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Update: JUUL Labs to Pay $40 Million in North Carolina Lawsuit Settlement
E-cigarette company JUUL Labs will pay $40 million and make changes to its business practices to settle the first sate lawsuit that alleged it marketed to teens and young adults, according to CNN .
The settlement follows a 2019 lawsuit filed by North Carolina Attorney General Josh Stein which alleged that Juul Labs marketed its e cigs to children and misled the public about health risks associated with those products. The order will restrict the e-cigarette manufacturer’s sales and advertising in the state, and provide funds to help those addicted to e-cigarettes.
“Juul Labs must abandon all marketing strategies and content that appeals to young adults," Stein said. "Juul Labs will be prohibited from influencer advertising, outdoor advertising near schools, sponsoring sporting events and concerts, and most importantly, most social media advertising. JUUL Labs cannot use anyone under the age of 35 years in their advertising. Juul Labs cannot make any claims that its e-cigarettes are safer or better for your health than combustible cigarettes.”
The consent order also requires that JUUL Labs institute a barcode age-verification system of IDs at places where its e cigs are sold, and that this system be tested through a retailer compliance program using mystery shoppers at 1,000 stores per year.
For online sales, the company is ordered to restrict sales to individuals to no more than 2 e cigs per month, 10 per year and no more than 60 pods per month.
The settlement money will go toward the youth vaping epidemic, and will be paid over six years.
How Do Electronic Cigarettes Work?
Electronic cigarettes (also known as e-cigarettes, ecigs or vapes) are devices powered by lithium ion batteries that deliver nicotine and other substances in the form of a vapor, which is inhaled by the user. The devices contain a rechargeable heating element, cartridge and atomizer.
What’s the Problem?
Each refillable e-cigarette cartridge contains a liquid solution made of different quantities of nicotine, dangerous chemicals and other substances. Since these solutions come in flavors ranging from cotton candy to bubble-gum, they may be appealing to younger consumers.
As a result, electronic cigarette use poses a danger to children’s safety, as the devices are not required to be childproof.
The sweet odor produced by ecigs has lured children to drink the liquid nicotine and become poisoned. Additionally, inhalation, direct skin and/or eye exposure can cause nicotine toxicity.
Poison Control Centers Report Spike in E-Cig Toxicity Cases
Accidental exposure and ingestion of electronic cigarette cartridges have resulted in a significant increase in reports of toxicity at poison control centers across the country.
According to the Centers for Disease Control and Prevention (CDC), between September 2010 and February 2014, poison control centers reported more than 2,400 e-cigarette exposure calls. Of these:
- 69% involved ingestion
- 17% involve inhalation
- 8.5% involved eye exposure
- 5.9% involved skin exposure
More than half of these incidents involved children who were exposed to toxic levels of nicotine, and 42% involved adults over the age of 20. The report also indicated that the number of electronic cigarette use poisoning cases jumped from just 1 call per month in 2010 to nearly 200 calls per month in 2014.
E Cigarette Side Effects
- Nicotine poisoning/toxicity
- Chronic obstructive pulmonary disease
- Popcorn lung
- Vaping related lung injuries
- Nicotine addiction
- Respiratory failure
- Vapor lung
- Accidental inhalation
- Skin/eye exposure
- Congestive heart failure (CHF)
What's in an E-Cigarette?
E-cigarettes use lithium ion batteries to heat up a special liquid into an aerosol that e cigarette users inhale. It's not just harmless water vapor.
The "e-juice" that fills the cartridges usually contains nicotine (which is extracted from tobacco), propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine. Additionally, when the e-liquid heats up, more toxic chemicals are formed.
Because the Food and Drug Administration has not begun its review of any e-cigarette or its ingredients, nor has the agency issued any standards on the products, e-cigarette composition and effects vary. What researchers do know is that these toxic chemicals and metals have all been found in e-cigarettes:
- Nicotine – adversely affects adolescent brain development
- Propylene glycol – a common additive in food; also used to make things like antifreeze, paint solvent, and artificial smoke in fog machines
- Carcinogens- chemicals known to cause cancer, including acetaldehyde and formaldehyde
- Acrolein – a herbicide primarily used to kill weeds, can cause irreversible lung damage
- Diacetyl – a chemical linked to a lung disease called bronchiolitis obliterans aka "popcorn lung"
- Diethylene glycol – a toxic chemical used in antifreeze that is linked to lung disease
- Heavy metals such as nickel, tin, lead
- Cadmium – a toxic metal found in traditional cigarettes that causes breathing problems and disease
- Benzene – a volatile organic compound (VOC) found in car exhaust
- Ultrafine particles that can be inhaled deep into the lungs
Source: American Lung Association
Outbreak of Lung Injury Associated with E. Cigarette, Vape Use
As of February 2020, at least 2,807 hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) cases or deaths have been reported to Centers for Disease from all 50 states, the District of Columbia, and 2 U.S. territories (Puerto Rico and U.S. Virgin Islands).
