Q&A: Robert Jackler, M.D. on JUUL‘s 5000 Lawsuits and Settlements

The Daily corresponded with Stanford Otolaryngologist Dr. Robert K. Jackler about the recent lawsuits against JUUL, an electronic cigarette company, and the impact of its youth-targeted marketing. In December 2022, Juul Labs announced that it would be settling 5000 lawsuits in association with youth-targeted marketing and addiction. 

Both JUUL co-founders James Monsees MFA ‘06 and Adam Bowen MS ‘05 are Stanford graduates and began the creation of the product as part of their Product Design thesis while at Stanford. 

Dr. Jackler has served as an expert witness for these lawsuits in multiple state Attorney General cases. His research group, Stanford Research Into the Impact of Tobacco Advertising (SRITA), has also published a series of academic research papers elucidating JUUL’s marketing to youth. Dr. Jackler and Stanford Professor Dr. Halpern-Flesh appeared on CNBC’s “American Greed” to make comments regarding JUUL targeting youth. 

The Stanford Daily [TSD]: How can Juul be particularly harmful for youth? 

Dr. Robert Jackler [DRJ]: JUUL’s co-founders claimed that their goal was to improve the lives of “a billion smokers” by satisfying their nicotine addiction via a less harmful product. However, instead of becoming an off ramp for adult cigarette smokers, JUUL became a heavily traveled on ramp to nicotine addiction among American teens. The nicotine habit is a very difficult addiction to break. Nicotine alters the teen brain wiring in harmful ways and primes the individual for subsequent addictions such as cigarettes and opioids.  

[TSD]: How was JUUL‘s youth advertising campaign so harmful?

[DRJ]: When introduced in 2015, JUUL’s advertising targeted “cool kids” by depicting 20-something models in playful activities more typical of underage teens than mature adults. Advertising professionals know this is precisely how to attract teens who aspire to emulate these trendsetting young adults. JUUL heavily advertised its vaping devices and sweet/fruity flavor pods on social media channels frequented by teens. This stimulated a viral uptake of JUUL among teens, many of whom evangelized JUUL to their peers. JUUL boosted the reach of its ads via hashtags and also used social media influencers with large numbers of youthful followers.

[TSD]: How do you believe the co-founders (Stanford graduates) are responsible in all this?

[DRJ]: Yes, [they are responsible] by both acts of commission and omission. They launched JUUL with a heavily youth focused advertising blitz despite claiming to be targeting mature adult smokers who average age 40 to 60 years. Later, while the youth surge was raging, they chose to chase the dream of becoming billionaires without regard to deleterious health consequences to millions of teens who were driving their prodigious profitability.

[TSD]: After these lawsuits, do you believe that JUUL will take different steps in its marketing campaigns?

[DRJ]: Legal settlements with a number of state attorney generals’ offices lay out specific limitations on JUUL’s use of youth-oriented advertisements, outdoor billboards, sponsorship of parties, use of social media and influencers, [and] distribution of free samples, and require compliance check[s] to identify any underage retail sales. Importantly, while for years the e-cigarette market was largely unregulated, the FDA is adopting regulations to reign in marketing excesses and to reduce the youth appeal of nicotine vapes. In December 2022, California removed all flavored tobacco products, including e-cigarettes, from the market.

[TSD]: How could other e-cigarette companies avoid making the same harmful decisions?

[DRJ]: It is hoped that holding JUUL accountable for its irresponsible actions, with penalties for its youth-targeted marketing so far amounting to [about] $1.5 billion so far, with a number of populous states including California not yet settling, other e-cigarette purveyors will get the message and be more scrupulous.  

[TSD]: Can JUUL possibly recover from the “bad press”?

[DRJ]: JUUL is a deeply tarnished brand which has seen its value plummet from a high of over $38 billion in early 2019 to under $1 billion today. In 2018, the company, which claimed its noble goal was to obsolete big tobacco, allowed Altria, [the] maker of the world’s #1 cigarette brand Marlboro, to buy a 35% stake in the company. In late 2022, the FDA ordered JUUL removed from the US market — an order not yet implemented as it is under judicial appeal. In 2023, media reports have JUUL in discussions with multiple transnational tobacco companies to acquire [it] to stave off bankruptcy.  

Time and again, tobacco companies absorb sizable legal settlements as a cost of doing business, only to reemerge as highly profitable purveyors of nicotine products, which they market to youth. If taken over by a big tobacco company, with their enormous financial and marketing muscle, the resurrection of JUUL as a dominant brand might just come to pass. 

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