Hawaii will receive $6.8 million as part of a nationwide settlement involving the e-cigarette company Juul Labs.
The settlement is the result of a two-year investigation into the company’s marketing and sales practices targeting youth.
“It’s a drop in the bucket,” said Scott Stensrud who serves as the statewide youth coordinator for Hawaii Public Health Institute’s Coalition for a Tobacco Free Hawaii. “Even that total is less than half what the (U.S. Centers for Disease Control and Prevention) recommends that Hawaii should be spending every year on prevention and cessation.”
The vaping epidemic has disproportionately affected Hawaii keiki, with a 2017 report from the CDC showing the state had the highest vaping rate among middle schoolers and the second-highest among high schoolers in the nation.
“Nearly one-in-three Hawaii high school students and one-in-five middle school students are reporting to be current users of e-cigarettes,” Stensrud said. “We’re hearing from principals from middle schools and elementary schools that this is going younger.”
Although there are plenty of e-cigarette brands available, students cited Juul as one of the most popular.
“For East Hawaii, as of the 2018-2019 school year, we saw Juul as the number one product of choice among several of our East Hawaii high schools,” said East Hawaii’s Drug Free Coalition coordinator Sally Ancheta. “To the point where we would see Juul pods littering the parking lots.”
Hawaii’s lawsuit alleged that Juul used marketing strategies that targeted teenagers, including the use of social media influencers and product flavors known to be attractive to underage users.
“We had students first-hand talking to local lawmakers about that when a bill was being heard to ban the sale of flavors,” said Ancheta. “Students were able to testify at the state capital that the flavors, in particular Juul flavors, had a tremendous impact on youth use in our high schools.”
House Bill 1570, which would have banned the sale of flavored tobacco products, was vetoed by Gov. David Ige earlier this year, citing an exemption in the legislation that would have allowed the sale of flavored vape products authorized by the Food and Drug Administration.
In addition to the financial settlement, Juul has agreed to comply with a series of restrictions on marketing practices, including refraining from funding education programs, selling flavors not approved by the FDA, using paid influencers, and misrepresenting nicotine levels.
“Nicotine has severe impacts on the developing brain,” said Stensrud, adding it can cause cognitive impairments, mood swings and anxiety. “Studies have shown that people who use nicotine products are much more likely to become addicted to other drugs later on in life.”
Stensrud noted Juul pods have the equivalent of roughly two packs of cigarettes worth of nicotine.
“With a combustible cigarette, some of the time it’s just burning, and not all of the nicotine in the cigarette is going to your lungs and into your brain,” he said. “With an e-cigarette, it’s only coming out when you take a rip of that device, so you’re getting 100% of that nicotine into your system. And it’s not just nicotine that’s a concern.”
Stensrud noted a variety of other chemicals have been found in e-cigarette products including lead, nickel and lithium which can be found in the devices themselves.
“There’s a whole host of chemicals that people that vape are subjecting themselves to, many that are known carcinogens,” he said. “But it will be 20 years before we know for sure how bad it really is.”
Hawaii could receive more than $7 million from the settlement if Juul opts to extend payments over a period longer than five years, but it is unclear what the settlement will go toward or when it will be used by the state.
“The settlement itself seems more like a slap on the wrist than a message to the industry to keep its hands off of keiki,” said Stensrud. “The fact that this settlement only impacts one company will have little impact at all on youth vaping here in Hawaii.”
The 34 states and territories involved in the settlement will receive an estimated $438.5 million, which will be paid within a 10-year period.
“Juul’s revenue in 2019 was over $3 billion, and even with some of the restrictions that were put in place around their fruity flavors, their sales last year were roughly $1.9 billion just in the U.S.,” Stensrud said. “If any of this money goes towards cessation or prevention activities, that will be helpful, but in the short run, I don’t see it having too much of an impact here in Hawaii.”
Email Grant Phillips at gphillips@hawaiitribune-herald.com.