--:-- Sean Rameswaram: Hello. Hello. Is this Ellen Mayer in Chicago, Illinois?
--:-- Ellen Mayer: Yeah, you've got Ellen Mayer in Chicago.
--:-- Sean Rameswaram: Hey, this is Sean Ramos from Today Explained. I hear you have a mattress problem.
--:-- Ellen Mayer: Yeah, well, I had a mattress problem once.
--:-- Sean Rameswaram: Oh, you did? Yeah, I did. Do you want me to tell you about it?
--:-- Ellen Mayer: I'd love to. Yeah, give me a second, though.
--:-- Sean Rameswaram: Okay. When I was a kid, I thought smoking looked pretty cool.
--:-- Ellen Mayer: How long have you been a smoker?
--:-- Sean Rameswaram: 22 years.
--:-- Ellen Mayer: But these days, the kids, they're more into vaping. They're more into Juul.
--:-- Sean Rameswaram: Yo, yo, yo, yo, yo. I'm going to attempt to hit the Juul for 30 seconds straight without exhaling.
--:-- Ellen Mayer: And we're going to go out in our bathing suits and roll around in the snow and then rip our Juul for like two minutes.
--:-- Sean Rameswaram: It tastes like a blueberry muffin, man.
--:-- Ellen Mayer: Another one hit, bro.
--:-- Sean Rameswaram: One more.
--:-- Ellen Mayer: Guys, I pimped my jewel and turned it gold.
--:-- Sean Rameswaram: I like the mango. It's just like one of the best flavors I've ever tried, really, in my vaping career.
--:-- Ellen Mayer: And now Uncle Sam's coming to crash the party. Federal health officials announced a nationwide crackdown on underage use of a popular e-cigarette brand following months of complaints from parents, politicians and school administrators.
--:-- Sean Rameswaram: It's a vaping device called Juul, but it looks like a regular computer flash drive.
--:-- Ellen Mayer: FDA regulators asked manufacturer Juul Labs to turn over documents about the design, marketing and ingredients of his product.
--:-- Sean Rameswaram: The kids love the Juul so much they're bringing them to school and to class.
--:-- Ellen Mayer: The Juul would be my favorite thing to take. Just get you something like that, like a small vape that you can hide.
--:-- Sean Rameswaram: Slip it into your underwear or something or like put it on your waistline.
--:-- Ellen Mayer: And when you go into the bathroom to get your fucking nicotine fix, you just reach in there and grab it.
--:-- Sean Rameswaram: And hey teacher, can I go to the bathroom?
--:-- Meg Kenney: This is Meg Kenney's an assistant principal at Burr and Burton Academy in Manchester, Vermont.
--:-- Sean Rameswaram: We started to catch on that students were using them in classes or on the school bus.
--:-- Meg Kenney: And because the device, you know, really looks like this USB drive and is small and compact and easily concealable.
--:-- Sean Rameswaram: And there is no really distinct odor and there's no smoke left behind.
--:-- Meg Kenney: That's one of the challenges for schools is that when you glimpse it, you're not thinking, oh, that's a Juul.
--:-- Sean Rameswaram: They're smoking nicotine oil with that.
--:-- Meg Kenney: You know, I think for teachers, a lot of teachers, that's just not obvious.
--:-- Sean Rameswaram: This seemed to be popular with our younger students, our 9th and 10th graders, more than our students in 11th and 12th grade.
--:-- Meg Kenney: We've also seen the combination of using the jewel on campus combined with social media.
--:-- Sean Rameswaram: Like there was a little bit of a who could use a jewel in different places and take a picture and snap it around.
--:-- Meg Kenney: Like here I am firing up the jewel on my school bus and here I am in my Spanish class and I'm going to Snapchat a picture around.
--:-- Sean Rameswaram: And that kind of became a little bit of a thing, I think, for students to be like, oh, I'm going to one-up you.
--:-- Meg Kenney: I'm going to fire up my jewel and nobody's going to know and I'm going to snap a picture wherever around the campus.
