The success of "puffs" among adolescents worries elected officials and health professionals

The rapid spread of disposable electronic cigarettes (puffs) among adolescents in France raises fears of a new epidemic of nicotine addiction and once again raises the question of compliance with the ban on sales to minors.

The attractiveness of the flavors, the low price and the ease of use seem to be the main factors in the success of puffs, disposable electronic cigarettes.[1]The device is very simple and does not require recharging or prior preparation: puff-type e-cigarettes are pre-filled and, once unpacked, you simply draw on the device to obtain a puff of flavored vapor, with or without nicotine. Presented in the form of a colored bar, each puff contains 500 to 600 puffs, which is equivalent to approximately two packs of cigarettes. Some models contain high levels of nicotine (2% - 20 mg/ml, the highest level authorized in the European Union). Inexpensive and sold on average for €8, puffs are less expensive than a pack of cigarettes (€10).

While the WPuff (Liquideo) brand is the best-known in France, around twenty other brands already offer products of this type. Sold in tobacconists, but also in vape stores, night grocery stores, certain household product retailers, and on numerous websites, the accessibility of these products to teenagers, to whom sales are normally prohibited, is problematic. These disposable e-cigarettes also pose significant environmental problems because they are made of plastic, a battery, and e-liquid, which generate persistent and abundant pollutants.

The ban on sales to minors is poorly respected

"I am terribly angry with all the traders who agree to sell without any control, even though it is forbidden for those under 18," said Professor Loïc Josseran, president of the Alliance Against Tobacco (ACT) on the subject.[2]. "When you're on a social network like TikTok, you're not there to reach out to 50-year-old smokers who want to quit smoking. That's not true, even if the manufacturers say they're there to help with quitting. We're there to catch young people.", he added, specifying that we are witnessing a real "pediatric epidemic".

The sellers' liability is therefore clearly engaged, as is the case for the sale of tobacco products. The manufacturers' liability is also at issue when they use social networks to broadcast advertisements and promotions for these products, which has been prohibited since the order of May 19, 2016.[3].

Sophie Métadier, UDI MP for Indre-et-Loire, questioned the government on this issue on February 15, 2022. Sarah El Haïry, Secretary of State for Youth and Engagement, responded that the authorities had contacted the advertising regulatory agency (ARPP) to remind manufacturers and influencers of the penalties they face when they advertise or promote these products on social media such as TikTok or Instagram.[4]She also indicated that she had contacted the Youth Guidance Council and that education on the dangers of addiction to these products would be developed.

A high risk of addiction linked to the presence of nicotine

The nicotine in some puffs is a major concern; the adolescent brain is particularly vulnerable to it and addiction can occur within just a few weeks of use, with this effect being accentuated when initiation occurs early.[5]However, the risk of addiction and the attractiveness of flavors are considered by the SCHEER report on electronic cigarettes as two major risks for adolescents.[6]The latest opinion from the High Council for Public Health (HCSP) considers the risk that young non-smokers introduced to vaping could then become tobacco smokers to be significant.[7]He also points out that the presence of flavors increases the appeal of e-cigarettes and reduces the perception of harm caused.

Keywords: disposable e-cigarettes, puffs, teenagers, flavors, sales to minors

©Generation Without Tobacco

MF

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[1] Queffélec M, The popularity of puffs among teenagers is worrying: "They are gradually becoming intoxicated and addicted to nicotine.", France Info, published February 23, 2022, consulted February 24, 2022. [2] "Puff" phenomenon: "We are facing a pediatric epidemic," warns the president of the Alliance Against Tobacco, France Info, published February 23, 2022, consulted February 24, 2022. [3] Vaping products, Public Health Code, Articles L3513-1 to L3513-19, Order No. 2016-683 of May 19, 2016. [4] Electronic cigarettes called "puff" a trap for our teenagers, Sophie Métadier’s website, published on February 15, 2022, consulted on February 24, 2022. [5] Age of initiation to vaping, predictor of future smoking among adolescents?, Generation Without Tobacco, published February 22, 2022, accessed February 24, 2022. [6] Scientific Committee on Health, Environmental and Emerging Risks (SCHEER), Opinion on electronic cigarettesPublished on April 16, 2021, accessed on February 24, 2021. [7] Advice on the benefits and risks of electronic cigarettes, High Council of Public Health, published on November 26, 2021, consulted on February 24, 2022. National Committee Against Smoking |