At least 68 deaths have been confirmed in 29 U.S. states and the District of Columbia:
- Alabama, California (4), Connecticut, Delaware, District of Columbia, Florida (2), Georgia (6), Illinois (5), Indiana (6), Kansas (2), Kentucky, Louisiana (2), Massachusetts (5), Michigan (3), Minnesota (3), Mississippi, Missouri (2), Montana, Nebraska, New Jersey, New York (4), Oregon (2), Pennsylvania, Rhode Island, South Carolina, Tennessee (2), Texas (4), Utah, Virginia and Washington (2).
- The median age of deceased patients was 49.5 years and ranged from 15-75 years (as of February 18, 2020).
Among the 2,668 hospitalized EVALI cases or deaths reported to CDC (as of January 14, 2020):
- 66% were male
- The median age of patients was 24 years and ranged from 13–85 years.
By age group category:
- 15% of patients were under 18 years old;
- 37% of patients were 18 to 24 years old;
- 24% of patients were 25 to 34 years old; and
- 24% of patients were 35 years or older.
2,022 hospitalized patients had data on substance use, of whom (as of January 14, 2020):
- 82% reported using THC-containing products; 33% reported exclusive use of THC-containing products.
- 57% reported using nicotine-containing products; 14% reported exclusive use of nicotine-containing products.
50% of EVALI patients who reported using THC-containing products provided data on product source (as of January 7, 2020):
- 16% reported acquiring products only from commercial sources (recreational and/or medical dispensaries, vape or smoke shops, stores, and pop-up shops).
- 78% reported acquiring products only from informal sources (family/friends, dealers, online, or other sources).
- 6% reported acquiring products from both commercial and informal sources.
54% of EVALI patients who reported using nicotine-containing products provided data on product source (as of January 7, 2020):
- 69% reported acquiring products only from commercial sources.
- 17% reported acquiring products only from informal sources.
- 15% reported acquiring products from both commercial and informal sources.
Emergency department (ED) visits related to e-cigarette, or vaping injuries, products sharply increased in August 2019 and peaked in September 2019.
National ED data and active case reporting from state health departments across the U.S. indicate a sharp rise in symptoms or cases of e-cigarette, or vaping, product use-associated lung injury in August 2019, with a peak in September 2019 and a gradual decrease since then.
Reasons for the decline include:
- Increased public awareness of the risk associated with THC-containing e-cigarette, or vaping, product use as a result of the rapid public health response.
- Removal of vitamin E acetate from some products.
- Law enforcement actions related to illicit products.
Laboratory data indicates that vitamin E acetate, an additive contained in certain THC e-cigarette or vaping products has been linked to the EVALI outbreak.
A recent study analyzed samples from 51 EVALI cases from 16 states and a comparison group of samples from 99 comparison individuals without EVALI for vitamin E acetate, plant oils, medium chain triglyceride (MCT) oil, coconut oil, petroleum distillates, and diluent terpenes.
Vitamin E acetate was identified in bronchoalveolar lavage (BAL) fluid samples from 48 of the 51 patients, but not in the BAL fluid from the healthy comparison group.
No other toxicants were found in BAL fluid from either group, except for coconut oil and limonene (1 EVALI patient each).
In August 2019, the Centers for Disease Control and Prevention started collecting data from states on e-cigarette, or vaping, product use-associated lung injury cases using a standardized case report form.
Due to the subsequent identification of the primary cause of EVALI, and the considerable decline in EVALI cases and deaths since a peak in September 2019, CDC stopped collecting these data from U.S. states in February 2020.
What is Vitamin E Acetate?
Vitamin E acetate is used as an additive in THC-containing e-cigarette or vaping products.
Vitamin E is a vitamin found in many foods, including vegetable oils, cereals, meat, fruits, and vegetables. It is also available as a dietary supplement and in many cosmetic products, like skin creams.
Vitamin E acetate usually does not cause harm when ingested as a vitamin supplement or applied to the skin. However, previous research suggests that when vitamin E acetate is inhaled, it may interfere with normal lung functioning.
Source: American Lung Association
Due to numerous safety concerns, Food and Drug Administration officials tested a small sample of cartridges from 2 leading brands of electronic cigarettes, Smoking Everywhere and Njoy.
The tests determined that:
- Diethylene glycol, a toxic ingredient contained in antifreeze, was found in 1 cartridge at approximately 1%.
- Tobacco-specific nitrosamines, which are harmful to humans, were found in half the samples.
- The tobacco-specific impurities anabasine, myosmine, and β-nicotyrine were detected in most samples.
- The ecig cartridges that were labeled as containing no nicotine were found to have low levels of nicotine in all cartridges tested except one.
- Three different e-cigarette cartridges with identical labels were tested, and each cartridge produced a different amount of nicotine with each puff. Nicotine levels ranged from 26.8 to 43.2 mcg nicotine/100 mL puff.
- One high-nicotine cartridge delivered twice as much nicotine when the vapor from that device was inhaled than was delivered by a sample of a nicotine inhalation product (used as a control) that was approved by the Food and Drug Administration for use as an anti-smoking device.
At a news conference discussing these findings, Dr. Jonathan Winickoff, chairman of the American Academy of Pediatrics Tobacco Consortium, expressed concerns that electronic cigarettes - particularly those that come in flavors - may appeal to children. He said e-cigarettes could lead to nicotine addiction and cigarette smokers later on in life.
