SMOKE AND MIRRORS
Juul Prevention Program Didn't School Kids on Dangers, Expert Says
JUUL—which made up 68 percent of the e-cigarette market as of mid-June—seems to have taken a page from the playbook of Big Tobacco.
The e-cigarette titan JUUL Laboratories, under fire for their alleged role in an “epidemic” of teen customers, insisted it doesn't want kids using their trendy nicotine dispenser. And to prove it, the company created and helped fund a curriculum for schools that it said would dissuade minors from using its lucrative product.
But an analysis of that curriculum, published Friday in the Journal of Adolescent Health, claims JUUL glossed over or left out important information that should be included and emphasized in a bona fide tobacco prevention education program.
“They [the curriculum materials] barely mention the word JUUL,” Bonnie Halpern-Felsher, a pediatrics professor at Stanford University and a senior author of the commentary, told The Daily Beast.
What’s more, the contract that JUUL offered schools allowed its consultants to sit in on program sessions, and schools had to turn over evaluations from students and parents to JUUL, according to a copy reviewed by The Daily Beast.
The curriculum backfired spectacularly. Massachusetts Attorney General Maura Healey this summer called JUUL cooperating with schools for youth prevention initiatives a “little like letting the fox into the henhouse.” Any JUUL involvement in schools, she added, is a “terrible idea.” The opposition was so strong that JUUL says it has since stopped reaching out to schools to implement the program.
But Halpern-Felsher’s review of the teaching documents concluded that JUUL—which made up 68 percent of the e-cigarette market as of mid-June—was taking a page from the playbook of Big Tobacco.
“Although the JUUL Curriculum covers the basics of the science behind addiction and nicotine in the brain, it does not emphasize youth’s susceptibility to the highly addictive nature of nicotine,” the paper notes. “The JUUL Curriculum’s approach to addressing the risk of e-cigarettes is insufficient because it neglects to present information on nicotine levels in JUULs, which is very high. Therefore, the JUUL Curriculum is not portraying the harmful details of their product, similar to how past tobacco industry curricula left out details of the health risks of cigarette use.”
Halpern-Felsher, who participated in Stanford Medicine’s push to develop its own tobacco and e-cigarette education materials, the Tobacco Prevention Toolkit, said that she was first alerted to JUUL’s curriculum by concerned educators. One of those educators sent her a copy of the materials, which she provided to The Daily Beast.
“A lot of what we found that was concerning is what we didn’t find,” she told The Daily Beast. “They don’t at all talk about flavors, and the fact that the tobacco industry is targeting youths through the use of flavors.”
What’s worse, she added, “They don’t talk about the marketing.”
“We know that the best practice when working with youth is to help them deconstruct ads and say, ‘Look, this ad with this cartoon character, or this ad with this shiny new device, is for you! And we don’t want you using this advice, and we don’t want you to be a pawn to the industry.’ That kind of language really works with youths. And none of that is in here,” Halpern-Felsher said.
“The other thing that’s really concerning is that throughout the curriculum—I don’t want to say never—but they barely mention the word JUUL [...]” she added. “And we know, more from anecdotal research, that [teens]may consider [JUUL’s] to be a vaping device, but they don’t call it that. So when you say to a young person, ‘Vapes or e-cigarettes are harmful,’ they say, ‘Oh I know, but I’m using a JUUL.’”
According to a 2017 research from the anti-tobacco Truth Initiative, 7 percent of surveyed teens aged 15 to 17 have used a JUUL, and 25 percent recognized the product’s signature USB-styled device.
She also took issue with one of the elements that was in the curriculum: mindfulness. The curriculum documents reviewed by The Daily Beast suggest that teachers build pendulums with washers and string, and to conduct an exercise where the students attempt to move that pendulum with their subconscious mind.
“The message: Our thoughts are powerful and can set action in motion,” one document states.
It also suggests that teachers lead students through mindfulness exercises. Those include two audio meditations—“Mindful Breathing” and “Mindful Movement”—and a meditation video called “Ocean Escape.”
“Mindfulness and talking about stress is certainly important,” Halpern-Felsher said, acknowledging that many youth minority groups use tobacco and nicotine to relieve stress. “But to ask a teacher to talk about mindfulness [...] is very concerning when that teacher’s not been trained to do so.”
Halpern-Felsher isn’t the only one to object to JUUL’s tactics. As the New York Times reported, school administrators in Colorado pushed back after they received offers for a funded, three-hour curriculum from JUUL Labs to help reduce e-cigarette use in their schools.
Carrie Yantzer, the principal at Nederland Middle-Senior High School, told the newspaper that the proposal was “preposterous” and made JUUL look “deceptive.”
“A company that stands to profit from, and currently profit off, youth using a product can’t be trusted to prevent use of this product,” Alison Reidmohr, tobacco communications specialist for the Colorado Department of Public Health, told the Times.
But Victoria Davis, a spokeswoman for JUUL Labs, disagreed with this characterization. “Several schools were looking for ways to address the issue of student use and we simply supported their efforts by offering financial support to the schools that requested it,” she told The Daily Beast via email.
Halpern-Felsher believes that the motivation behind the JUUL curriculum is “image,” an attempt to deflect the “pushback” they faced after minors began using their products.
Indeed, the FDA has aggressively pursued e-cigarette makers in recent months. In April, the agency first requested research and marketing data from JUUL—and in September, their efforts ramped up. On September 12, the agency announced that e-cigarette retailers had 60 days to turn in plans to get their products out of minors’ hands, threatening bans if they did not comply. Six days later, FDA commissioner Scott Gottlieb issued a blistering press release condemning the sale of e-cigarettes to minors. And on September 28, investigators launched a raid of JUUL’s headquarters and seized more than a thousand documents.
“I won’t be deterred or obstructed. And I’m committed to seeing these actions to their conclusion,” Gottlieb wrote in his press release. “I won’t stop until this problem is solved.”
JUUL Labs defended their curriculum in an email to The Daily Beast, noting that “The science-based curriculum included information on the nicotine content in vapor products and the science behind nicotine. It was designed as a guide to help educators develop lessons or have conversations with their students about why they should not use e-cigarettes or other nicotine products.”
The curriculum was developed in conjunction with “several seasoned educators with extensive curriculum development and pedagogical expertise,” Davis, the spokesperson for JUUL Labs, said.
Davis added, “JUUL Labs is committed to combating underage use in every way that it can. We do not want any young person—or non-nicotine user—to ever try JUUL. To that end, we wanted to provide support to educators to help prevent use among minors. We never developed nor promoted 'a school program' but rather an adult-focused curriculum of science-based and community resources for teachers who work with youth in schools.”
Davis noted, however, that after receiving “feedback from those who thought our well-intended efforts were being misunderstood,” the company stopped reaching out to schools five months ago.
“We only want to implement initiatives that will help current adult smokers switch to JUUL, while ensuring young people do not access our product,” she said.
Based on the curriculum she saw, Halpern-Felsher isn’t convinced. “The marketing and the flavors and the manipulation of the industry is not in there,” she said. “And of course it wouldn’t be in there, because they’d be putting themselves down.”