--:-- Sean Rameswaram: And that's often how we found out about it.
--:-- Meg Kenney: Like somebody would say, hey, so-and-so is sending pictures around of them jeweling in the bathroom or in their class.
--:-- Julia Belluz: This is Julia Belluz, the senior health correspondent at Vox.com.
--:-- Sean Rameswaram: So I've never felt older reporting on a story than I did reporting on The Jewel.
--:-- Julia Belluz: Because it's like this whole language and culture that's emerged among high schoolers.
--:-- Sean Rameswaram: And I don't know, do you have friends who are like avid jewelers or vapers?
--:-- Julia Belluz: Because I don't.
--:-- Sean Rameswaram: Unfortunately, I do and I make fun of them.
--:-- Julia Belluz: Okay, there we go. When I think about my time in high school, there was like the smoking section outside the school.
--:-- Sean Rameswaram: It's a different scene out there that you see on social media.
--:-- Julia Belluz: And it's cooler than bell bottoms, apparently, or something, right?
--:-- Sean Rameswaram: The Juul is not cool, but it does have this really catchy name, and its pods come in eight flavors.
--:-- Julia Belluz: Mango, Virginia tobacco, cool mint, cool cucumber, classic menthol, fruit medley, creme brulee, and classic tobacco.
--:-- Sean Rameswaram: Some of these flavors sound a lot more like things you'd find in a kid's snack box than a vape device.
--:-- Julia Belluz: How do you use the Juul?
--:-- Sean Rameswaram: So you stick the pod into a cartridge on one end of the device, and then you inhale through a mouthpiece at the other end of the Juul, and then the device vaporizes this e-liquid in the pod, and then you're vaping.
--:-- Julia Belluz: And when the device runs out of power, you just stick the Juul into your computer's USB port and you recharge it.
--:-- Sean Rameswaram: You mentioned that it's kind of exploding right now just in terms of sales.
--:-- Julia Belluz: How popular is the Juul?
--:-- Sean Rameswaram: It seems like Juul's the top-selling cigarette by a long shot, and it's only been on the market for three years, which is just staggering when you think about the fact that there are hundreds of other e-cigarettes on the market.
--:-- Julia Belluz: Wow. To put that into perspective, in March this year, Juul had more than half of the market share for retail e-cigarettes in the U.S.
--:-- Sean Rameswaram: And that just bonkers for a single device
--:-- Julia Belluz: So who buying this Juul? Who using it?
--:-- Sean Rameswaram: So we don't know how many users are adult smokers and how many are teens.
--:-- Julia Belluz: But there's a lot of anecdotal reports about, you know, this just spreading like wildfire on campuses.
--:-- Sean Rameswaram: And if you look on Twitter or on YouTube under hashtags like DoItForJuul, you find kids showing off, kind of doing tricks with the devices.
--:-- Julia Belluz: Yeah. Yo, what's good? We got the jewel here.
--:-- Sean Rameswaram: Gonna teach you some tricks.
--:-- Julia Belluz: How many tricks? Four, right? Top four tricks.
--:-- Sean Rameswaram: Top four tricks with the jewel.
--:-- Julia Belluz: Get that buzz. Jewel army.
--:-- Sean Rameswaram: Alright, so to start, we're gonna start with a ghost.
--:-- Julia Belluz: And it's basically where the smoke comes out of your mouth.
--:-- Sean Rameswaram: It comes out your mouth that way.
--:-- Julia Belluz: And you just inhale it back in.
--:-- Sean Rameswaram: So it's kind of something like this.
--:-- Julia Belluz: So this was enough evidence for the FDA to announce this crackdown last week and single out this company.
--:-- Sean Rameswaram: And yeah, when you start to talk to teenagers who are using it, I think there are a lot of reasons why it might be particularly appealing for youth.
--:-- Julia Belluz: So, you know, the fact that you can easily hide it, you know, your parents might not know what it is.