In a statement addressing the FDA results, the American Lung Association said that it shared similar concerns. The group urged the FDA "to act immediately to halt the sale and distribution of all e-cigarettes unless the products have been reviewed and approved for sale by the FDA.”
Flavors and Marketing Make E-Cigarettes More Appealing to Youth: CDC
E-cigarettes come in various flavors, including fruit, candy, mint, and menthol.
A 2014 study found that most children who use e-cigarettes start with a flavored variety, and flavors are the primary reason youth report using e-cigarettes.
In 2020, most youth who reported using e-cigarettes used flavored varieties (82.9%). Among high school students who used any type of flavored e-cigarettes in 2020, the most commonly used flavors are fruit (73.1%), mint (55.8%), menthol (37.0%), and candy, desserts, or other sweets (36.4%).
On January 2, 2020, the FDA finalized an enforcement policy that prohibits the sale of pre-filled cartridge e-cigarettes in any flavor other than tobacco or menthol, unless authorized by the agency. FDA has since taken additional steps to prohibit certain e cigarette manufacturers from selling youth-appealing, flavored disposable e-cigarettes and flavored e-liquids without authorization.
Several states and communities have restricted the sale of flavored tobacco, including menthol-flavored products.
E-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth initiation of other tobacco, including cigarettes. In 2016, about 7 in 10 middle school and high school students (69.3%)—more than 18 million youth—said they had seen e-cigarette advertising.
Widespread advertising for e-cigarettes, including via media for which advertising for conventional tobacco is prohibited (e.g., TV), and the lower costs of some e-cigarettes relative to regular cigarettes has contributed to use among youth.
Many youth also report using e-cigarettes because they are curious about these products.
Why is Nicotine Unsafe for Teens and Young Adults?
Most e-cigarettes contain nicotine, an addictive drug found in traditional cigarettes, cigars, and other tobacco products.
A recent study from the Centers for Disease Control and Prevention found that 99% of the e-cigarettes sold in assessed venues in the U.S. contained nicotine.
Some e-cigarette labels do not disclose that they contain nicotine, and some e-cigarettes marketed as containing 0% nicotine have been found to contain nicotine.
Nicotine can harm the developing adolescent brain. The brain keeps developing until about age 25.
Using nicotine in adolescence can injure parts of the brain that control attention, learning, mood, and impulse control.
Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells. Young people’s brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.
Using nicotine in adolescence may also increase risk for future addiction to other drugs.
Can E-Cigarette Use be a Gateway to Cigarette Smoking?
Many young adults who use e-cigarettes also smoke traditional cigarettes. There is evidence that young adults who use e-cigarettes may be more likely to smoke traditional cigarettes in the future, according to the Centers for Disease Control and Prevention.
A 2018 National Academy of Medicine report found evidence that e-cigarette use increases the frequency and amount of cigarette smoking in the future.
E-cigarettes also can be used to deliver other drugs, including marijuana; in 2016, more than 30% of U.S. middle and high school students who had used an e-cigarette reported using marijuana in the device.
E Cigarette Aerosols
E-cigarette aerosol are vapors that users breathe from the device and exhale which can contain harmful and potentially harmful substances, including:
- Ultra-fine particles that can be inhaled deep into the lungs
- Flavorings such as diacetyl, a chemical linked to a serious lung disease
- Volatile organic compounds
- Cancer-causing chemicals
- Heavy metals such as nickel, tin, and lead
The aerosol that e-cigarette users inhale and exhale can expose both themselves and bystanders to harmful substances.
It is difficult for consumers to know what e-cigarette products contain, according to the CDC. For example, some e-cigarettes marketed as containing 0% nicotine have been found to contain the drug.
Are There Any Benefits to Vaping?
In addition to whatever enjoyment vaping brings, some evidence suggests that vaping helps some people stop smoking. However, how it compares to a nicotine patch or other methods of smoking cessation is not clear.
So far, the FDA has not approved vaping as a method of smoking cessation. And many smokers who vape continue to use both cigarettes and e-cigarettes.
The CDC’s position is that “E-cigarettes have the potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.” Meanwhile, the FDA warns that vaping is “not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco.”
E Cigarette Regulation
In August 2016, the regulatory authority of the FDA was extended to cover e-cigarettes through the agency’s “deeming rule.”
Through authority granted by the Family Smoking Prevention and Tobacco Control Act (FSPTCA), FDA has the power to develop regulations that address the manufacturing, marketing, and sale of e-cigarettes.
There are certain strategies that the FDA does not have authority to implement, such as including e-cigarettes in smoke-free policies or increasing the minimum legal sales age for these products, unless directed to do so by Congress.
However, the FSPTCA does not prevent states and communities from including e-cigarettes in smoke-free policies or from regulating the sale and distribution of e-cigarettes. These types of strategies can include further raising the minimum legal sales age, licensing retailers, implementing price policies, and restricting or prohibiting the sale of tobacco.
