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HEALTH

Here's everything you need to know about vape, Juul, e-cigarettes and the FDA

Hamilton County Sheriff's Department Deputy Brad Osswald holds one of three Juul devices he has confiscated this year from students at Hamilton Heights High School. The e-cigarettes contain nicotine, and have become popular among teens in Hamilton County.

In an effort to slow the rising tide of teens who vape and smoke, the Food and Drug Administration is taking a number of steps to dissuade youth from picking up the habit. But what is vaping? Do e-cigarettes contain nicotine? Are these more toxic than regular cigarettes?

Here’s what you need to know about vaping, e-cigarettes, Juul and the FDA.

What is the FDA doing to curb smoking and vaping among young?

The FDA’s latest effort would allow only stores that verify customer’s ages to sell sweet-flavored vaping products, which appear to appeal primarily to younger users. Flavors other than tobacco, mint, or menthol can only be sold in establishments restricted to those legally old enough to vape. The new rules will also ban menthol cigarettes and many flavored small cigars. Online sales will have more stringent requirements for customers to prove they are of age.

Will Indiana vape shops be impacted?

No. One must be over age 18 to purchase e-cigarettes in Indiana.

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What is vaping?

Vaping is using a battery-powered device to heat liquid-based nicotine into an inhalable vapor. The liquids often come in enticing flavors, like cotton candy or bubble gum.

Many of the devices, including Juul, look more like a flash drive than a cigarette.

Is vaping illegal for people under 18?

Yes. In Indiana, purchasing e-cigarettes is illegal for anyone under the age of 18. In some states, however, the legal purchase age is 21.

Does vape contain nicotine?

Not every liquid heated to create vapor contains nicotine. Indiana code defines e-liquid as a substance that may or may not contain nicotine. However the American Lung Association warns most do. The five brands targeted by the FDA  make up more than 97 percent of the U.S. market for e-cigarettes, USA Today reported.

Does it make sense to pull flavored e-cigarettes off the market?

Some research indicates that the chemicals used in the flavoring may themselves be toxic, said Dr. Richard Feldman, director of medical education at Franciscan Health Indianapolis and a former state health commissioner. In addition, taking those products off the market could effectively dissuade teens from use.

“The public health fear is that we’re going to renormalize smoking behaviors again. We have come so far,” Feldman said. “We have come a long way in reducing the social acceptability of smoking, but now we have potentially a new generation of kids being introduced to nicotine, one of the most addictive substances we have.”

Does vaping help you quit smoking?

Many of these products, like Juul, are marketed as an alternative to traditional cigarettes. Some say vaping can help smokers quit.

Juul officials have said restricting flavors “will negatively impact current adult smokers” who want to switch from smoking to vaping.

While there's plenty of research that shows negative effects of cigarettes, e-cigarettes are so new there's still little definitive research about their long-term effects.

Is vaping safe?

Not according to those in the public health community, said Feldman.

Scientists know that even in the absence of nicotine, vaping lets loose other substances such as formaldehyde that can be detrimental to one’s health. And there’s evidence in the short term that vaping may damage tissue.

Are Juuls and other vaping products just as toxic as traditional cigarettes?

The two work in different ways, Feldman said. Cigarettes involve combusted, or burned, tobacco. E-cigarettes are heated, but not to the point of combustion. Combustion will liberate the most toxins, but even heating a substance can lead to the release of toxins, Feldman said.

“It probably is safer, but I like to call it less toxic rather than safer than combusted tobacco,” he said.

What is Juul?

Juul is one type of flavored e-cigarette that contains nicotine. The light weight device can fit in the palm of hand. Juul devices charge by plugging into a computer's USB port.

The Juul starter kit costs $49.99. After that, it costs $15.99 for a pack of four flavored liquid cartridges called pods, which are 5 percent nicotine. Each pod is the equivalent of a pack of cigarettes, according to Juul's website, but pods are about $1.50 cheaper than a pack of cigarettes in Indiana. 

Juul's website describes the product as having "cigarette-like" nicotine levels.

Is Juul doing anything to deter teen users?

Juul announced its own initiative to deter teen smokers. The company said it would no longer sell its mango, fruit, creme or cucumber pods to more than 90,000 retail shops. 

Why did vaping concern school officials?

The smaller devices are easy to hide and discrete to use, making it more difficult for schools to catch. Unlike cigarette smoke, the vapor evaporates quickly when exhaled and the oil gives off a sweet smell that officials said can sometimes be confused with perfume.

How did teens used to buy e-cigarettes?

Indiana attempted to regulate e-liquid products by requiring retailers to make a “good faith effort” to verify purchasers are 18 or older. The state also requires manufacturers to label products that contain nicotine and package them with child-proof caps.

Many of the products were available in stores and online where there are not stringent checks on age.

Juul's age verification requirements have strengthened: New users are now asked to provide a social security number and other personal information to "validate your name and date of birth against public records."

If vaping is not as bad as cigarettes, why is everyone so upset about teens doing it?

The problem, Feldman said, is that many of the teens who start vaping did not smoke in the first place.

“We are balancing harm reduction in smokers with increasing harm for kids that don’t smoke and are picking up an unsafe habit,” he said.

Are there any other measures to take to lower teen use?

Increase taxes, Feldman said. “Probably the single most effective way to discourage teen use is to tax it.”

Contact IndyStar reporter Emma Kate Fittes at 317-513-7854 or efittes@gannett.com. Follow her on Facebook and Twitter: @IndyEmmaKate.

Call IndyStar reporter Shari Rudavsky at 317-444-6354. Follow her on Facebook and on Twitter: @srudavsky.