“Puff”, the new disposable electronic cigarette:
a trap for children and adolescents
Press release from the French National Academy of Medicine
28 February 2023
“Puff” is a new form of electronic cigarette (e-cigarette), single-use and therefore disposable. Due to the risks associated with smoking, it constitutes a particularly sneaky trap for children and adolescents.
The e-cigarette generates an aerosol, with or without nicotine, intended to be inhaled. In 2015, the National Academy of Medicine considered the e-cigarette to be less dangerous than cigarettes, but to be used only by tobacco smokers. This opinion is still valid today, as e-cigarettes prove to be more effective than traditional nicotine substitutes for quitting smoking (1). The Academy has also advised that they should not be sold to minors, as well as advertised or used where smoking is prohibited (2, 3). It has been established that trying e-cigarettes encourages smoking even if to a lesser extent (40%) than trying tobacco directly (4).
Smoking among schoolchildren has never been so low (in the ninth grade: half as much if it is an experimentation on a trial basis, and four times if it is a daily use, in 2021 compared to 2010) (5). At 17 years old, tobacco use is falling, as is e-cigarette use (6). If this trend continues, the goal of a virtual elimination of smoking in France by 2030 would be achievable. This prospect is undoubtedly intolerable for those who profit financially from tobacco. By doubling the demand for e-cigarettes among children and teenagers, it would be possible to slow down, or even reverse, this virtuous trend.
This is what “Puff’ has been successfully doing since 2021, as it is designed to be attractive to children and adolescents, even when it does not contain nicotine (7,8). Its competitive price, attractive packaging, sweet and fruity flavours, and availability in a large number of places (tobacco shops, kiosks, restaurants, even supermarkets and home decoration shops) make it easily accessible. Discreet, it is easy to use, even at school. It induces an addiction to the gesture of “ vaping”, which may represent a new mode of entry into cigarette addiction, subsequently reinforced by using “Puffs” with nicotine. Some “Puffs” can contain up to 5% nicotine. They can then increase the risk of addiction, like all tobacco products, a risk recognized by the Senate which, on 8 November 2022 as part of the first reading of the draft budget of the Social Security for 2023, voted to introduce a “dissuasive tax” on these disposable electronic cigarettes.
In July 2022, one in ten adolescent aged 13-16 had already tried “’Puff’” and 28% of e-cigarette users had started with the ‘Puff’, which was then no longer a cessation tool (7). In England, 8.6% of 11-18 year olds had vaped in 2022, compared with 4% in 2021 (9).
Its success with minors has been supported by a strong promotion on digital social networks, particularly via influencers, and even by dedicated websites that are now banned.
A real trap set for children and teenagers with a view to leading them into an addiction to tobacco products, “Puff”, which is disposable, is made of plastic with a lithium battery. It is therefore also a toxic waste that adds to the 4.5 trillion cigarette butts discarded worldwide each year.
The risks associated with “Puff” for the health of children and adolescents lead the National Academy of Medicine to recommend to:
– Inform widely the public, starting at school age, about the danger that “Puff” promotes tobacco addiction;
– Make middle and high school teachers aware of this risk;
– Reinforce regulations aimed at protecting children and adolescents from “Puff” (increased taxation; reinforced control of the effectiveness of the ban on sales to minors; (obligation of a neutral packaging), as also requested in Switzerland (10);
– Reserve the use of disposable e-cigarettes for people who smoke tobacco in order to help them to quit.
- Electronic cigarettes for smoking cessation. Cochrane Data Base of Systematic Reviews 17/11/2022 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub7full
- Dubois G., Goullé J.P., Costentin J., La cigarette électronique permet-elle de sortir la société du tabac. Bull. Acad. Natle Méd, 2015, 199, n° 2-3, 363-369.
- The Academy of Medicine recalls the proven advantages and unduly alleged disadvantages of the electronic cigarette (vaporette). Press release 6/12/2019.
- Legleye S. et al, Experimenting first with e-cigarettes versus first with cigarettes and transition to daily cigarette use among adolescents: the crucial effect of age at first experiment. Addiction, 2021,116, n°6, 1521-1531.
- Tendance-OFDT. N°148, December 2021: Alcohol, tobacco and cannabis use among 9th grade students in 2021.
- OFDT. ESCAPAD, 20 years of observation of drug use in adolescence. Paris, OFDT, Théma, 2022, 62 pages
- BVA for Alliance contre le tabac, Les Adolescents de 13 à 16 ans et les nouveaux produits du tabac, August 2022 (https://alliancecontreletabac.org/2022/10/25/1-ado-sur-10-a-deja-utilise-la-puff-lact-reclame-son-interdiction/)
- Hall R., UK campaigners call for tighter regulations on vapes to match tobacco. To tackle their popularity with children, campaigners and councils want vapes to be taxed and sold in plain packaging behind counter, The Guardian, 11 February, 2023
- Velarde Crézé C., et al, New disposable electronic cigarettes “puffs”: expert consensus on their regulation, Rev. Med. Suisse, 2023, 19, p. 181-185