Doctor gives tips for students struggling to quit Juuling

Hamad AlMohaimeed said he gets a headache if he does not hit his Juul within an hour of waking up. As a previous smoker, the sophomore majoring in computer science and engineering took up Juuling as a first-year at UNC. 

He did not anticipate growing more dependent upon the Juul than he ever was upon conventional cigarettes.

“When I came here, I was like, 'I don’t want to buy more cigarettes, so I’ll just buy a Juul,'” AlMohaimeed said. “So I bought a Juul, and then I got hooked on it.”

He said he has grown so dependent upon his electronic cigarette that he does not feel like himself when he is not using the product.

"I think I’m not an easily stressed person, but I feel I'm less stressed when I’m on nicotine products,” AlMohaimeed said. “At this point, I don’t think it gives me any benefit, but at this point, when I don’t have it, I don’t feel like what I want to feel like.”

There was a period of time when AlMohaimeed attempted to stop using nicotine products. At the end of his first semester at UNC, he went three months without using conventional or electronic cigarettes. But after a successful stint away from nicotine products, AlMohaimeed eventually returned to his Juul.

“I don’t think there was an exact reason for it,” AlMohaimeed said. “I just got back into nicotine products in general, and I felt that the Juul was the healthiest of the worst. Every time I find myself back smoking, I try to push myself back to Juul, rather than do cigarettes.”

Like many other college students, AlMohaimeed said he believes that a Juul is a healthier alternative to conventional cigarettes. 

But Ilona Jaspers, director of the Center for Environmental Medicine, Asthma and Lung Biology, said a Juul is not any less harmful than conventional cigarettes. 

“I think they just don’t understand how much nicotine is in these devices,” Jaspers said, referring to college students who routinely use electronic cigarettes. “They have no idea that there is probably three times as much nicotine in a Juul as there is in a cigarette.”

Dr. Bradley Drummond, an associate professor at the UNC School of Medicine and director of the Obstructive Lung Diseases Clinical and Translational Research Center, said recent data from the Center for Disease Control and Prevention even suggests that approximately two-thirds of Juul users between the ages of 15 and 24 do not know that Juul always contains nicotine.

Dr. Drummond said he counsels patients who are trying to stop using electronic cigarettes the same way he counsels people who are trying to stop using conventional cigarettes. He said one of the most important first steps is for users to identify the triggers that prompt them to use their Juul.

“We often tell patients who are trying to quit that if they’re always smoking around the same group of people, they may have to change their social activities until they can get off of those products,” Drummond said. 

Dr. Drummond said he often advises his patients to identify alternative stress relievers to avoid relying on an electronic cigarette.

He recommends trying a strategy that involves creating concrete action plans that replace electronic cigarettes by using "if-then" statements.

“So if I’m in a stressful situation, then I’m going to take a 10-minute walk,” Drummond said. “If I’m in a social situation where people are using electronic cigarettes, then I’m going to leave that situation for 30 minutes.”

Some students who have resolved to stop Juuling have purchased other e-cigarettes that are marketed as nicotine free products. However, Dr. Drummond advises against these products.

“At this point, because we don’t have a full understanding of all of the components of the vapor, and because of the fact that the electronic cigarette market isn’t regulated, we do not recommend using products that report no nicotine,” Drummond said. 

Jaspers said students looking for extra support can try apps designed to help people modify their behaviors. She said a major player in the anti-Juuling movement, the Truth Initiative, recently launched an app that could help college students looking to stop using these products.

"You really have to be committed to quit it and really understand that you have no idea what this may do in 20, 30 years,” Jaspers said.

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