Health groups urge states to spend Juul settlement dollars on tobacco prevention

This article originally appeared in Stateline, an initiative of The Pew Charitable Trusts.

Major medical groups are urging states that won a $438.5 million settlement in a case against electronic cigarette maker Juul Labs Inc. to use the money for tobacco prevention and cessation programs, particularly those aimed at young people.

Selling e-cigarette products to children is illegal in all 50 states. But teen use of the nicotine-laden products increased after Juul introduced sweet-flavored e-cigarettes in 2017. States and school districts reacted with a variety of educational campaigns designed to dissuade kids from using the harmful and addictive products.

In addition to paying states over six to 10 years, the Sept. 6 settlement agreement prohibits Juul from any further marketing campaigns aimed at young people, limits where products can be sold and advertised, bans flavors not approved by the U.S. Food and Drug Administration and prohibits free samples and brand name merchandise marketing.

In a Sept. 27 letter, the Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Americans for Nonsmokers’ Rights and the Truth Initiative called on the states “to both build on the successes of the historic 1998 Master Settlement Agreement (MSA) with the tobacco industry and avoid some of the mistakes that were made.”

The groups cited a report from the Campaign for Tobacco-Free Kids showing that of the $27 billion states collected from tobacco settlements and taxes in fiscal 2022, only 2.7% was spent on programs to prevent kids from smoking and help smokers quit.

“JUUL’s cynically calculated advertising campaigns created a new generation of nicotine addicts,” Connecticut Attorney General William Tong wrote in a statement announcing the deal, which is expected to be finalized in October. “They relentlessly marketed vaping products to underage youth, manipulated their chemical composition to be palatable to inexperienced users, employed an inadequate age verification process, and misled consumers about the nicotine content and addictiveness of its products.”

Juul in a statement called the settlement “a significant part of our ongoing commitment to resolve issues from the past.”

“The terms of the agreement are aligned with our current business practices which we started to implement after our company-wide reset in the Fall of 2019,” it added.

According to the federal Centers for Disease Control and Prevention, more than 2 million middle and high school students reported using e-cigarettes in 2021, with at least 8 in 10 of them using flavored products.

In 2019, Gov. Gretchen Whitmer made Michigan the first state to ban flavored e-cigarette products to reduce youth vaping. Other states issued similar orders and all states included e-cigarettes in laws limiting tobacco sales to underage people. At least 18 states raised their legal smoking age to 21.

In 2020, the FDA banned all flavors of nicotine products other than menthol and tobacco.

In announcing the settlement, attorneys general in several states said they intended to use the money for smoking cessation and prevention programs. In its letter, the health groups urged all states to “translate that admirable intention into a firm commitment expressed in the text of the final agreement.”

In 2020, attorneys general in Connecticut, Oregon and Texas began investigating the company’s marketing and sales practices and were joined by 30 other states: Alabama, Arkansas, Delaware, Georgia, Hawaii, Idaho, Indiana, Kansas, Kentucky, Maryland, Maine, Mississippi, Montana, North Dakota, Nebraska, New Hampshire, New Jersey, Nevada, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin and Wyoming.

Maine has since opted out of the settlement, objecting to a provision that would prevent school districts from suing Juul.