JUUL is the vape giant that went from zero to $16 billion in three years. Truth Initiative is the largest anti-smoking organization in the United States.

Both the company and the non-profit claim to have the same goal: helping smokers quit tobacco cigarettes. But Robin Koval, CEO and president of Truth Initiative, hasn't been shy about slamming JUUL.

"The fact that JUUL is acting like, 'What, young people are using JUUL? We never intended that to happen,' is a little disingenuous," she said.

Oh yes, that. Teenagers love JUUL. Twitter, Instagram, and Snapchat are filled with #juul references. These days, downtime at college is basically all about posting Stories of yourself JUULing to Drake.

The devices are sleek, small, and everywhere. There’s no need to refill them with liquid — just pop in a new JUULpod. They even recharge via USB.

Unlike some vapes, they deliver a lot of nicotine. The company says each JUULpod contains 5 percent nicotine, about as much as a pack of cigarettes. Early on, the company reached plenty of young people on social media with ads of models living their best #vapelife.

The blowback from parents and the press has been severe. In response, JUUL removed models from its feeds, which now only feature ex-smokers sharing their stories. It committed $30 million to fighting underage use of its products. The company also has a secret shopping program to carry out "random compliance checks" to make sure retail stores aren't selling to minors.

Koval wants JUUL to do more. She dismissed the $30 million that JUUL is spending as a "rounding error" for a company that just raised $1.2 billion from investors.

"Frankly, if they really wanted to do something to impact youth sales, they could voluntarily comply with all of the rules that got postponed until 2022," she said.

During the Obama administration, the U.S. Food and Drug Administration (FDA) determined that e-cigarette makers would have to submit their products for review by this summer. Trump administration officials delayed that deadline until 2022, saying that it didn't want to stifle innovation.

JUUL said that it supports "effective legislation and regulation," but hasn't stated support for the FDA rules. And the company has spent $240,000 on lobbyists in hopes of influencing e-cig regulations, according to Wired.

And not everyone is convinced that $30 million will keep young people from trying JUUL.

"Tobacco companies have a long history of creating and promoting their own programs which they say are for 'youth smoking prevention,'" said Pamela Ling, professor at the University of California, San Francisco. Those programs were simply "PR tools to avoid regulation," she said. And JUUL could be following the same strategy.

"As far as I know, there is no published evidence that the JUUL youth program actually decreases youth use of JUUL."

Then there's the issue of teen-friendly flavors, most notably mango and "fruit medley." Koval wants them off the market. JUUL insists fruity flavors help smokers who "don't want to be reminded of the tobacco-taste of a cigarette."

There's evidence that vaping could lead teenagers to try traditional cigs — the ultimate nightmare for anti-smoking activists

Helping smokers quit is a noble goal, of course. A study published earlier this year by University of Michigan researchers concluded that the "benefits outweigh the risks" when it comes to vaping — essentially, they save more lives by helping smokers quit than cost lives by hooking new smokers with nicotine.

Tobacco kills more than 7 million people each year, according to the World Health Organization. Several experts — including Koval — say it's better for people to vape than smoke tobacco cigarettes. But do they actually help people quit? Some studies say they're effective. On the other hand, a Georgia State University study from July found no evidence that vape use helped adult smokers quit at higher rates than smokers who didn't vape.

For teens, the stakes are even higher. Nicotine addiction could "harm the developing adolescent brain" and cause attention and mood disorders, said Adam Leventhal, director of the University of Southern California's Health, Emotion, & Addiction Laboratory. And earlier this year, a report from the National Academies of Sciences, Engineering and Medicine found evidence that vaping could lead teenagers to try traditional tobacco cigarettes — the ultimate nightmare for anti-smoking activists.

JUUL said it would widely release mint and "Virginia Tobacco" JUULpods with less nicotine at 3 percent in October.

That's still enough nicotine to addict non-smokers. And there's another problem.

Leventhal said while lower nicotine levels could decrease the risk of teens getting addicted, JUUL is only releasing those new products in flavors teens don't like.

"Their sweet flavors like mango, fruit medley, and crème brulee are most popular among kids," he said.

JUUL is also entering the U.K. market, which limits nicotine levels to 1.7 percent.

"Why don’t they launch that here?" Koval said. "Clearly, they know that the product is going to be a lot more addictive with higher levels of nicotine, and that’s been the tobacco industry model since year one."

That's not the kind of thing JUUL wants to hear. Underage use is the dark stain on an otherwise fairytale success story, and the company is determined to battle the perception that it's profiting from teen addiction.

"Amazon's Choice." Image: Amazon

"JUUL is intended for current adult smokers only. We cannot be more emphatic on this point: no minor or non-nicotine user should ever try JUUL," the company said in response to the Truth Initiative's concerns.

So far, the government has taken minor action. The FDA sent a letter to JUUL and other e-cigarette makers in May requesting internal documents "to better understand the youth appeal" of their products. JUUL said it has complied with the FDA's request.

Tech companies could also do more to stop the spread of JUUL. Twitter, Instagram, and Snapchat should provide more data on who is creating and consuming JUUL content, Koval said. And Amazon could stop selling skins — stickers that wrap around JUUL vapes — on its site. At the very least, it could remove the ones featuring cartoons and video games, including Rick and Morty and Fortnite.

"I don’t think young people are taking up JUUL because they want to get addicted to nicotine," Koval said. "They think it looks cool, it’s new, it comes in different flavors, and everyone is doing it."

With the help of those edgy "truth" ads, Truth Initiative saw teenage cigarette use in the U.S. drop from 23 percent in 2000 to less than 6 percent in 2018. It would be a shame if a product designed to help smokers quit actually stalled, or even reversed, that progress.



