Decades of scientific research unequivocally established that cigarette smoking causes numerous diseases and conditions, including lung and other cancers, heart disease, stroke, diabetes, chronic obstructive pulmonary disease (COPD), asthma, erectile dysfunction, and premature/low birth-weight babies. Although tobacco companies were aware of the health dangers and addictiveness of nicotine years before the independent scientific community, publicly they shifted the narrative, denied the science, and manufactured doubt to distract and delay regulation of cigarettes to maximize their profits for as long as possible.

In the US, the “success” of the industry’s efforts over the years caused millions of deaths and trillions of dollars in medical care costs and lost productivity.

Juul and other e-cigarette companies are working from the same playbook to gain private profit at the expense of the public’s health.

What are the short- and long-term health and safety risks specific to e-cigarettes? This should be the first question driving the narrative about the potential harms of these products. Despite most of these products entering the market less than 10 years ago, independent scientific research has demonstrated numerous potential harms, such as:

How do these risks compare and contrast to those of conventional cigarettes? This is also an important question. However, Juul only frames its products in contrast to the worst harms of the combustible cigarette, a product responsible for 480,000 annual deaths in the U.S., generating a widespread, yet unproven, belief e-cigarettes have a net health benefit. Maybe they do. Maybe they don’t. 

In the meantime, while uncertainty remains about the public health consequences of e-cigarettes, Juul has seized the opportunity to drive its own narrative – as savior of the world’s smokers. Perception is reality and Juul is shaping it.

Juul’s corporate image began as a sexy tech start-up that “accidentally” marketed its sleek, flavorful products to teens. Within a few years, Juul not only took over the market, but led to overall market growth of more than 500 percent. With this growth and reported large uptake by teens, the company had to quickly mature into its latest image as a savvy corporation that pitches its e-cigarettes as health products to smokers and publicly discourages underage purchase and use.

Marketing at the edge of regulatory authority, Juul helps smokers “switch,” not “quit,” and sells them “improved lives,” if not “reduced harm.” The company is now pitching this scientifically unproven story of Juul as an anti-smoking wellness tool to large employers, healthcare insurers, and Native American nations.

Public relations rather than science is driving the narrative of e-cigarettes.

And now there is a new job title at Juul, Senior Scientific Affairs Advisor. This is a “principal scientist role,” requires doctoral level education, and has a key duty to “work closely with regulatory, medical and clinical affairs, region presidents and global scientific affairs to disseminate and maintain integrity of corporate scientific narrative.” [emphasis added]

Every day that Juul can prevent effective policy action is one more day that it can make more money. The tobacco industry playbook kept a deadly product from being regulated until 45 years after the U.S. Surgeon General first concluded that cigarettes cause lung cancer in 1964. Sorting out the science from the PR is essential to creating policy that protects the public’s health and not e-cigarette profits.

Resources on the science and public health consequences of e-cigarettes:


Written by Tracy Sides, Policy Analyst
June 19, 2019