The FDA To Decide Which E-Cigarettes, Including Juul, May Be Sold In U.S.

NOEL KING, HOST:

Juul, the e-cigarette maker, is facing a judgment. The FDA is going to decide this week which e-cigarettes can be sold in this country and which will be banned. Here's NPR's Bobby Allyn.

BOBBY ALLYN, BYLINE: Juul was launched in 2015 by two Stanford grads who wanted to disrupt big tobacco. They also wanted to help people kick their cigarette addiction, and this vaping device was different. It was a sleek metallic gadget about the size of a flash drive. It almost looked like it was made by Apple. It projected an image of cool.

JAMIE DUCHARME: It launched with this very flashy marketing campaign with kind of young, hip-looking models using the device, plastered ads across Times Square in New York City, partnered with Instagram influencers to get the campaign spreading on social media.

ALLYN: That's author Jamie Ducharme, who wrote the book "Big Vape: The Incendiary Rise Of Juul." She says Juul's biggest breakthrough was how its cartridges were packed with a special kind of liquid nicotine.

DUCHARME: It allows you basically to pack more nicotine into the liquid without making it disgusting to use.

ALLYN: In fact, for many young people, it was the opposite of disgusting. Its cucumber, mango and creme brulee flavors led to a huge surge in youth vaping. In 2019, hundreds of teens were hospitalized for lung injuries linked to vaping with cartridges that contained cannabis. Juul itself doesn't offer cannabis cartridges, but some use Juul devices for it anyway. The scandal brought new scrutiny about how it markets to teens, and a flood of lawsuits followed. Juul then launched a massive makeover.

DUCHARME: They've stopped selling their flavored products. They only have menthol and tobacco flavors now. They don't advertise. They're off social media in the U.S. All they're focusing on now is rebuilding trust with the public.

ALLYN: But now the question is have they won the trust of the Food and Drug Administration, which will this week decide whether Juul and millions of other e-cigarettes can continue to be sold in the U.S. There are big stakes for the tobacco industry, too. While Juul originally tried to challenge tobacco companies, it's now almost an extension of it. Altria, the maker of Marlboro, is Juul's largest investor and one of its former executives now runs Juul. Matthew Myers heads the campaign for Tobacco-Free Kids. He says regulators need to put Juul out of business.

MATTHEW MYERS: What I worry about is if we continue to sell these products, we continue each year to addict a new generation, and the problem only grows.

ALLYN: Health groups like the American Heart Association and the American Academy of Pediatrics agree with Myers. But other medical researchers, like Michael Siegel (ph) of Tufts University, say if the FDA cracks down too hard on Juul, cigarette sales will pick up.

MICHAEL SIEGEL: I think it would be a public health disaster because what would happen is that a large number of vapers would just go back to smoking.

ALLYN: Siegel admits that many young people who love to Juul might not have been drawn to cigarettes. But if one vaping product is banned, they will find another one. On balance, he says, Juul helping millions quit smoking outweighs the risk to teens.

SIEGEL: Vaping is not causing a culture of smoking. It's actually replacing that culture. And if you look at the numbers, they bear that out. As vaping rates have gone up astronomically, youth smoking rates continue to decline very, very rapidly.

ALLYN: But critics like Myers say even if Juuling is better for you than smoking a cigarette, the company's past behavior and marketing to teenagers shows it cannot be trusted.

MYERS: The entire growth of Juul was among young people. When young people, most of whom previously never smoked, start using Juul, there's no harm reduction. There's harm increase.

ALLYN: After scaling back the company, Juul has lost some of its reach. It now controls about 40% of the vaping market. That's down from 75% at the company's peak. If the FDA takes a sledgehammer approach, it could bring that number down to zero.

Bobby Allyn, NPR News, San Francisco.

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