Experts have mixed opinions on whether banning the sale of Juul products will reduce the popularity of electronic cigarettes among teenagers.
In late last month, the FDA garnered praise from anti-tobacco advocates and legislators after it issued a ban on electronic cigarette giant Juul from the market. The agency stated that Juul had failed to demonstrate that keeping its products on the market was "appropriate for the protection of public health.
Less than two weeks after Juul's lawsuit, the FDA withdrew their opposition and announced that they will temporarily allow Juul products to remain on the market while they reassess the company's application.
The FDA has warned that additional reviews should not be misunderstood as overturning its initial decision, and Juul devices may still ultimately be banned. However, even if this were to occur, it is unclear whether it would have a significant impact on young people's e-cigarette use.
Joe Murillo, chief regulatory officer at Juul, declared in a statement to The Hill that the company clearly meets the FDA's standard for protecting public health. Murillo stated, "We remain confident in the quality and substance of our application.
Since its first product hit the market in 2015, Juul has faced strong criticism for marketing to minors. Juul's e-cigarettes resemble USB flash drives and were initially sold in flavors like mango, with its founders claiming to aim at helping people quit smoking. However, these flavors have widely been deemed as a way to lure teenagers and children into using e-cigarettes.
Following this, Juul has removed all flavors except for tobacco and menthol, and has suspended its marketing activities. The company argues that the current environment surrounding e-cigarettes is vastly different, and that Juul products no longer pose a threat to public health. Other e-cigarette products are now even more popular than Juul, including disposable e-cigarettes made by Puff Bar and Vuse.
It is unclear how much of an impact Juul's exit from the market would have on its efforts to prevent youth smoking. According to the National Youth Tobacco Survey, 26% of high school students reported using Puff Bar as their usual brand, while approximately 11% used Vuse. Currently, less than 6% of high school-aged youth say they prefer Juul.
Clifford Douglas, director of the University of Michigan Tobacco Research Network and professor at the university's School of Public Health, has expressed that Juul should not be labeled as the "evil child" of youth e-cigarette use. "Clearly, Juul played an important role in increasing experimentation with e-cigarette products among young people, most notably in 2018. However, since then, they have made significant changes in response to FDA pressure," Douglas said.
However, Parents Against Vaping E-cigarettes (PAVE) argues that Juul's hype created by marketing to children will send a strong message to the industry if it is removed from the market. The organization also criticizes the company for ignoring evidence that its mint-flavored products are popular among young people. "Kids are using your mint-flavored products. If you really don't want young users, according to your own public statements and logic, it will be removed," said Meredith Berkman, co-founder of the organization. "Their predatory behavior is basically still ongoing.
In 2015, Juul introduced an electronic cigarette as a replacement for clunky traditional e-cigarettes, which required users to use pods. By the end of 2017, it had become the most popular e-cigarette on the market. In 2018, the health minister issued a warning that youth e-cigarette use had become an "epidemic," with over 20% of high school students reporting e-cigarette use that year, a 78% increase from 2017.
Under pressure from the FDA and Congress, Juul discontinued their flavored pods in the same year. Currently, only mint and tobacco flavored pods are available in stores. The company was valued at $38 billion at its peak, but now is only worth about $16 billion.
In 2019, Congress discovered that JUUL had implemented a complex plan targeting school and summer camp children. The company was also accused of targeting young people in their advertising and marketing. The FDA spent two years reviewing JUUL's request to sell tobacco and mint-flavored e-cigarettes. While advocates praised this move, the agency's sudden reversal raised questions.
Robin Koval, the CEO and President of anti-smoking organization The Truth Initiative, has expressed mixed feelings about the decision to allow Juul to remain on the market after the company refused to gain marketing authorization for its products. In a statement, Koval said, "We are in the exact same place we were a year ago, with millions of young people at risk of nicotine addiction and the FDA failing to take action against the majority of e-cigarette products on the market." "Just a few weeks ago, what seems like progress now was a mirage in the summer sun and a failure for youth and public health in our country.
Douglas, the director of the Tobacco Research Network, told The Hill that the FDA's decision to delay its marketing denial order was "mysterious". He said, "They had to tighten up and go back to the drawing board - almost immediately - which suggests they're really off-kilter and have more questions than answers.
The US Food and Drug Administration (FDA) stated that it will not comment on pending lawsuits. When asked about how it will evaluate applications from other companies, including Vuse and Puff Bar, the federal agency said it will individually assess each application and require that all manufacturers demonstrate that their new products are "appropriate for protecting public health." The statement added, "This standard requires us to consider risks and benefits for the entire population.
As the legal battle continues, experts are divided on whether the popularity of electronic cigarettes among young people is worsening or improving. According to the latest data from the FDA, in 2021, about 11% of high school students and about 3% of middle school students reported using e-cigarettes, a decrease from 2020 when the FDA found 3.6 million youth e-cigarette users, with 26.5% of high school students using these products.
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