in particular are the beloved e-cig brand of the high school set; “Juuling” is all over teenage social media, and a University of Michigan survey even found that 1 in 4 high school seniors said they vaped in 2017.

                      Going after flavored pods may be a good step in fighting teen use. The Campaign for Tobacco Free Kids reported that flavored pods might be easing the runway into vaping: 81 percent of 12-17 year olds “who had ever used e-cigarettes had used a flavored e-cigarette the first time they tried the product,” their report reads. And flavored pods remain popular even after the first time: “81.5 percent of current youth e-cigarette users said they used e-cigarettes “because they come in flavors I like.”

                      Given that research, restricting sales of the flavors might deter some first time Juulers. Although, plenty of companies sell other flavored pods that still work with Juuls.

                      However, the Campaign — and anyone who has eyes — first attributes the rise of Juul to the “sleek design” and easy ability to hide the activity from adults. That is, like so many other trends, it’s the rebellious, aesthetic cool-factor of Juul that has made it so popular with teenagers — not just fun flavors. 

                      Juuling is also a verb all its own that specifically does not look like smoking; it’s a necessarily nonchalant action in the same way smoking was, but with an under the radar swagger all its own.

                      That aura is something harder for the FDA to regulate. The cool factor (and subsequent use) of cigarettes has only ebbed as the adverse health effects and stigma have taken precedence over the James Dean look. Teens also reportedly don’t view vapes as being that bad for them, despite current research indicating that vaping comes with health risks all its own. 

                      Juul and the FDA have a long road ahead of them if they’re both committed, together, to getting teens to stop Juuling. Making mango pods slightly harder to buy isn’t the end of the road.

                      Read more: http://mashable.com/

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                      FDA plans to launch new restrictions on e-cigarette flavors

                      (CNN)Taking on epidemic levels of teen e-cigarette use, the US Food and Drug Administration is expected to announce new restrictions on the sale of e-cigarette products an agency official confirmed Thursday.

                      Gottlieb is also expected to propose a ban on menthol in regular cigarettes.
                      The new restrictions were first reported by the Washington Post.
                        The convenience store ban on flavored e-cigarette sales would not include menthol. Because the FDA will continue to allow the sale of menthol in regular cigarettes, the agency doesn’t want to give cigarettes an advantage over e-cigarettes.
                        E-cigarette makers argue the devices help adult smokers give up cigarettes — potentially saving them from related illnesses — by giving a nicotine fix without the smoke and smell of combustible cigarettes. The scientific consensus is still out on the long-term health effects of vaping.
                        About 6.9 million adults used e-cigarettes in 2017, according to a US Centers for Disease Control and Prevention report released Thursday.
                        But the FDA says it didn’t foresee the “epidemic” of youth e-cigarette use. More than 2 million middle and high school students were current users of e-cigarettes in 2017, the FDA said, and e-cigarettes were the most commonly used tobacco product by youth.

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                        The FDA announced in September it would investigate major e-cigarette makers Juul, MarkTen, Vuse, Blu and Logic, including reviews of marketing and sales practices. It also said it cracked down on 1,300 retailers who illegally sold e-cigarettes to minors.
                        Juul declined to comment on the new restrictions.
                          The FDA recently launched a massive education campaign aimed at the nearly 10.7 million teens at risk for e-cigarette use, taking the message that vaping is dangerous into high school bathrooms and social media feeds.
                          “E-cigs have become an almost ubiquitous — and dangerous — trend among teens,” Gottlieb said in September. “The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable.”

                          Read more: http://edition.cnn.com/

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