In 2019, North Carolina filed a lawsuit against American electronic cigarette (e-cigarette) company, Juul, alleging that it had deliberately targeted teenagers resident in that state in its advertising and was therefore instrumental in creating what was described as “a vaping epidemic”, by the state’s attorney general. The case was set for trial this month, but on Monday last, Juul settled out of court, and will pay North Carolina US$40 million over six years as well as change its advertising in that state.
E-cigarettes are rechargeable or single-use battery-powered devices, which disperse nicotine and other chemicals as vapour that users inhale. Juul sells these devices along with pods, which according to its website, contain nicotine, benzoic acid, propylene glycol, glycerine, and flavour. As is well known, nicotine is an addictive stimulant and the flavours initially offered, including creme brulee, mango, fruit medley, mint, menthol, apple pie, bubble pop, strawberry cotton candy and peanut butter cup, obviously appealed to teenagers and children, who began using them in numbers high enough to cause concern. As of October 2019, researchers found that upwards of five million young people were vaping and the Centers for Disease Control and Prevention revealed that there were 1,604 people suffering from serious and debilitating lung injury associated with e-cigarettes use and there had been 34 related deaths. Those numbers have since risen.
Juul found itself staring down a lawsuit because it had obscured and embellished the truth about its e-cigarettes with the use of information it knew was misleading. In short, it pulled the old smoke and mirrors game, no pun intended, in an effort to push its product, deliberately peddling misinformation.
The US Food and Drug Administration (FDA) had received information that a Juul represen-tative made a presentation at a school where he told students that Juul was safer than cigarettes, they should recommend it to their friends and that the FDA was about to announce that it was 99% safe and approve its use shortly. All lies.
Further, Juul sent representatives to make a presentation to American Indians of the Cheyenne River Sioux Tribe, telling them that they should switch to Juul because it was a smart, really well thought-out alternative to smoking and an amazing invention that would improve the lives of the world’s one billion adult smokers. Juul also reportedly targeted health insurers and employers with the same messaging.
As a result of this, the FDA issued Juul with a warning letter in September 2019 for “marketing unauthorized modified risk tobacco products by engaging in labelling, advertising, and other activities directed to consumers”. Following the warning, the company voluntarily halted all sales of its fruit and dessert-flavoured e-cigarette pods, leaving only mint, menthol and tobacco-flavoured products on the market. Was that enough? Unfor-tunately, it was not as this is clearly a case of history repeating itself.
Let us backtrack to the 1950s when Big Tobacco (a name traditionally used to collectively refer to the global bigwigs in the industry: Phillip Morris International, British American Tobacco, Japan Tobacco, and Imperial Tobacco) began what would turn out to be a decades-long global deception, in the interest of raking in profits. The industry deliberate-ly lied about the addictive and carcinogenic nature of cigarettes and tobacco; targeted women, teenagers and children in its advertising campaigns; and paid unscrupulous scientists to produce research that criticized the facts associated with smoking dangers. Once it realised the jig was beginning to be up in the developed world, Big Tobacco expanded its reach in low-income, under-developed countries the world over with the same aggressive obfuscation mentioned above.
The result is all around us, manifesting in the biggest public health threat the world has ever seen with an estimated eight million annual deaths from cardiac and pulmonary/respiratory and other chronic non-communicable diseases like cancers owing to tobacco use and secondhand smoke which affects non-users who are exposed to it. Further, the burden placed on health systems by these diseases affecting millions of people annually is tremendous.
In 1998, American states reached an historic landmark settlement with the major players in the industry in the US, requiring those companies to pay out $246 billion over several years as compensation for tobacco-related healthcare costs. In 2006, the American Cancer Society and other plaintiffs won a major court case, which saw the tobacco companies being forced to publicly correct their lies at their own expense as well as affix warnings to cigarette packaging. Most of this has since caught on in the rest of the world, aside from the multi-billion-dollar payouts of course, but none if it has remedied the addiction so the companies continue to prosper and to meet their court mandated payments.
It should surprise no one that Juul, founded in 2005 by two former cigarette smokers, is now 35 percent owned by Altria, the parent company of Phillip Morris. The playbook is virtually the same. Who knows what delving into the companies producing hookahs (communal water pipes) and the tobacco used in them will reveal? Regardless of who owns them, however, hookahs, though made to look attractive, are no less dangerous than other products used to deliver tobacco to users. In fact, considering their communal usage, hookahs might actually be more risky to health, particularly in this era.
Unfortunately, there will never be a vaccine to curb this pandemic. Despite all the known dangers, tobacco is still not a prohibited substance. Moreover, given its excessive lucrativeness, those profiting from its sale will continue to find ingenious ways to keep the cycle turning.
The best one can hope for in the future is that good sense will somehow prevail, people will begin to see beyond the illusion and fake glamour that surrounds tobacco use and will choose to stop or never to start smoking and vaping and thus maintain good health and finances.
