Recently, the sale and distribution of e-cigarettes without FDA approval was banned in San Francisco. The ban is expected to go into effect early next year and will also affect other flavored tobacco products. The ordinance will make it illegal for tobacco shops to sell any flavored tobacco products or electronic cigarettes that have not been approved by the FDA. According to Ned Sharpless, who became Acting Commissioner of Food and Drugs in April of this year, “There are no authorized e-cigarettes currently on the market.”
Beverly Hills also passed a similar law in early June, which will go into effect in 2021. Historically, California has blazed the trail for other states on tobacco-related bans. They were the first to prohibit indoor smoking in public places more than two decades ago.
However, tobacco companies remain vehemently committed to gaining new customers no matter the cost. While the 2009 Family Smoking Prevention and Tobacco Control Act restricts marketing to youth through advertising and adding flavors in combustible cigarettes (except menthol), e-cigarette companies found themselves in the comfort of a gap in regulation. In fact, they can concoct any flavor imaginable. Despite claiming to market to adults, many flavors appear to be designed to tempt young users and particularly appeal to those willing to try for the first-time.
Using data from the 2016 National Youth Tobacco Survey, the Centers for Disease Control and Prevention and the Food and Drug Administration found the “availability of appealing flavors” was one of the top self-reported reasons for using e-cigarettes among middle and high school students.
It is very reminiscent of the old tactics tobacco companies used for decades prior to the development and enforcement of regulations. Juul, the largest e-cigarette company has always positioned itself as anti-tobacco. In fact, the company’s mission is “to improve the lives of the world’s one billion adult smokers by eliminating cigarettes.” They go a step further stating, “We don’t want anyone who doesn’t smoke, or already use nicotine, to use Juul products. We certainly don’t want youth using the product. It is bad for public health, and it is bad for our mission.” (Juul website) E-cigarettes are often marketed to help individuals wean off combustible cigarettes, which aligns with Juul’s mission. However, as the old adage says, actions speak louder than words. And e-cigarette companies are behaving strikingly like well-known tobacco giants.
Juul spent more than $1 million dollars in marketing their products on the internet, according to one research study. They focused on YouTube, Instagram, and Twitter which promoted ads conveying having fun, relaxing, sex appeal, and being cool with those who use Juul. In fact, the strategic campaign to drastically increase their social media presence equated to growing their Juul-related tweets from 765 (on average) per month in 2015 to 30,565 per month just two years later. And it worked. The number of tweets highly correlated with retail sales enabling Juul to control more than half of the e-cigarette market share by the end of 2017.
Additionally, the gap in regulation allows e-cigarette companies to sponsor music festivals and sporting events, something that is strictly prohibited for cigarettes and smokeless tobacco. However, thanks to the loophole, sponsors can set up vaping rooms, charging stations, samples, and even host surprise guest appearances from performers to lure in a bigger crowd.
E-cigarette companies have gone as far as offering college scholarships to teens in exchange for essays. It’s a way for the companies to get their brand name on college websites which looks to many like an endorsement. Some of scholarship topics seem innocuous while others outright ask for students to write about the benefits of vaping or why people still choose to smoke. If all e-cigarette companies strictly market to adults and primarily existing smokers, why would teens applying for college be in that demographic?
Even when their mission statement claims they are not targeting teenagers, their actions are telling a much different story. Juul, which touts one of their core values is “mission first” still ironically claims, “Switching adult smokers and eliminating cigarettes are at the center of all we do.” Yet, in December of 2018, Altria (owner of Marlboro) invested $12.8 billion in Juul. In fact, the deal made them owners of 35 percent of the company. It appears like a large investment to place in an e-cigarette company who claims to be on a mission to eliminate your primary product and revenue.
Consequently, another mask emerges for tobacco companies to hide behind. E-cigarette companies proclaiming to the public that their product will improve their health by helping them quit smoking. Akin to the disturbing marketing images that were used to peddle tobacco products plastered in print and television through the 1950s. Despite e-cigarettes being marketed only to adults, the U.S. Surgeon General has declared that vaping by teenagers is at epidemic levels. We know that nicotine is as addictive as heroin, and once young users are addicted, they will likely become long-term users.
Still when surveyed, many users feel e-cigarettes are harmless, simply because they are a heat not burn method like combustible cigarettes. Unfortunately, this myth is pervasive. E-cigarettes produce an aerosol by heating a liquid that contains nicotine, flavorings and other chemicals. Users and second-hand bystanders inhale harmful substances directly and deeply into their lungs through the aerosol that include nicotine, ultra fine particles, flavorings such as diacetyl (known to cause popcorn lung), heavy metals (nickel, tin, and lead), cancer-causing chemicals and volatile organic compounds like benzene, ethylene oxide, acrylonitrile, acrolein, and acrylamide.
The recent bans in California should lead the way for other cities and states to pass similar policies. I urge you to contact your local representatives and advocate for proposing similar legislation in your state to hold e-cigarette companies accountable to the same regulations as cigarettes and smokeless tobacco. Without such action, we will likely find ourselves repeating history with the newest face of tobacco companies once again padding their pockets as the public pays the heavy price of preventable health conditions.