Sometimes referred to as “heat-not-burn” technology, heated tobacco products (HTPs) represent a diverse class of products that heat the tobacco leaf to produce an inhaled aerosol. They are different from e-cigarettes, which heat a liquid that can contain nicotine derived from tobacco.
Heated tobacco is available in at least 40 countries and several have been authorized for sale by the FDA. In 2018, few U.S. adults (2.4% of all surveyed, including 6.7% of people who currently smoke surveyed) had ever used HTPs. In 2020, 1.4% of U.S. middle and high school students reported having used heated tobacco in the past 30 days.
Scientists are still learning about the potential health effects of HTPs, but the available science shows they contain potentially harmful ingredients. Youth use of any tobacco, including heated products, is unsafe, according to the CDC.
What is JUUL?
JUUL is a brand of e-cigarette that is shaped like a USB flash drive. Like other similar devices, the JUUL E cigarette is powered by lithium ion batteries that heat a nicotine-containing liquid to produce an aerosol that is inhaled.
All JUUL e-cigarettes have a high level of nicotine, with a single JUUL pod containing as much nicotine as a pack of 20 traditional cigarettes.
The JUUL e-cigarette is one of a few e-cigarettes that uses nicotine salts, which allows particularly high levels of nicotine to be inhaled more easily and with less irritation than the free-base nicotine used in tobacco and other brands of e-cigarettes.
News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.
More than 60% of JUUL e-cigarette users aged 15 – 24 do not know that JUUL products always contain nicotine, according to the Centers for Disease Control and Prevention .
Although JUUL is currently the top-selling e-cigarette brand in the U.S., other e-cigarette manufacturers sell e-cigarettes that look like USB flash drives. Examples include the MarkTen Elite and the PAX Era, a marijuana delivery device that looks like JUUL.
Additional information about USB-shaped e-cigarettes and actions that parents, educators, and health care providers can take to protect kids is available at CDC’s Infographic .
Status of Juul Claims
As of July 2020, at least 758 Juul e cigarette lawsuits had been consolidated in multidistrict litigation MDL-2913. Many lawsuits claim Juul’s marketing targets minors, and the company denies this.
“We have never marketed to youth and do not want any non-nicotine users to try our products,” Juul Labs spokesperson Ted Kwong told VICE. “These suits largely copy and paste unfounded allegations previously raised in other lawsuits, which we have been actively contesting for over a year. These cases are without merit, and we will defend our mission throughout this process.”
The cases represented both class action e cigarette lawsuits and individual personal injury cases filed in 4 states. The litigation is expected to continue growing.
JUUL Class Action Lawsuit
Schools across the U.S. have joined a class action lawsuit against JUUL, alleging that the company targeted minors in its advertising campaigns and downplayed the health risks associated with vaping.
The class action, filed in a California federal court, alleges that JUUL targets high school students by enticing them with fun and fruity flavors. Lexington One, which joined the lawsuit in October 2020, claims that vaping has affected everyday school operations, adding that suspensions over e-cigarette use have sharply increased in recent years.
Richland Two, South Carolina’s fifth-largest school district, is also considering whether to join the class action. School district trustee Amelia McKie acknowledged a recent proposal to sue, which was prompted “because of the addictive nature of vaping” and the “potential for health problems and other consequences for our students…”
The lawsuit seeks to recoup expenses related to addressing in-school JUUL vaping, including hiring additional employees to monitor vape use in hallways and bathrooms.
Some schools have been forced to buy expensive vaping detectors, while others have used resources on educational programs to inform students and parents about the effects of vaping, according to the complaint.
Nationwide statistics show that parents and schools do have cause for concern. According to the Centers for Disease Control, more than 21% of South Carolina high school students currently use tobacco. The most used products are e-cigarettes, and students report using JUUL more than any other brand.
The lawsuit comes after years of scrutiny against JUUL, which has come under fire for allegedly targeting teens and young adults with their sleek designs and fruity flavors.
The company also markets their products as a “safer alternative to cigarettes,” even though they contain nicotine and expose the lungs to diacetyl, which can cause bronchitis obliterans (popcorn lung).
What are Juul Lawsuits Alleging?
Allegations in Juul E-cigarette lawsuits include:
- Juul marketed its products in a manner to attract minors
- The company promoted nicotine use
- Its marketing failed to warn that its nicotine products are more potent and addictive than tobacco cigarettes
- The company’s products are defective and unreasonably dangerous
To date, no trials in the MDL have been scheduled. Most of the initial lawsuits in the litigation were filed before incidents of vaping related lung injuries and deaths began being reported in mid-2019. The New York Times reported in October 2019 that several people who were affected had used JUUL brand nicotine products before becoming sick.
JUUL Wrongful Death Lawsuit
The first wrongful death lawsuit against JUUL was filed in a California federal court in October 2019.
The mother of 18-year-old David Wakefield alleged that her son was first exposed to JUUL marketing when he was 15, started smoking e-cigarettes soon afterward and continued doing so for years.
The lawsuit further alleged that a year after he started vaping, Wakefield was hospitalized for 3 days due to breathing and lung complications. He was so addicted to nicotine that hospital staff had to use nicotine patches to ease his cravings, according to the suit.