--:-- Sean Rameswaram: The fact that there are all these flavors that are really appealing, it's very discreet, it's lightweight, it's easier to use than other devices.
--:-- Julia Belluz: How much does it cost the Juul?
--:-- Sean Rameswaram: What's it run?
--:-- Julia Belluz: So there's a starter kit and you get the e-cigarette, the USB charger, four pods, and it sells for about $50.
--:-- Sean Rameswaram: And then the device itself alone, $35.
--:-- Julia Belluz: Where are these kids getting all that money?
--:-- Sean Rameswaram: Back in my day, a pack of cigarettes was like $4.
--:-- Julia Belluz: And a pack of four Juul pods is about $16.
--:-- Sean Rameswaram: So how did this become the biggest e-cigarette in the country?
--:-- Julia Belluz: Part of it is the design.
--:-- Sean Rameswaram: So it was designed by these two Stanford design graduates.
--:-- Julia Belluz: One had a background working at Apple.
--:-- Sean Rameswaram: And you can see that in the device.
--:-- Julia Belluz: It looks like this, you know, high-tech, sleek little thing.
--:-- Sean Rameswaram: It looks different from other cigarettes.
--:-- Julia Belluz: It's also easier to use.
--:-- Sean Rameswaram: It doesn't require users to replace coils or atomizers, which other e-cigarettes require.
--:-- Julia Belluz: Oh, but what really sets it apart, I think, is that it just delivers this mega dose of nicotine.
--:-- Sean Rameswaram: So these two Stanford grads who designed the jewel, were they targeting kids, adolescents?
--:-- Julia Belluz: Was it their idea? No.
--:-- Sean Rameswaram: Like, hey, let's make a cool thing for the kids?
--:-- Julia Belluz: No, that's the interesting thing.
--:-- Sean Rameswaram: So when you look at the official marketing online, they talk about how they're targeting adult smokers who want to quit and how they want to end the smoking epidemic and how that's their official position and mission.
--:-- Julia Belluz: How much nicotine does the Juul have in comparison to a cigarette?
--:-- Sean Rameswaram: So Juul claims that one of their little e-liquid pods, those things that you stick in the end of the device and vaporize, they claim that it has the same levels of nicotine as a pack of cigarettes.
--:-- Julia Belluz: But the tobacco experts I spoke to said they think it's more like two packs of cigarettes.
--:-- Sean Rameswaram: Oh shit.
--:-- Julia Belluz: And so users will go through a pod like some are using a pod a day some are using a pod every you know four to five days a week but you're ripping through nicotine really quickly and the way Juul hits your body it delivers a very similar nicotine peak as cigarettes and part of that is because the nicotine in Juul comes from nicotine salts
--:-- Ellen Mayer: Okay, well, the problem I think is a problem that a lot of people have, which is that I graduated from college and moved to the big city. of Chicago and needed something to sleep on.
--:-- Sean Rameswaram: Your problem was you didn't have a mattress.
--:-- Ellen Mayer: That right. That interesting.
--:-- Sean Rameswaram: We haven't come across that problem yet.
--:-- Ellen Mayer: Okay, so what were you initially sleeping on or did you go get a mattress on like day one?
--:-- Sean Rameswaram: Oh, that's a good question.
--:-- Ellen Mayer: Well, I was initially sleeping on my friend's mom's guest bed.
--:-- Sean Rameswaram: Okay.
--:-- Ellen Mayer: But then I moved to my own grown-up apartment, and then I didn't have a mattress.
--:-- Sean Rameswaram: So my problem was really, like, the floor or go to the mattress store.
--:-- Ellen Mayer: Oh, which mattress store did you go to?
--:-- Sean Rameswaram: I actually went to mattress store.
--:-- Ellen Mayer: Oh, perfect.
--:-- Sean Rameswaram: Did you use the coupon code podcast10 to get 10% off at mattressfirm.com slash podcast, or did you enter a physical mattress firm in your neighborhood?
--:-- Ellen Mayer: Yeah, I entered a physical mattress firm.
