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Adam Goldstein, MD, MPH, and Ilona Jaspers, PhD, share their responses to the terms of e-cigarette manufacturer Juul Labs’ settlement in a lawsuit from North Carolina’s attorney general. Read their opinions on what this means for the state and the future of youth vaping.

It comes as no surprise that Juul Labs, Inc., the largest e-cigarette company in the U.S., decided to settle their North Carolina lawsuit from the state Attorney General for $40 million, right as the trial was starting. The lawsuit stemmed from extensive evidence that Juul helped entice youth across the U.S., including North Carolina, to start using e-cigarettes, through youth-oriented advertising, appealing flavors, and very high nicotine concentrations in their products.

“It is way past time that Juul is forced to pay a price, however small, for addicting many generations of North Carolina teens to e-cigarettes,” said Adam Goldstein, MD, MPH, professor of Family Medicine in the UNC School of Medicine and Director of the University of North Carolina Tobacco Intervention Programs.

“Before Juul became popular with teens, we had never seen that extent of rise in nicotine addiction in adolescents,” said Ilona Jaspers, PhD, director of the UNC Center for Environmental Medicine, Asthma, and Lung Biology, and professor of Pediatrics. “At the time, we really only had tools and treatment for nicotine addiction for adult smokers. There was no understanding of how to treat 16-year-olds addicted to vaping.”

As part of the settlement to try and reduce Juul youth sales, the company agreed to the following conditions: to have their products placed only behind the counter in stores, to use third party age verification systems for online sales, to send secret buyers to 1,000 stores annually in North Carolina to see if the federal laws preventing sales to minors are being enforced, to use models over the age of 35 in advertisements, and to not post advertisements for Juul products near schools.

“It’s time to stop marketing all tobacco products in ways that appeal to youth,” said Goldstein. “This includes eliminating candy and fruit flavors in all e-cigarettes, cigars and smokeless tobacco products, similar to cigarettes. Our research has shown such flavors are highly appealing to youth.”

UNC research has shown the potential health risks associated with various chemicals in e-cigarettes, including chemicals that create popular flavors. And nicotine itself is a dangerous and highly addictive chemical. It can increase blood pressure, heart rate, and flow of blood to the heart, and it can contribute to the narrowing of arteries. Some studies suggest nicotine may also contribute to the hardening of the arterial walls, which in turn, may lead to a heart attack.

“I commend NC Attorney General Josh Stein on his courage to be the first AG in the country to try and right this wrong and advocate for our kids,” Goldstein said. “Knowing the $40 million settlement will be paid to North Carolina to fund programs to help people quit e-cigarettes, prevent e-cigarette addiction and fund more research like ours is promising. We have treatments that work, and we can break the chain of nicotine addiction threatening our youth.”

“I hope this sends a message to other e-cigarette manufacturers who are now filling the void that Juul has left, continuing to target teens with attractive flavors and marketing,” Jaspers said. “Nicotine addiction in adolescents is still there. With this settlement, we can find more innovative and efficient ways to support e-cigarette cessation treatments, especially for teens.”

Learn more about the settlement here.