Wakefield continued vaping after he was released from the hospital. His father found the teen had died in his sleep early on the morning of August 31, 2019, according to the complaint.
The lawsuit claimed Juul marketed its products to minors and the company’s “conduct and the defects in Juul products were a substantial factor in causing Wakefield’s death.”
Lawsuit Alleges Juul Sold 1 Million Contaminated Vape Pods
A former senior vice president at Juul filed a lawsuit against the company in October 2019, alleging that he was fired after he raised concerns over 1 million contaminated mint-flavored Juul pods that were distributed to retailers and consumers.
Plaintiff Siddharth Breja’s lawsuit claimed Juul “refused to recall those contaminated pods or even issue a product health and safety warning,” and that the company sold expired products over his repeated protests.
The company’s former CEO, Kevin Burns, told CBS This Morning in September 2019 that Juul’s products were legal and tested for toxicity, and that said Juul would not sell a dangerous product.
Chicago Files E-Cigarette Lawsuit Over Flavored Tobacco After New Tobacco Regulations
February 2, 2021 - The city of Chicago is suing an e-cigarette company over its sales of flavored tobacco and for marketing to minors, alleging that the seller violated both federal regulations and local age restrictions on buying tobacco and electronic cigarettes.
The suit claims that Vapes.com, which is owned by Equte LLC, markets and sells flavored e-cigarettes to residents, despite a new law passed in September that makes it illegal to sell such products to residents of Chicago.
“E-Cigarettes are unhealthy and addictive, and businesses deliberately target young people in the hope that they’ll develop lifelong customers,” said Mayor Lori Lightfoot. “The City of Chicago’s message to e cigarette manufacturers is clear: If you break the law, we will go after you, especially if you try to sell to our youth.”
While the minimum age for buying tobacco in Chicago is 21 years old, Vapes.com and its social media platforms only ask that e-cigarette users be 18 and over and don’t employ the “age gate” features that YouTube and Instagram offer.
The city says it has filed numerous lawsuits against vape companies for selling to underage Chicagoans, but this is the first suit seeking to enforce the recently passed prohibition against flavored vaping products.
As the FDA began its crackdown on the vaping industry in 2019 for allegedly targeting minors and getting them addicted to nicotine, it warned retailers about selling fruit-flavored e-cigarette products without approval.
Vaping Linked to Lung Disease, CDC Says
August 22, 2019 - The CDC said on Saturday that it had counted at least 94 probable cases of severe lung illness or "pulmonary disease" associated with vapes or e-cigarettes in 14 states from June 28 to August 15.
Patients suspected of having the illness were hospitalized for “multiple weeks,” in some cases ending up in the intensive care unit, according to health officials. Symptoms included shortness of breath, fever, cough, vomiting, diarrhea, headache, dizziness and chest pain.
Teenagers and JUUL
Teenagers between the ages of 15-17 are more likely to use JUUL products than the company’s primary demographic, adults trying to quit smoking. This is largely due to the JUUL’s youth-focused marketing tactics.
JUUL e-liquids come in dessert- and fruit-like flavors, accounting for a large part of the products’ appeal to younger consumers. Additionally, JUUL e-cigarettes have a small and sleek design that resembles a USB drive, which makes it easy for underage teenagers to hide the device from parents and teachers.
JUUL Labs claims it has taken steps to prevent minors from purchasing their products, such as deleting many of their social media accounts; however, the number of teenagers who still use JUUL is unacceptably high. These young people are now addicted, and many will likely continue to use the product for years to come.
The Centers for Disease Control and Prevention recently conducted a study in which they surveyed 20,189 middle and high school students to determine how many young people used e-cigarettes in 2018.
E-Cigarette Use Among Middle and High Schoolers in 2018
- Middle School Girls 4.8% of middle schoolers vaped
- Middle School Boys 5.1% of middle schoolers vaped
- High School Girls 18.8% of high schoolers vaped
- High School Boys 22.6% of high schoolers vaped
Unfortunately, since a person’s brain doesn’t stop developing until age 25, teens are highly susceptible to the mental and physical health risks of vaping — especially nicotine addiction.
Why is Nicotine so Addictive to Kids?
Nicotine is dangerous at any age, but the drug is particularly dangerous before the brain is fully developed, around the age of 25.
“Adolescents don’t think they will get addicted to nicotine, but when they do want to stop, they find it’s very difficult,” said Yale neuroscientist Marina Picciotto, PhD. A key reason for this is that “the adolescent brain is more sensitive to rewards,” she explains.
This reward system, known as the mesolimbic dopamine system, is one of the more primitive parts of the brain that developed as a positive reinforcement for behavior we need to survive. Because the mesolimbic dopamine system is so engrained in the brain, it is especially hard to resist.
When a teenager inhales vapor laced with nicotine, the drug is quickly absorbed through the blood vessels lining the lungs. It reaches the brain in about 10 seconds and its particles fit lock-and-key into a type of acetylcholine receptor located on neurons in the brain.