--:-- Sean Rameswaram: Unfortunately, it was a few years too soon for podcast 10.
--:-- Sean Rameswaram: Here's a piece of news. Summer is basically here in D.C., and Today Explained is looking for its first ever summer intern.
--:-- Elijah Stewart: I'm Elijah Stewart, and I'm 19 years old, and I attend Providence College.
--:-- Sean Rameswaram: I first heard about the jewel my sophomore year in high school.
--:-- Elijah Stewart: I think it started to become a habit maybe after even a week of using it.
--:-- Sean Rameswaram: I mean, I cycle through a pod between every four to five days, which means like $16, $32 of my own money, which over time you're paying $1,200 in jewel pods for a year.
--:-- Elijah Stewart: So it really does do some damage to your wallet once you become hooked.
--:-- Sean Rameswaram: When I was a senior in high school, there was this group of girls that thought tobacco was so disgusting and despised it.
--:-- Elijah Stewart: And was like, how could you do that to yourself?
--:-- Sean Rameswaram: And then a couple weeks later, every single one of them owned a jewel.
--:-- Elijah Stewart: And by a week in, they were hooked.
--:-- Sean Rameswaram: I think the flavors were really appealing to the public because when you hit like a mango pod per se, it kind of tastes in a way like candy almost, and you also get the head rush.
--:-- Elijah Stewart: I was talking with some students who I help tutor in math and science, and they were telling me how they even do it.
--:-- Sean Rameswaram: And they were in middle school still.
--:-- Elijah Stewart: They're in seventh grade, eighth grade who despise cigarettes and everything, like think it's the cool thing to do, to Juul.
--:-- Sean Rameswaram: I feel like a lot of the concerns with smoking are alleviated by vaping because there's obviously so much less damage to your lungs.
--:-- Elijah Stewart: You're not smoking tobacco. It's vapor.
--:-- Sean Rameswaram: But how harmful are e-cigarettes? How harmful is Juul?
--:-- Elijah Stewart: Yeah, so there's no question that e-cigarettes are safer than cigarettes, and most public health groups, I think, would agree with that assessment.
--:-- Sean Rameswaram: But safer doesn't mean safe.
--:-- Elijah Stewart: And I think that's what people forget here, what the comparator is.
--:-- Sean Rameswaram: Cigarettes are one of the deadliest products available to consumers.
--:-- Elijah Stewart: They still kill something like one in five Americans, and that's the message, I think, that gets lost here.
--:-- Sean Rameswaram: And the reality is we don't know about the long-term effects of e-cigarettes.
--:-- Elijah Stewart: Will they cause cancers? Are they going to harm the lungs or circulatory system in ways we can't even imagine right now?
--:-- Sean Rameswaram: We just have no idea, and they haven't been used for long enough to know.
--:-- Elijah Stewart: What about nicotine? We know it's addictive, but is it dangerous?
--:-- Sean Rameswaram: Here's the thing. Nicotine is not as deadly as many of the toxins and chemicals in conventional cigarettes, but it is extremely addictive.
--:-- Elijah Stewart: It targets the reward circuitry of our brain, and there's some concern that exposing young people to nicotine may affect how their brains are developing and in ways that may sensitize them to substance use disorders later.
--:-- Sean Rameswaram: And quitting nicotine, it's serious.
--:-- Elijah Stewart: People go through really intense withdrawal symptoms.
--:-- Sean Rameswaram: So we're talking about nervousness, restlessness, moodiness, anxiety, sleep disturbances, you know, changes in appetite, headache, constipation, weight gain, fatigue.
--:-- Elijah Stewart: It's hard enough for adults to handle this.
--:-- Sean Rameswaram: And I think these are symptoms we probably don't want our teenagers experiencing.
--:-- Elijah Stewart: On the other hand, if you're a smoker, maybe a product like Juul can help you quit.
--:-- Sean Rameswaram: And it's this potentially powerful harm reduction tool.
