A cloudy future

The JUUL generation takes on McGill smoking ban

By Gabriel Helfant, Photo Editor -- September 25, 2018
https://www.youtube.com/watch?v=KCi1wITHcwY

I am one of few people who owe a great deal to cigarettes. My parents met in the smoking section of an airplane and got married soon after. Unfortunately, I won’t find the love of my life in the smoking section of an airplane. As of May 2018, I won’t find my cigarette-toting life partner on McGill’s campus either.

Aside from a handful of designated areas, smoking cigarettes is now banned on McGill’s campus. For most, such a ban is not of much concern. Cigarettes were once a fixture of college campuses, but smoking rates have steadily declined in recent decades. While this data might indicate that nicotine addiction is on its way out, public health officials shouldn’t get too excited. University students and children alike are developing a new habit: JUULing.

An electronic cigarette, or ‘e-cigarette,’ or ‘e-cig’, or ‘vaporizer,’ or ‘vape,’ is any handheld device that simulates the experience of tobacco smoking. JUULs are a new player in the cigarette-simulator game. With a patented tobacco salt-based nicotine delivery system and a sleek Apple product feel, JUULs are delivering more nicotine faster, earning JUUL Labs almost half of the e-cigarette market share only two years after becoming an independent company.

The JUUL’s modern design, flavoured-nicotine pods, and discreet usability set it apart from the cumbersome, outdated vapes of yesteryear. In addition to its inconspicuous shape and size and unlike traditional cigarette smoke, JUUL vapour dissipates within a few seconds without any lingering odour. JUULers can pick from an array of flavours including mint, mango, cucumber, fruit medley, and crème brulée. The company offers each pod flavour with either three or five per cent nicotine content. JUULs are in, vaporizers are out.

"Typical e-cigarettes contain six to 30 milligrams of nicotine per milliliter of liquid, the 5% JUULpod contains 59 milligrams, roughly equivalent to the nicotine a pack of cigarettes."

Research suggests that a high concentration of nicotine is to credit for JUUL’s popularity. According to Vox, a JUULpod contains three times the nicotine levels permitted in the European Union. Typical e-cigarettes contain six to 30 milligrams of nicotine per milliliter of liquid, the 5% JUULpod contains 59 milligrams, roughly equivalent to the nicotine a pack of cigarettes. Such a difference may account for what a conventional smoker needs to satisfy the sensation of a cigarette. While the JUUL website emphasizes that their product is “for smokers, by design,” the appeal to cigarette smokers trying to quit has attracted non-smokers too.

Mark Eisenberg, cardiologist at Jewish General Hospital and clinical epidemiologist at McGill’s School of Medicine, has been researching e-cigarettes’ effect on curbing cigarette addiction. Eisenberg’s research focuses on people cutting down on their smoking habits after suffering from heart attacks.

“I am very interested in getting people to stop smoking after having a heart attack,” Eisenberg said in an interview with The McGill Tribune. “Because if you can get them to stop smoking after a heart attack you can reduce their chance of death or a recurring heart attack by 35 per cent within six months.”

Eisenberg and his colleagues have noticed that smoking cessation agents such as nicotine patches are not working for smokers as effectively as e-cigarettes. This is encouraging, because despite e-cigarettes’ and JUULs’ nicotine content, they do not carry the same respiratory danger as traditional cigarettes.

“Vaping won’t give you lung cancer and coronary lung disease,” Eisenberg said. “So, if you can use e-cigarettes to stop people from smoking conventional cigarettes, that’s great.”

While e-cigarettes do provide a healthier alternative to traditional cigarettes, their success as a smoking cessation agent should not encourage non-smokers to start JUULing.

In an article published by The Economist, titled “E-cigarettes are almost certainly better than smoking,” the writer eventually mentions potential concerns with flavoured nicotine.

“Vapour also contains free radicals, highly oxidising substances which can damage tissue or DNA, and which are thought to come mostly from flavourings,” the article reads. “Several studies in mice have confirmed that the vapour can induce an inflammatory response in the lungs.”

One has to wonder, however, whether young adults who encounter such an affirming headline online are going to click through to the subheaded clarification: But ‘better than smoking’ is not necessarily the same as ‘good for you.’ Evidently, while e-cigarettes are allegedly healthier than the cigarettes of my parents’ generation, they may carry worrying health concerns of their own.

Recent popular news coverage has addressed concerns of children developing addictions to e-cigarettes, and nicotine is proven to have adverse effects on a developing brain. But, searching “vape tricks” on YouTube will yield thousands of videos of adolescents blowing Os, puffing vapour at their iPhone front-cameras, and performing other impressive vapour-exhale-based stunts.

At McGill, e-cigarettes have become increasingly popular among smokers and non-smokers. The McGill Tribune conducted a survey to gauge students’ smoking habits. Of the 94 respondents who own or consume e-cigarettes, 47 per cent were not cigarette smokers beforehand. Of 188 total respondents, only 45 per cent were concerned with the health risks associated with e-cigarettes relative to regular cigarettes.

Ben*, a U2 Arts student, typifies general attitudes towards e-cigarettes among undergraduate students.

“[I smoke cigarettes] pretty rarely, occasionally on nights when I would be out with friends, but I would not consider myself a cigarette smoker,” Ben said.

Though only a social cigarette smoker, Ben’s current use of e-cigarettes falls into a familiar pattern of nicotine addiction.

“I tried it with friends who smoke e-cigarettes, and it’s nice to relieve stress especially when school becomes super heated,” Ben said. “When school gets intense, I [start] using it after [going to] the library.”

As to the general beliefs of his peers, Ben cited a widespread lack of information on the potential risks of e-cigarettes.

“There is a rise in popularity of e-cigarettes at McGill because many people don’t understand the risk associated with it, along with the fact that it is well known that it is significantly better than smoking,” Ben said.