“Nicotine, alcohol, heroin, or any drug of abuse works by hijacking the brain’s reward system,” said Yale researcher Nii Addy, PhD, who specializes in the neurobiology of addiction. The reward system wasn’t meant for drugs, but rather evolved to interact with natural neurotransmitters in the body, like acetylcholine, which is used to activate muscles in the body. The reason nicotine fits into a receptor meant for acetylcholine is because the 2 have very similar shapes.
Once nicotine binds to that receptor, it sends a signal to the brain to release the neurotransmitter dopamine, which helps create a ‘feel-good’ feeling. Dopamine is part of the brain’s feedback system that says “whatever just happened felt good” and trains the brain to repeat that action.
The problem is that nicotine, unlike other drugs such as alcohol, quickly leaves the body once it is broken down by the liver. Once it’s gone, the brain craves nicotine again.
When an addicted teenager tries to quit nicotine, the problem of cravings is linked to the drug that causes the dopamine hit. Additionally, human brain imaging studies indicate that “environmental cues, especially those associated with drug use, can change dopamine concentrations in the brain,” Addy said.
This means that simply seeing a person you vape with, or visiting a school restroom—where teens vape during the school day—can unleash intense cravings. “In the presence of these cues, it’s difficult not to relapse,” Addy said.
FDA Issues Warning on "Severe Respiratory Failure" Linked to E-Cig/Vape Use
At least 215 potential cases of severe respiratory failure in 25 states, in addition to patients with pulmonary illness, are being investigated by the FDA, according to Safety Communication . Most patients presented with a gradual onset of the following symptoms:
- Breathing difficulty
- Shortness of breath
- Chest pain before hospitalization
Some patients reported symptoms of gastrointestinal illness, including:
In addition to the CDC investigation, states are completing their own probes into the cases based on a newly-released federal standardized case definition. If you use e-cigarettes or vapes, and are concerned about these findings, FDA recommends that you refrain from use and consult your physician.
14 Hospitalizations in 2 States Linked to Vaping
August 6, 2019 - Serious injuries related to the use of e-cigarettes or vapes continue to hit record highs, as Wisconsin and Illinois reported 14 emergency hospitalizations between the 2 states in e-cigarette users, according to CNN .
At least 7 other cases are also under investigation in Wisconsin, according to the state's health and services department, which has also issued a formal warning strongly advising against the use of e-cigarettes and similar products.
Since 2010, FDA has received at least 35 reports of seizure in e-cigarette users -- both novice and tenured, young and not so much -- that occurred either during use or shortly after the fact. The cases were fielded by poison control centers across the U.S., as well as the FDA’s adverse event reporting system.
“While 35 cases may not seem like much compared to the total number of people using e-cigarettes, we are nonetheless concerned by these reported cases,” FDA head Scott Gottlieb said in the press release. “We also recognize that not all of the cases may be reported.”
FDA was unable to conclude one way or another whether the smoking devices caused the seizures, since there was no clear pattern in the incidents that led to the patients’ strokes. Some of the victims were novices, while others were veteran smokers. Several of the patients had a prior history of seizures, complicated by marijuana and amphetamine use.
FDA also failed to specify any specific brand name vapes or vape juices implicated in the seizures, as this information wasn’t provided in all these cases (though it should be noted that some devices, in particular Juul, deliver higher doses of nicotine than most other e-cigs).
What is a Seizure?
Seizures are characterized by erratic bursts of electrical activity in the brain, somewhat like an electrical storm. The events can vary greatly in form and severity from patient to patient. Anything the brain does normally may also occur without warning during a seizure.
- Temporary confusion
- A staring spell
- Uncontrollable jerking movements of the arms and legs
- Loss of consciousness or awareness
- Psychic symptoms such as fear, anxiety or deja vu
(Courtesy Mayo Clinic) 
E-Cigarette Lawsuit Filed in Illinois
June 25, 2017 - An Illinois couple is suing two vape shops alleging that lithium ion batteries purchased there caught fire and exploded in the husband’s pants, leaving him with third-degree burns.
According to the lawsuit, Plaintiff Scott Schroeck was checking on a load of lumber in his truck when he felt a burning sensation in his front pocket, according to the Chicago Tribune . He said he had put a spare lithium-ion battery in each pocket for his e-cigarette.
Schroeck's wife, Denise, alleges that she lost her husband's companionship after the incident. The complaint alleges the batteries were defective and that no warnings were provided on the risk of explosion.
Defendants in the case include Rockin Vape, Tobacco Zone and battery manufacturer LG. Plaintiffs are alleging damages of negligence and product liability. The complaint was filed earlier this week in Cook County circuit court.
Texas Man Dies From Vape Explosion
February 14, 2019 - A U.S. Navy veteran from Dallas, Texas, who claims he was severely burned when his electronic cigarette exploded in his pocket has filed a products liability lawsuit against the manufacturer, retailer and distributor.
According to the lawsuit, Plaintiff Matthew Bonestele's LG Chem HG2 18650 battery exploded in his right pants pocket on April 21, 2016. The explosion caused third degree burns to his right leg and made a hole in his right thigh, according to KHOU .
