On Jan. 31, the Attorney General of North Carolina released internal documents of e-cigarette company Juul Labs revealing the company spent “significant sums” of money on political donations, think tanks and Washington lobbyists, all made public in a 2021 settlement.
The settlement, in which Juul didn’t admit wrongdoing, came after a lawsuit against the company for alleged efforts to target teenagers. A Feb. 15 report on the documents by STAT News noted attempts by Juul in 2018 and 2019 to avert the onslaught of negative attention after the U.S. Surgeon General declared youth vaping an epidemic.
The Herald spoke to researchers at the University and what they mean for the e-cigarette industry.
“All industries use lobbyists,” said Jasjit Ahluwalia, a professor of behavioral and social sciences.
But Juul differed in its response to social and political pressure, he explained. In 2018 and 2019, “Juul was under the microscope with the FDA and the United States Congress” because of widespread youth vaping, he said.
But, the documents highlighted by STAT News don’t illustrate illegal activity, Ahluwalia noted. Juul’s lobbyist and marketing activity may have crossed “a moral line, but crossed no legal line,” he said.
Suzanne Colby, a professor of behavioral and social sciences, also acknowledged that actions taken by Juul cited in the Stat News article were legal.
In Colby’s view, money can greatly influence statements made by think tanks or research institutes with potential significant impact on public policy.
A Juul spokesperson told STAT News that the company believes that “it is fundamentally appropriate for companies like ours to participate in the public dialogue and engage with others who are part of that dialogue … This includes, under certain circumstances, providing those stakeholders with support for their work.”
The spokesperson added that the company’s lobbying actions were part of efforts to “contribute to a more science- and evidence-based public discussion about how best to reduce the death and disease caused by smoking and to reduce underage appeal and access to tobacco and nicotine-containing products.”
According to Colby, “the field of tobacco science is very divided about e-cigarettes.”
“There is evidence according to the most recent Cochrane Review that e-cigarettes do help people who smoke, quit smoking,” said Colby, the professor. “On the other hand, they appeal to young people and can get young people using tobacco products who never would have otherwise.”
She added that it is “unfortunate” that Juul opted to market itself as a “lifestyle brand” rather than a “medicinal cessation route,” thus catering to a much younger audience that is prone to nicotine addiction.
Juul did not respond to The Herald’s request for comment.
Kathryn DeCarli, a medical oncologist and palliative care physician at Lifespan, sees many cancers caused by long-term smoking. But she doesn’t recommend vaping as a means to help quit smoking due to a lack of robust research.
“Part of the problem is that there’s such a wide variety of products on the market,” she said. “There could be different chemicals in each of them.”
Medical cases of e-cigarette and vaping-associated lung injury provide some insights into the effects of nicotine inhalation in the body, added DeCarli, who authored the report “A Case of Vaping-Associated Lung Injury in Rhode Island.” But she emphasized that there is still much to learn.
E-cigarette products can cause acute and “potentially life-threatening lung injury” for a small subset of people, she noted.
If patients ask whether vaping is an alternative to traditional tobacco use, DeCarli instead recommends strategies like nicotine replacement — often self-administered through a patch, piece of gum or lozenge — or cognitive behavioral therapy, a widely-used form of psychological treatment.
DeCarli said that part of her job is “giving someone the information they need to make the best decisions for their own health.”
“If someone wants to continue smoking, it’s not my job to make that decision for them,” she said.
Ranjana “Jaanu” Ramesh is a Bruno Brief-er, photographer and Senior Staff Writer covering science & research. She loves service, empathetic medicine and working with kids. When not writing or studying comp neuro, Jaanu is outside, reading, skiing, or observing Providence wildlife (ie: squirrels).
Claire Song is a Senior Staff Writer covering science & research. She is a sophomore from California studying Applied Math-Biology. She likes to drink boba in her free time.
