Makers of Marlboro Invest in Juul E-Cigs

Juul Laboratories is already the largest force in e-cigarette sales in the U.S., with three-quarters of the market share.¹ It could potentially get even bigger, due to a new partnership with Altria, one of the world's largest tobacco companies.

Altria owns some of the most well-known companies in the tobacco industry, including Philip Morris USA, maker of Marlboro cigarettes, U.S. Smokeless Tobacco Company, which makes Copenhagen and Skoal, and Nat Sherman, a maker of premium cigarettes and cigars, among others.

In December 2018, Altria announced a minority investment of $12.8 billion into Juul for a 35 percent ownership in the company — along with services to accelerate their mission.² That mission, according to Juul, "is to eliminate cigarettes. JUUL is intended for adult smokers who want to switch from combustible cigarettes."

At first glance, it's an unlikely partnership. Even Juul admitted, "We understand the controversy and skepticism that comes with an affiliation and partnership with the largest tobacco company in the U.S. We were skeptical as well. But over the course of the last several months we were convinced by actions, not words, that in fact this partnership could help accelerate our success switching adult smokers."³

The benefits for both sides are clear. Juul gains access to retail shelf space alongside cigarettes, along with advertisements via cigarette pack inserts and mailings to current smokers in Altria's database, for starters.

And Altria gets to broaden its share of the e-cigarette market, which is growing rapidly (Altria also owns Nu Mark, which manufactures e-vapor products). Who may ultimately lose as a result of this deal are those who become addicted to e-cigs as a result — especially children.

Tobacco Company Preparing for an E-Cigarette Future

Altria stated that it invested in Juul "to prepare for a future where adult smokers overwhelmingly choose noncombustible products over cigarettes."⁴ Indeed, while e-cigarettes and vaporizers make up only 3 percent of U.S. tobacco retail sales (cigarettes made up 84 percent),⁵ the market is growing exponentially.

From 2016 to 2017, Juul e-cigarette sales increased 641 percent, from 2.2. million devices to 16.2 million, according to data compiled by the U.S. Centers for Disease Control and Prevention (CDC).⁶

This is likely an underestimate, as it only included sales from U.S. retail stores, not purchases made online or in vape shops. Most of the sales counted by the CDC likely reflect products obtained by youth, the CDC noted, adding that the rising Juul sales are a "danger to youth."

While Juul claims they've taken a number of actions to prevent underage vaping, such as halting the sale of flavored e-cigarettes in retail stores and enhancing age-verification for online sales,⁷ a survey by Truth Initiative, a nonprofit public health organization focused on ending tobacco use, found that youth get Juul most often via retail stores.⁸

The Altria collaboration, then, potentially stands to make the problem of youth vaping worse, considering Juul's tobacco and menthol-based products will soon appear alongside regular combustible cigarettes via Altria's "premier innovative tobacco products retail shelf space."⁹ Further, according to Truth Initiative:¹⁰

"The popularity of JUUL among youth has helped the product account for 73 percent of e-cigarette sales in the U.S., as of September 2018. Many are attributing the product's rise to its sleek design that could be mistaken for a flash drive — which makes it easy to disguise and use discreetly — and availability of youth-appealing flavors."

E-Cigarettes Are the Most Popular Tobacco Product Among Youth

Combustible cigarettes are no longer the tobacco product of choice among U.S. youth. That dubious distinction now goes to e-cigarettes, which were used by more than 2 million middle and high school students in 2017.¹¹

U.S. Food and Drug Administration (FDA) data also revealed a sharp increase in e-cigarette use among youth, with 1.5 million more students using them in 2018 compared to 2017.¹² Further, compared to 2017, in 2018:

• There was a 78 percent increase in e-cigarette use among high school students
• There was a 48 percent increase in e-cigarette use among middle school students
• 28 percent more high school students used e-cigarettes on 20 or more days
• 68 percent more high school students used flavored e-cigarettes

Thirty-one percent of those surveyed said the availability of flavors like mint, candy, fruit or chocolate was the reason why they used e-cigarettes, while 17 percent cited the belief that they're less harmful than other forms of tobacco, such as cigarettes.