Bonestele alleges that LG Chem America, Inc. defectively designed and manufactured the e-cigarette battery, which his complaint alleges did not have warnings regarding its potential dangers. The e-cigarette was distributed by Lightfire Group, LLC, and sold to Bonestele by Great Vapes, LLC. -- both of which are named as defendants in the lawsuit.
This is not the first incident in which a U.S. veteran has been injured by exploding e-cigarette batteries. Tim Jensen, an Army veteran from Alabama, also had a vape battery explode in his right pocket last year. He suffered second and third degree burns to his hands and legs, and had to receive 60 staples and skin grafts.
Last month, the Navy banned e-cigarettes from its vessels after several reports of exploding vapes injuring sailors. The U.S. Department of Transportation (DOT) in 2016 prohibited airline passengers from carrying portable electronic smoking devices in checked baggage, and from using or charging the devices aboard aircraft.
New Study Questions E-Cigarette Effectiveness at Helping Smokers Quit
February 5, 2019 - Electronic cigarettes or “vapes” are nearly twice as effective at helping smokers of normal cigarettes kick the habit, according to a recent study published in the New England Journal of Medicine (NEJM) . The findings contradict a popular opinion among many that e-cigs are not reliable tools for smoking cessation and may increase the risk of serious injuries such as popcorn lung.
The groundbreaking research marked the first time e-cigarettes have been tested against nicotine replacement products to determine their effectiveness as devices to help quit smoking, according to Peter Hajek, a psychologist at the Queen Mary University of London, who led the study.
The researchers found that 18% of e-cigarette users had quit smoking cigarettes after 1 year, compared with 9.9% of participants who used traditional nicotine replacement products. Both groups received additional support in order to kick smoking.
The scientific community has been generally reluctant to view electronic cigarettes as reliable smoking cessation products due to a lack of research, but “This is now likely to change,” Hajek said.
However, many are still not convinced, and there was even an editorial written in the same NEJM issue the study was published calling on the FDA to enforce an immediate ban on all electronic smoking devices and their “juices” over their potential addictive tendencies.
“We fear that the creation of a generation of nicotine-addicted teenagers will lead to a resurgence in the use of combustible tobacco in the decades to come,” said lead author Jeffrey Drazen, editor in chief of NEJM.
E-Cig Flavoring Contains Popcorn Lung Chemical
December 8, 2015 - Ever since electronic cigarettes hit the market more than a decade ago, researchers have debated the potential side effects posed by the devices. This week, a study released by the Harvard School of Public Health  suggests that 75% of flavored e-cigarettes and liquids contained diacetyl, a chemical that causes an incurable respiratory disease called popcorn lung.
E Cigarette Use Lawsuit Filed in Kansas
April 30, 2018 - A Kansas man who claims the spare battery to his electronic cigarette exploded inside his pocket and caused him severe burn injuries has filed a products liability lawsuit against the vape shop where he purchased the device.
The explosion was a result of metal from some of the other items plaintiff had in his pocket interacting with the spare battery in a way that caused a short leading to a “thermal runway,” the complaint states.
Illinois Couple Alleges Loss of Consortium from Vape Explosion
June 29, 2017 - A married couple from a Plainfield, Illinois, have filed a lawsuit against 2 vape shops alleging that batteries for an e-cigarette purchased there exploded in the man’s pants, causing 3rd degree burn injuries. Plaintiff's wife alleges that she lost her husband’s companionship after the incident.
Ex-Navy Seal Suffers Burns, Laceration in Vape Explosion
May 15, 2017 - A U.S. Navy veteran from Dallas, Texas, who claims he was severely burned when his e-cigarette exploded in his pocket has filed a products liability lawsuit against the manufacturer, retailer, and distributor of the device.
Plaintiff Matthew Bonestele claims that his LG Chem HG2 18650 battery exploded in his right pants pocket, causing third degree burns to his right leg and puncturing his right thigh.
Navy Bans E-Cigarettes Over Nicotine Addiction, Exploding Battery Concerns
April 18, 2017 - Malfunctioning e-cigs have forced at least one aircraft to land, started fires on ships and left multiple sailors with severe burns, according to the Navy Times . Vape injuries have occurred when the devices were being used, charged or replaced, or when they came into contact with other metal objects.
The ban took effect on Friday and comes as the e-cigarette industry faces increasing scrutiny over the safety of its products. Last year, the U.S. Department of Transportation (DOT) prohibited airline passengers from carrying vapes in checked baggage, and from using or charging the devices aboard aircraft.
The U.S. Food & Drug Administration’s Center for Tobacco Products  identified at least 137 reports of e-cigarette overheating, fires and explosions between 2009 and 2015. FDA received at least 20 reports of e-cigarette overheating, fires and explosions last year.
The e-cigarette ban prohibits uniformed personnel and civilians from using, possessing, storing and charging the devices. It will remain in effect until a risk analysis is complete.
The Navy reported at least 15 incidents from October 2015 to June 2016 where fires were started or personnel were injured from electronic cigarettes or portable vaporizers, according to the Naval Safety Center. It’s unclear whether the FDA figures include statistics from the Navy.
Eight of the incidents occurred aboard ships or aircraft, and in one incident an aircraft had to return to base because e-cigarette batteries were creating smoke in the cargo area.
