Public health advocates based at Northeastern University on Monday initiated a class action lawsuit against e-cigarette titan Juul Labs, demanding that the company fund a statewide treatment program for teenagers who begin using the company’s e-cigarettes before age 18 and want to quit.
This is one of the first lawsuits in the country asking for this type of action from Juul, the company facing criticism — and a rash of lawsuits — for marketing to young people.
“We don’t have anywhere to send these parents or these kids,” said Mark Gottlieb, executive director of the Public Health Advocacy Institute at Northeastern. “There’s a real need for figuring out how to treat them and providing them with treatment.”
In a five-page letter sent to Juul, the institute claimed the company used “unfair and deceptive trade practices.” The document accuses the company of creating products designed to be highly addictive and appealing to minors. It closes with a request that Juul fully fund treatment and prevention programs throughout the state, as well as clinical and public health research on e-cigarette addiction among youths.
These programs are asked to include, but not be limited to, “individual and group nicotine cessation counseling, telephone quit-line support, intensive nicotine cessation support services, and the provision of nicotine cessation medications.”
Juul will have 30 days to respond to the request before an actual lawsuit is filed, although Gottlieb said he does not expect the company to satisfactorily meet the institute’s expectations.
“JUUL Labs is committed to eliminating combustible cigarettes, the number one cause of preventable death in the world. Our product is intended to be a viable alternative for current adult smokers only,” Juul said in a statement. “We do not want non-nicotine users, especially youth, to ever try our product. To this end, we have launched an aggressive action plan to combat underage use as it is antithetical to our mission. To the extent these cases allege otherwise, they are without merit and we will defend our mission throughout this process.”
Although it has not been determined yet how much money Juul would be expected to pay for these programs, Gottlieb estimates it would be at least a few thousand dollars per patient, plus funds for research. The institute has yet to calculate the number of eligible class members in the state.
“I don’t think it’s bankrupting kind of money, but it’s also not money anyone is putting up right now to do this,” Gottlieb said. “Since there’s no effective therapy, it’s hard for people to get insurance to pay for anything.”
Juul Labs was founded in 2017, a spin-off venture from electronic vaporizer company Pax Labs. It enjoyed swift success and, by December 2017, the company’s sales comprised nearly one in three e-cigarette sales nationally, giving it the largest market share in the United States. Last December, one of the world’s largest cigarette manufacturers, Altria, bought a 35 percent stake in the company for $12.8 billion.
Since Juul’s founding, the company has faced a slew of lawsuits and investigations. In the last year, a handful of actions have been brought against the company by parents of teenagers claiming their children did not realize Juul had nicotine in it when they began using the e-cigarette, only to become addicted. Much of the litigation focuses on Juul’s advertisement to minors, including its social media outreach, flavored JUULpods, and young, attractive models.
In response, the company stopped selling flavored pods in stores last year (but continues offering them online) and tightened its age-verification process. Those who use the website are greeted by a sober warning that the product contains nicotine, an addictive chemical. The age requirement to purchase Juul products online and in Massachusetts stores is 21.
Although the company states that its e-cigarette is a device for adult smokers trying to quit, a recent study released by the federal Office on Smoking and Health found less than 25 percent of users cited quitting tobacco as their reason for using Juul products.
The issue of youth vaping in Massachusetts has only intensified in recent months. Attorney General Maura Healey launched an investigation into the company last year in an effort to curb the teenage e-cigarette epidemic. In stark contrast, Martha Coakley, the former Massachusetts attorney general, joined Juul as a member of its government affairs team earlier this month.
The thin, futuristic-looking e-cigarette has become a staple of student life in high schools and on colleges campuses across the nation. But how unhealthy is the product?
Health professionals say they don’t actually know yet. Michael Siegel, a community health professor at Boston University, said there are no acute, immediate cardiac or lung problems associated with the product. However, he is concerned with long-term health effects, as Juul’s e-cigarettes were never meant to be a lifelong product, he said.
He explains that Juul’s devices are highly addictive, even more so than other e-cigarettes, because they contain nicotine salt. This type of nicotine enters the bloodstream very quickly, creating the high Juul customers enjoy. But it also leaves the bloodstream just as fast, eliciting an intense and immediate craving, according to Siegel.
Although Siegel believes the emphasis on youth vaping distracts from the more dangerous issue of cigarette use, he worries about the highly addictive qualities of Juul’s e-cigarette. Even if a young person switched to an e-cigarette that doesn’t contain nicotine salt, that would be a step up, he said.
“It’s not a problem because Juul is having particular health effects. It’s a problem because kids are addicted and that addiction itself has consequences,” Siegel said. “Decreasing academic performance because you are unable to focus or you have to run to the bathroom to Juul. Interference with life and losing control. The danger is if they become addicted for life.”