--:-- Elijah Stewart: And that's also why regulators are a little hamstrung and there's been this conundrum around these devices.
--:-- Sean Rameswaram: Products like Juul, they might hook a generation on nicotine with all these nasty effects that we've described, but they also might help smokers quit.
--:-- Elijah Stewart: Is that happening?
--:-- Sean Rameswaram: So that's another thing we don't know.
--:-- Elijah Stewart: So the National Academies of Science came out with a big report this year and they looked at questions around the health impact of e-cigarettes and they found there was insufficient evidence that e-cigarettes can help people quit smoking.
--:-- Sean Rameswaram: But there is a lot of evidence that most of the adult e-cigarette users are dual users.
--:-- Elijah Stewart: So they smoke and vape.
--:-- Sean Rameswaram: So they might be people who are using vape devices to try to quit smoking.
--:-- Elijah Stewart: Maybe they're smokers who are vaping in places where they can't smoke just to get the nicotine they need.
--:-- Sean Rameswaram: How has that changed the way tobacco companies sell cigarettes or market cigarettes?
--:-- Elijah Stewart: So yeah, a lot of these big tobacco companies have their own e-cigarette products and the market is pretty mixed.
--:-- Sean Rameswaram: There are these small companies and startups with vape products and then there are many products coming from big tobacco companies.
--:-- Elijah Stewart: Vaping sounds kind of like the Wild West, but the FDA is policing this on some level.
--:-- Sean Rameswaram: It is sort of the Wild West out there.
--:-- Elijah Stewart: So there are some things that the FDA is already doing.
--:-- Sean Rameswaram: The FDA does have strong regulations not allowing e-cigarette sales to minors, and it's trying to enforce these, but some retailers and manufacturers are doing it anyway.
--:-- Elijah Stewart: The other thing that's happening now is that manufacturers are supposed to be registering their ingredients with FDA and they also supposed to be including warning labels about nicotine on their packaging.
--:-- Sean Rameswaram: But most of the products that are on the market now including Juul have probably not been vetted by FDA
--:-- Elijah Stewart: So why do we think the FDA commissioner cracked down on Juul and asked the company to share all this information about how it markets its Juul?
--:-- Sean Rameswaram: I think they're doing that for a couple reasons.
--:-- Elijah Stewart: So they've been under a lot of pressure by public health groups like Tobacco-Free Kids and the American Academy of Pediatric and others.
--:-- Sean Rameswaram: They're worried that vaping is going to offset the health gains that have been made around seeing our smoking rates decline.
--:-- Elijah Stewart: And so they've been pressuring FDA to do something about this.
--:-- Sean Rameswaram: I think there's also this genuine concern and confusion about what's happening with this market and why we're seeing a single product explode the way Juul has.
--:-- Elijah Stewart: So what did Juul say back to the FDA?
--:-- Sean Rameswaram: So Juul's CEO, Kevin Burns, released his statement on April 25th, and he said, quote, Our company's mission is to eliminate cigarettes and help the more than one billion smokers worldwide switch to a better alternative.
--:-- Elijah Stewart: At the same time, we're committed to deterring young people as well as adults who do not currently smoke from using our products.
--:-- Sean Rameswaram: We cannot be more emphatic on this point. No young person or non-nicotine user should ever try Juul.
--:-- Elijah Stewart: Is it the job of Juul or the FDA to make sure that kids aren't becoming addicted to nicotine through Juuling?
--:-- Sean Rameswaram: So the FDA is the regulatory body that's supposed to protect public health and make sure that products harmful to young people aren't being marketed directly at them.
--:-- Elijah Stewart: But having said that, it's a conundrum because e-cigarettes, they're almost designed to evade regulation, right?
--:-- Sean Rameswaram: The technology is evolving so quickly.
--:-- Elijah Stewart: Their use is evolving.
--:-- Sean Rameswaram: The culture around them is evolving really quickly.
--:-- Elijah Stewart: And regulators are in this position of catch-up about what to do with them.