The 2018 Monitoring the Future survey similarly reported a dramatic rise in the number of youth using e-cigarettes and other vaping devices. The survey of eighth, 10th and 12th-graders found 37.3 percent reported "any vaping" in the past 12 months, compared to 27.8 percent in 2017.¹³

Use of vaping nicotine in the past 30 days also nearly doubled among high school seniors, while more than 1 in 10 eighth-graders said they had vaped nicotine in the past year. In a news release, Dr. Nora D. Volkow, director of the National Institute on Drug Abuse (NIDA), stated:¹⁴

"Teens are clearly attracted to the marketable technology and flavorings seen in vaping devices; however, it is urgent that teens understand the possible effects of vaping on overall health; the development of the teen brain; and the potential for addiction …

Research tells us that teens who vape may be at risk for transitioning to regular cigarettes, so while we have celebrated our success in lowering their rates of tobacco use in recent years, we must continue aggressive educational efforts on all products containing nicotine."

'Juuling' Is the New 'Smoking' — What Are the Risks?

Juul's e-cigarettes are so popular that if you asked most youth what "juuling" is, they'd probably know what you're talking about. It's the e-cigarette equivalent of "smoking."¹⁵ Part of the problem is that one Juul cartridge contains double the amount of nicotine found in other e-cigarettes — about the same amount you'd find in a pack of cigarettes.

Nicotine is addictive to anyone, but especially among teenagers due to the vulnerability of their prefrontal cortex, the part of the brain involved in decision making, emotional control and impulse regulation. In short, nicotine, like any other drug, impacts developing brains more than those of adults. According to the American Academy of Pediatrics (AAP), which released a special factsheet on Juuling:

"Juul is highly addictive … This high concentration [of nicotine] is a serious concern for youth, who are already uniquely susceptible to nicotine addiction. The addictive potential is so high that the U.S. Surgeon General has declared that youth use of nicotine in any form is unsafe.

What's more, research suggests that using Juuls may increase teens' risk of becoming cigarette smokers, as youth who use e-cigarettes are more likely to progress to smoking cigarettes."¹⁶

Aside from their incredible potential for addiction due to nicotine, Juul also exposes users to other potentially harmful compounds, including highly reactive free radicals.¹⁷ In traditional cigarette smoke, these highly reactive free radicals are associated with cancer, chronic obstructive pulmonary disease and heart disease.

The researchers found e-cig levels were more than you may be exposed to in heavily polluted air, but less than what you find in traditional cigarette smoke. Heavy metals have also been detected. Scientists at Johns Hopkins Bloomberg School of Public Health examined devices owned by 56 users, finding a significant number of them generated aerosol with unsafe levels of lead, nickel, chromium and manganese.¹⁸

The antifreeze chemical diethylene glycol, which is linked to cancer, has also been found in e-cigarette cartridges.¹⁹ And according to Americans for Nonsmokers Rights, secondhand smoke from e-cigs may contain at least 10 chemicals that have been identified on California's proposition 65 list of reproductive toxins and carcinogens.²⁰

In fact, they note that the aerosol from e-cigarettes and other electronic smoking devices (ESDs) is made up of a high concentration of ultrafine particles, higher than that found in conventional cigarette smoke. Toxins already identified in ESD aerosol (or secondhand aerosol) include:

It's because of these toxic elements that, as of October 1, 2018, 789 municipalities and 12 states include e-cigarettes among the products prohibited for use in smoke-free environments.²¹

Is a Tobacco Company, or E-Cigarette Maker, Really Looking Out for Public Health?

Smoking e-cigarettes may prove to be less harmful than smoking cigarettes, but it does come with a set of risks of its own — risks that you're not exposed to if you quit smoking via other methods. And for a nonsmoker who takes up Juuling, there's no benefit to be had, only potential harm.

The National Academies of Sciences has stated, "Little is known about the health effects of e-cigarettes." While noting that they contain fewer numbers and lower levels of toxins found in combustible cigarettes, they add:²²

"Overall, the evidence reviewed by the committee suggests that e-cigarettes are not without biological effects in humans. For instance, use of e-cigarettes results in dependence on the devices, though with apparently less risk and severity than that of combustible tobacco cigarettes. Yet the implications for long-term effects on morbidity and mortality are not yet clear."

What's more the Academies noted that while e-cigarettes may help adults to stop smoking cigarettes, they may cause youth vapors to transition to the use of cigarettes. And in the former case, you could have a population which is similarly addicted to e-cigarettes as they once were to combustible cigarettes.

While much remains to be revealed about how e-cigarettes affect human health, there are a few trends already in the making. E-cigarettes are set to become even more popular, and Juul in particular is poised to be here for the long haul, especially with Altria added to the mix.

If you're a parent, be sure to talk to your kids about e-cigarettes, just as you would the combustible kind, and if you're an adult looking to quit smoking, remember that Juul and similar devices are also designed to get you to keep using them — much like cigarettes.

They may be the lesser of two evils in this regard, but there are other ways to quit smoking that carry no such risks, and if possible I recommend you try these first.