Vaping and Youth: The Latest on the Ban of Disposable E-Cigarettes Known as “Puff”

The “puff” (English word meaning “puff”) is a disposable e-cigarette, operating with a battery (lithium battery), pre-charged and pre-filled. It is therefore a very polluting and non-recyclable object!

[Article issu de The Conversation, écrit par Philippe Arvers, Médecin addictologue et tabacologue, Université Grenoble Alpes (UGA)]

Beyond these ecological considerations, other arguments motivate the bill currently under consideration, aimed at banning it. This relatively inexpensive mini e-cigarette is particularly popular with adolescents, despite a ban on sales to minors. What do you need to know?

Easier to vape nicotine

Created in 2019 by Patrick Beltran and Nick Minas in California (United States), both co-CEOs of the Puff Bar company, the puff (or “disposable pod”) is a mini electronic cigarette with an attractive design, which contains 1 to 2 ml of liquid.

It allows you to obtain 300 to 600 puffs with sweet and fruity aromas, for a price ranging from 6 to 10 euros (other models allow you to obtain up to 1,600 puffs). Puff comes in many flavors: puffs containing a wide variety of sweet and fruity flavors are available for sale.

Whatever their taste, the liquids contained in the puffs are composed of synthetic nicotine, in other words not coming from tobacco leaves. More precisely, these are nicotine salts. What exactly are these substances?

Nicotine salts are obtained by adding an acid (such as benzoic acid, lauric acid, sorbic acid, etc.) to a nicotine base. They have the advantage of being less acidic compared to the nicotine contained in cigarettes and in conventional e-cigarette liquids. Research suggests that this is accompanied by better absorption of nicotine and modifies sensations: less irritating, they cause less coughing.

There are 5% nicotine salts on the market, i.e. 50 mg/ml of nicotine, more than double authorized in Europe (20 mg/ml). Remember that levels of 57 mg/ml had been observed in the liquids used in the Juul, another designer and colorful (but refillable) cigarette having enjoyed some success in the United States – before the Food and Drug Administration (FDA) , the American agency in charge of regulating food and drug products, is not in favor of banning it.

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The use of nicotine salts is not trivial, because it avoids feeling the negative effects of classic cigarettes, irritation and cough, which limit the use of cigarettes in a person who has never smoked. Thus, their use will be easier, without adverse effects.

The presence of nicotine can therefore lead to nicotine dependence, as can be observed in a non-smoker who takes nicotine lozenges or tablets (TSN) or a cigarette, of course (which also contains other toxic substances). ).

This ease of vaping is part of a context where the use of electronic cigarettes by certain middle and high school students is increasing, despite a ban on sales to minors in our country.

Youth, tobacco and vaping

According to the EnCLASS study published in 2024, lifetime (which reflects experimentation), monthly and daily use of cigarettes decreased between 2018 and 2022 among French college students. Consumption of 10 cigarettes per day or more remains low (0.5%) and remained stable between 2018 and 2022. Use in life and in the month of vaping also remained stable over the same period.

The experimentation of the e-cigarette by middle school students and its use during the month have not changed either. In 2022, one in five middle school students had already vaped, and one in ten had done so during the month. Daily use concerned 1.4% of middle school students in 2022 (first year the question was asked). This means that the prevalence of daily use is equivalent to that of conventional cigarettes.

Among high school students, the lifetime (experimental), monthly and daily use of cigarettes decreased between 2018 and 2022, as did the use of 10 cigarettes per day or more, which increased from 4.2% to 1.4% between 2018 and 2022. Regarding vaping by high school students, things are more nuanced.

If a drop in experimentation with electronic cigarettes was observed between 2018 and 2022, use in the month as well as daily use increased (respectively 24.2% vs 16.6% and 3.8% vs 2.8%) over the same period.

Let us remember, however, that vaping does not represent a gateway to smoking: it rather has an eviction effect, a distracting effect, as we demonstrated in a recent publication presented by pulmonologist Bertrand Dautzenberg at the 2023 congress of the French-speaking tobacco society.

Where are we with the puff ban in France?

On March 21, 2024, deputies and senators, meeting in a joint committee, reached an agreement on a final text. This text must still be definitively voted on by the National Assembly and the Senate, before its promulgation. Its single article modifies the public health code to prohibit the manufacture, offering for sale, sale, distribution or free offer of disposable or single-use electronic cigarettes, known as “puffs”. Possession with a view to sale, distribution or free offering is also prohibited.

Violation of these prohibitions will be punished with a fine of up to 100,000 euros (200,000 euros in the event of a repeat offense). Competition, consumer and fraud prevention officers will be able to note this new offense.

At the end of the CMP, the Minister of Health announced her decision to immediately notify the text to the European Commission, in accordance with the European directive of April 3, 2014 called “tobacco”. The Commission will have six months to approve or reject it.

Other European countries, such as Germany, Ireland and Belgium are also considering banning “puffs” in their legislation. On March 18, 2024, the European Commission gave its agreement to the Belgian government.

However, it is not certain that this is enough to completely avoid the use of these products. And all the more so since now, nicotine sachets to slip between the lip and the gums have taken over. These “nicotine pouches” are also on the radar of the authorities.

The risks of circumvention via social networks

A post titled “#Discreetshipping on TikTok: Online Sales of E-Cigarettes” shows that TikTok users around the world are violating local, state and federal laws by selling e-cigarettes hidden within other products or bundled in packages that avoid detection.

Banning TikTok by the authorities would probably have some effectiveness… However, a less radical solution relies on parents, who can control, limit or prohibit access to TikTok via parental controls. The same approach can be taken with other social networks such as Facebook or Instagram.

Their own behavior also constitutes a lever: a survey published in 2023 by the “Alliance Against Tobacco” revealed that prevention begins first and foremost with parents. In particular, we can read that adolescents have “a use of the puff [qui] is higher when at least one parent smokes” (28%). The figure is even higher when both parents smoke (41%).

But we know full well that adolescents, in search of novelty or strong sensations, sometimes do not hesitate to defy prohibitions, as evidenced by occasional heavy drinking, or experimentation with synthetic cannabinoids, or nitrous oxide. .

Relying on psychosocial skills, as we do at the Territorial Observatory of Risky Behavior in Adolescents (OTCRA of the University of Grenoble-Alpes, in conjunction with the rectorate and the prefecture of Isère, is another avenue to consider. These skills are defined as “a person's ability to cope with the demands and challenges of daily life”.

The acquisition of these social, cognitive and emotional skills makes it possible to reduce the consumption of alcohol, tobacco and cannabis in particular, which confirms the effectiveness of this global approach and not just focused on products.

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