According to Ben, McGill students associate e-cigarettes with relatively low health consequences. When school-related stress inevitably begins to pile up, JUULing is an easy, seemingly consequence-free coping mechanism for students.

With this year’s new smoking legislature, smoke breaks outside of McLennan are officially a thing of the past. The Board of Governors (BoG) May decision is the first step in a five-year plan that seeks to create an entirely smoke-free campus by 2023. The BoG memorandum on the policy concerning smoking at McGill University outlines the specific purposes of the policy.

“[The policy seeks to establish] a smoke-free environment in order to promote and preserve the health and well-being of all members of the University community, while allowing for the exercise of personal choice,” the policy reads.

While the BoG has often been accused of dismissing student concerns, it seems as if this policy, for the most part, took student opinions into consideration.

The campus smoking ban was initially proposed by the McGill Medical Students’ Society in 2015. The BoG policy reflects data obtained from surveys conducted in 2016 by the Students’ Society of McGill University (SSMU) and the Postgraduate Students’ Society (PGSS), which revealed that 73 per cent of undergraduate students and 77 per cent of postgraduate students supported the idea of a smoke-free campus.

A not-insignificant contingent of McGill students, however, who have decried the policy’s effect on campus accessibility.

“The reality is that a campus-wide ban on smoking is effectively a ban on smokers themselves,” Mona Luxion wrote in a 2016 open letter to the administration in The McGill Daily. “Obligating students and staff to leave campus in order to smoke reduces their ability to participate in on-campus activities.”

While designated smoking areas exist on campus, there are only six downtown, and, with only 10-minute breaks between classes, the ban will inevitably inconvenience smokers. The logic behind the policy’s isolation of smoking zones is intuitive—second-hand smoke is proven to adversely affect the respiratory health of those nearby—but the same might not be true for e-cigarettes.

Despite the lack of a scientific consensus on the effects of second-hand vaping, the prohibition extends to e-cigarettes as well. To this end, Luxion’s 2016 letter calls into question McGill’s commitment to promoting tangible cessation strategies among the smoking subset of the student body.

“The website for McGill’s smoking policy pays lip service to the need for smoking cessation resources but offers no new or additional resources beyond existing counseling services and nicotine gums and patches,” Luxion writes. “Further, there is no indication of plans to increase the level of funding towards these existing resources, which limits the number of students it can appeal to.”

Considering e-cigarettes’ potential as a smoking cessation agent, McGill’s purportedly pro student wellbeing smoking ban isolates even JUULers trying to quit smoking to six on-campus zones, with little-to-no additional support provided.

In an emailed statement to The McGill Tribune, Robert Couvrette, associate vice-principal (Facilities Management and Ancillary Services), justified the inclusion of e-cigarettes in the ban.

“The University is following best practices observed at other institutions and by jurisdictions such as the government of Quebec and Health Canada,” Couvrette wrote. “In 2015, the Quebec government amended its Tobacco Control Act to include e-cigarettes. E-cigarettes and similar products are now subject to the same regulations as tobacco products and their use is forbidden in all places where smoking is prohibited.”

Because cigarettes and e-cigarettes are coupled in the same policy, McGill now has the difficult task of enforcing this ban on campus. Devices like the JUUL could be discreetly used both indoors and outdoors. For those unconcerned with the repercussions of violating the ban, the inconvenience of going outside to JUUL is not worth the trouble.

“I don’t think about the parallel of a normal cigarette while using my JUUL in the library,” said Sam*, a U2 Arts student. “I find myself sitting in the library, using my JUUL, without even thinking about if others will notice or care.”

According to the Tribune’s survey, 47 per cent of those who consume e-cigarettes do not comply with the McGill Smoking Policy. Pierre Barbarie, Director of Campus Public Safety, described security’s attitude toward those who are violating the ban.

“When we see somebody smoking outside one of the designated smoking areas, we politely explain to them where they are allowed to smoke,” Barbarie wrote in an email to the Tribune. “We rely on other people to do the same. Security is another pair of eyes, just like anyone else in the community.”

When asked about the ban’s application to e-cigarette users, Barbarie reiterated the limitations of enforcement.

“Just as for cigarettes, we recognize that the enforcement of the policy is not easy,” Barbarie wrote. “We hope we can count on the thoughtfulness, consideration, and cooperation of smokers and non-smokers alike and that a culture change will occur over time. McGill security agents include problematic areas in their rounds and seek to educate anyone who is ignoring or unaware of the policy. We invite community members to respectfully do the same. Best practices from other institutions suggest that community enforcement is broadly effective, and that violations reduce over time.”

Both Barbarie and Couvrette agree that security enforcement is marginally effective and recognize that changes in student behaviour are dependent on shifts in attitude. When students are freely blowing JUUL clouds in the library, however, it becomes difficult to forecast if and how this culture shift might develop on campus.

E-cigarettes occupy a unique and unclear position in public consciousness. In particular, while the booming JUUL industry gives new hope to prospective cigarette quitters, its allure for non-smokers is equally concerning. There’s a reason JUULs have gained such popularity so quickly. For better and for worse, they are a widely appealing alternative to cigarettes. Though McGill’s policy paints vapers and smokers with the same brush, the scientific community and JUULers everywhere have yet to reach the same consensus.

*Names have been changed to preserve the interviewees’ anonymity. About the survey: The student survey referenced in this article does not meet scientific standards.

The author of this article distributed the survey to the McGill student body using an anonymous Google form. The survey used combination of multiple-choice and open-ended questions about students experiences with e-cigarettes during their time at McGill University.

During the data-collection period, the author posted the survey link to various McGill community groups on Facebook and Reddit over the course of eight days from March 15 to March 22. In total, 329 students responded to the survey.