JUUL Labs: Case Study In Ethical Vaping Research

Cardiovascular Business | Anicka Slachta | August 2, 2019

An editorial published in The Lancet August 2 scrutinized JUUL Labs’ participation in and sponsorship of e-cigarette research in the U.S., finding the vaping giant fell short in seven of eight categories designed to test ethical integrity.

JUUL is by far the most dominant player in the e-cig space, Andy S. L. Tan, of the Dana-Farber Cancer Institute in Boston, and colleagues wrote in the journal, accounting for nearly 80% of retail e-cigarette sales in the country. Initially branded as a Silicon Valley startup in 2015, it wasn’t long before JUUL racked up considerable criticism for marketing its flavored products toward kids and teens.

A 9% surge in the rate of e-cig use among high school students between 2017 and 2018 pushed U.S. Surgeon General Jerome Adams, MD, to issue a rare national advisory last December, declaring youth e-cigarette use a national epidemic and directly implicating JUUL as a major driver of that surge. And though JUUL announced mid-November 2018 it would be suspending retail sales of most of its flavored “pods”—which contain about as much nicotine as a 20-pack of cigarettes—it inked a $12.8 billion deal with Altria just weeks later.

“Tobacco companies including Philip Morris USA, an Altria company, have had a long history of using findings from industry-sponsored scientific research to positively portray the tobacco industry and lobby against regulatory actions,” Tan and co-authors wrote. “For instance, the industry founded the Tobacco Institute and the Center for Indoor Air Research to fund internal and external research by scientific consultants and research organizations to support their positions.

“Shortly after the investment from Altria, JUUL Labs appeared to employ similar strategies used by Philip Morris and other tobacco companies to influence research on vaping.”

The authors said JUUL established JLI Science in early 2019—an organization with a stated goal of better understanding the long-term impact of vaping products “while also discouraging new users, and to share those results with the scientific community.” A search on ClinicalTrials.gov just two months ago revealed JUUL Labs was funding six registered trials, including one that’s ongoing.

Tan and colleagues used eight previously established criteria for evaluating tobacco industry-supported scientific research to measure JUUL’s integrity, including transparency and independence; competitive funding process; ownership of data and freedom to publish; independent research agenda; governance; protection against conflict of interest; industry public relation gains that counteract public health; and feasibility.

The team found what they identified as “potential weaknesses” in JUUL’s sponsored research program in seven of the eight categories.

Tan et al. said their findings undermined both the scientific credibility of JUUL-sponsored research and public health as a whole. They recommended continued scrutiny of JUUL’s research funding activities and how that research is used to boost their public relations strategies and lobbying actions.

“Rigorous and independent research is needed to establish acute and long-term risks and benefits of vaping for different populations and provide the evidence base for prevention and control interventions and regulation of vaping devices,” the authors wrote. “The ultimate goal for research, interventions and policies is to maximize potential public health benefits of vaping, if any, while minimizing risks. Safeguarding against the industry’s undue influence on the tobacco control research agenda will be necessary to maintain the scientific integrity of the research and to protect the public’s health.”

In late June, San Francisco—the home of JUUL Labs—became the first city in the U.S. to ban e-cigarette sales and distribution. San Francisco’s Board of Supervisors passed the ordinance with a unanimous vote on June 25, and JUUL responded with a statement claiming prohibition would drive former adult smokers “back to deadly cigarettes” and create a “thriving black market instead of addressing the actual causes of underage access and use.”

The ban will go into effect in early 2020.

Published by Tobacco Stops With Me on August 20, 2019