April 19 (UPI) -- Although many young people are aware of the e-cigarette brand JUUL, few know it contains nicotine, according to a new survey.
Truth Initiative, a national public health organization that pushes for youth and young adults to reject tobacco, conducted the online survey in November. The results were published this week in the journal Tobacco Control.
In the 1,012-person survey, 25 percent of people between age 15 and 25 recognized JUUL in a photo. But 63 percent of JUUL users did not known the product contains nicotine, and among those who recognized the e-cig, 25 percent thought it was in its own category.
JUUL comprises 46.8 percent of the e-cig market, according to tracking by Nielsen.
Those aged 18-24 were more likely to recognize JUUL -- 29 percent -- compared with 21 percent among those aged 15-17, who are considered adolescents. And 7 percent of the younger group said they have tried JUUL, compared with 12 percent of the older group.
"It is no wonder that JUUL e-cigarettes have rapidly caught on with youth -- they look like a sleek USB flash drive, are easily concealed, and come in youth appealing flavors like mint, mango and crème brulee," Robin Koval, CEO and president of Truth Initiative, said in a press release.
A spokewoman for JUUL told UPI it is investing in efforts to combat teen use of its product, but did not comment on the perception among young people that it does not contain nicotine beyond noting that its packaging says JUUL cartridges do, in fact, contain nicotine.
"JUUL Labs' mission is to eliminate cigarette smoking by offering existing adult smokers a true alternative to cigarettes. JUUL is not intended for anyone else," the spokeswoman told UPI. "We strongly condemn the use of our products by minors, and it is in fact illegal to sell our product to minors. No minor -- or non-nicotine user -- should be in the possession of JUUL. In fact, we clearly state on our package labeling that JUUL is for adult smokers only and contains nicotine."
Although e-cigarettes may be less harmful than combustible tobacco products, e-cigarettes have been shown to strongly increase the likelihood of cigarette use among young people, according to a 2014 Surgeon General's Report. More than four times as many young adults who use e-cigarettes eventually switch to smoking tobacco cigarettes than those who do not vape.
Truth Initiative on Wednesday was one of six leading public health and medical organizations that sent a letter to Food and Drug Administration Commissioner Dr. Scott Gottlieb urging the agency to take action addressing the dramatic increase in teen use of JUULs.
The other groups are the the Campaign for Tobacco-Free Kids, American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association and American Lung Association.
"JUUL is putting kids at risk of nicotine addiction and threatens to undermine decades of progress in reducing youth tobacco use," the health groups wrote to the FDA. "The FDA is responsible for regulating tobacco products, including e-cigarettes, and it is unacceptable that the FDA has yet to take action to address the skyrocketing youth use of JUUL."
Senate Democratic Whip Dick Durbin of Illinois and 10 of his Senate colleagues on Wednesday also sent letters to the FDA and JUUL about the products. They want to know, according to a release, "how the product is marketed to children and teens, what ingredients are in the flavorings that accompany these devices, and requests that the company take a series of important steps to limit youth use of their product."
Last month, the FDA announced it was taking the first steps to limit fruit flavoring and menthol in tobacco products, and Truth Initiative and six other public health and medical groups have sued the FDA for its decision to allow e-cigarettes to avoid full regulatory compliance until 2022.
A survey released in March from the 2016 National Youth Tobacco Survey also found that teenagers who use tobacco products other than cigarettes often see their habit as harmless.
The survey asked the 20,675 sixth- to 12th-grade teens whether they considered themselves tobacco users. Sixty percent of e-cig users did not consider themselves tobacco users.
Three-quarters of kids who used e-cigarettes and 56 percent of those who used hookahs didn't see the products as harmful among teens who agreed that "all tobacco products" are not safe.