In one case, a battery melted through the pocket of a sailor in a submarine and ignited after it hit the deck of the torpedo room.
In another case, a vape exploded while the user was attempting to remove its batteries, burning his hands and fingers. He was hospitalized for 2 days and spent 14 days on convalescent leave, according to the Naval Safety Center
1 in 4 Children Exposed to Secondhand Smoke from E-Cigs, CDC Study Finds
April 3, 2017 - A new study from the Centers for Disease Control and Prevention (CDC) has found that nearly one-quarter of teens in the U.S. has been exposed to potentially dangerous secondhand vapors from electronic cigarettes over the past 30 days.
Children who were exposed to secondhand tobacco smoke were also more likely to be exposed to secondhand vapor from e-cigarettes, CDC found.
Vapes a “Major Health Concern,” Surgeon General Says
January 16, 2017 - A new report from the U.S. Surgeon General is calling vape use a grave threat to children and young adults in the U.S., igniting a controversy over whether the practice is safer than traditional cigarette smoking.
The report found that e-cigarette use among U.S. high school students was up more than 900% since 2011, and described in scientific terms how young people with developing brains are sensitive to nicotine.
FDA to Investigate Electronic Cigarette Explosions
January 4, 2017 - The FDA is planning to hold a 2-day public meeting in April to discuss the dangers of e cigarette use and exploding batteries in electronic cigarettes and vapes. The Associated Press  reported in December that the agency had identified at least 66 e-cigarette explosions between 2015 and early 2016.
American Youth Bombarded with E-Cigarette Ads, CDC Says
January 5, 2016 - About 18 million U.S. middle and high school students – 70% – are exposed to electronic cigarette advertising, the Centers for Disease Control and Prevention (CDC)  announced today. The ads are using the conventional tobacco marketing tactics of decades past with themes of independence, rebellion and sex appeal, says CDC Director Tom Frieden.
E-Cigarettes Could Damage Cells, Cause Cancer - Study Claims
December 29, 2015 - Adding to the growing health concerns over e-cigs, a new study published in the journal Oral Oncology  has warned that vapor emitted by e cigarette use may cause cancer. The findings came after a lab team at the Veterans Affairs San Diego Healthcare System tested 2 popular brands of e-cigarettes and found their negative impact on human cells.
What Can I Do to Prevent My Child from Using E-Cigarettes?
You can set a good example by being tobacco-free and ensure that your child is not exposed to the secondhand emissions from any tobacco, including e-cigarettes.
Cigarette users should know that it’s never too late to quit. For free help, visit smokefree.gov or call 1-800-QUIT-NOW.
Talk to your child or teen about why e-cigarettes are harmful for them. It’s never too late.
Get the Talk With Your Teen About E-cigarette tip sheet (PDF)  for parents. Start the conversation early with children about why e-cigarettes are harmful for them.
Let your child know that you want them to stay away from all tobacco, including e-cigarettes, because they are not safe for them. Seek help and get involved.
Set up an appointment with your child’s healthcare provider so that they can hear from a medical professional about the health risks of tobacco, including e-cigarettes.
Speak with your child’s teacher and school administrator about enforcement of tobacco-free school grounds policies and tobacco prevention curriculum.
Encourage your child to learn the health risks and get tips for quitting tobacco at Teen.smokefree.gov.
The Centers for Disease Control and Prevention recommends that people not use THC-containing e-cigarette or vaping products, particularly from informal sources like friends, family, or in-person or online dealers.
Vitamin E acetate should not be added to any e-cigarette or vaping products. Additionally, people should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments.
Adult cigarette users who use nicotine-containing e-cigarette or vaping products as an alternative to cigarettes should not go back to smoking; they should weigh all available information and consider using FDA-approved smoking cessation medications.
If cigarette users choose to use e-cigarettes as an alternative to cigarettes, they should completely switch from cigarettes to e-cigarettes and not partake in an extended period of dual use of both products that delays quitting smoking completely.
Cigarette users should contact their healthcare professional if they need help quitting tobacco products, including e-cigarettes, as well as if they have a similar outcome.
E-cigarette or vaping products should never be used by youths, young adults, or women who are pregnant.
Adults who do not currently use tobacco products should not become cigarette users by using e-cigarette, or vaping, products.
THC use has been linked to a wide range of health effects, particularly with prolonged frequent use. The best way for cigarette users to avoid potentially harmful effects is to not use THC-containing e-cigarette or vaping products.
Cigarette users engaging in ongoing cannabis use that leads to significant impairment or distress should seek evidence-based treatment by a healthcare professional.
Get a Free Electronic Cigarette Lawsuit Evaluation With Our Lawyers
The Product Liability Litigation Group at our law firms are an experienced team of trial lawyers that focus on the representation of plaintiffs in E Cigarette Use Lawsuits. We are handling individual litigation nationwide and currently accepting new e cigarette use cases in all 50 states.
Free Confidential Case Evaluation: If you or a loved one has been injured by e cigarette use, you should contact our law firm immediately. You may be entitled to compensation by filing a class action suit and our law firm can help.