--:-- Sean Rameswaram: You mentioned smoking rates have been on this steady decline over the past several decades.
--:-- Elijah Stewart: So if all these kids are smoking Juuls now, could they end up reviving cigarettes, ironically, tragically?
--:-- Sean Rameswaram: That's really the million-dollar question.
--:-- Elijah Stewart: Again, when we were growing up we didn't have these less harmful options available when maybe we wanted to dabble in smoking and try something out and so maybe you know the kids these days who are trying Juul or other devices maybe they're going to be exposed to less harm than we were when we were trying cigarettes but on the other hand maybe these devices renormalize smoking or they get young people into nicotine, and that leads to this tsunami of public health effects that no one can foresee now.
--:-- Sean Rameswaram: When I was in Toronto smoking cigarettes for the first time, I remember when they put images on the packs of cigarettes, like a cancerous lung, or a kid saying, my mom's dead.
--:-- Elijah Stewart: And I'll never forget that image of a hand squeezing 20 cigarettes and all this toxic bile coming out of it.
--:-- Sean Rameswaram: These images are seared into my mind.
--:-- Elijah Stewart: But I haven't heard anything about vaping to make me feel like it's dangerous or terrible.
--:-- Sean Rameswaram: So we haven't updated our health warnings on cigarette packs since 1985.
--:-- Elijah Stewart: What if our show made a song to help kids understand what's wrong with juuling?
--:-- Sean Rameswaram: That would be great.
--:-- Elijah Stewart: You know what musical artists we could parody? Juul?
--:-- Sean Rameswaram: Teenager sucker, no need USB key
--:-- Elijah Stewart: He says at least it's not a cigarette and you agree
--:-- Sean Rameswaram: He hits the thing a hundred times a day
--:-- Elijah Stewart: The teacher tries to confiscate the kids, there's no way
--:-- Sean Rameswaram: Another mango puff, a cucumber puff, can't get enough
--:-- Elijah Stewart: You know you love it when your selfie blows up
--:-- Sean Rameswaram: But don't go rape your jewel Cause it's full of nicotine
--:-- Elijah Stewart: Vape your Juul It's like one or two packs of smokes
--:-- Sean Rameswaram: Don't go vape your Juul It's really not cool
--:-- Elijah Stewart: La-da-dee-da-da-dee-dee-da-da Ah-ha-ha-ha
--:-- Sean Rameswaram: Julia Blues doesn't Juul She writes about health at Vox.
--:-- Elijah Stewart: Christina Animeshan sings better than anyone else at Vox.
--:-- Sean Rameswaram: And Noam Hassenfeld is the Rick Rubin of Vox.
--:-- Elijah Stewart: I'm Sean Ramas from This Is Today Explained.
--:-- Sean Rameswaram: Irene Noguchi is our executive producer.
--:-- Elijah Stewart: Bridget McCarthy is our editor.
--:-- Sean Rameswaram: Afim Shapiro is our engineer.
--:-- Elijah Stewart: Luke Vanderplug produces.
--:-- Sean Rameswaram: And the unreachable Breakmaster Cylinder makes music for us.
--:-- Elijah Stewart: Today Explained is produced in association with Stitcher.
--:-- Sean Rameswaram: And we're part of the Vox Media Podcast Network.
--:-- Elijah Stewart: I'm John Henry. I am eight, nine years old, and I live in Washington, D.C.
--:-- Sean Rameswaram: You can follow Today Explained on Twitter at today underscore explained.
--:-- Elijah Stewart: The nice thing about going to the store uh like Luke Vanderplug learned is that you can just like try out a bunch of different mattresses and figure out what your type is yeah so which type are you firm i'm a firm gal all the way okay and and you currently have this mattress firm firm mattress i do in fact i am lying on it right now oh wow it feels very luxurious uh and i think i'm not gonna have it forever mattressfirm.com slash podcast the coupon code podcast 10 gets you 10 off before may 8th you don't need it but someone out there might yes that's true
