People walk past signs for Juul e-cigarette products and other tobacco products. (Kevin N. Hume/S.F. Examiner)

Don’t be fooled by ‘Big Vaping’

By Kimberly Newell Green, John Maa and Steve Heilig

Just last year, “Big Tobacco” spent almost $12 million to try to fool San Franciscans and repeal our landmark ban on menthol and other flavored tobacco products that attract young people to both smoking and vaping. Voters soundly rejected Big Tobacco’s deception, and flavored tobacco bans are now sweeping across America. In 2019, leading vaping company Juul is repeating history by authoring Proposition C, which seeks to evade federal law and enable them to continue selling products that are addictive and unhealthy.

Juul’s majority stakeholder is Big Tobacco. Juul is currently under criminal investigation for marketing to youth. Their CEO recently resigned amidst an expanding epidemic of lung illnesses and death linked to vaping, and was replaced by a former Big Tobacco executive. Today, in light of tobacco’s harms and the tobacco industry’s long history of suspect practices, anyone working for tobacco could be said to be lacking a “moral compass.” Juul’s questionable practices have included youth-targeted marketing, even bribing schools to gain access to young students. Make no mistake – they have catalyzed the current youth vaping crisis.

We are not too surprised that Juul has now suspended further spending on Prop. C, as that would be throwing bad money after bad. The negative publicity they are getting for their money must have given them pause. Juul says they support regulation with Proposition C, but in fact had recently sunk $7 million more into their campaign to pass Proposition C to evade FDA regulation, despite a promise not to fight flavor bans or market to youth. As former San Francisco City Attorney Louise Renne warned “Don’t trust anything they say.”

Juul was warned by the FDA for advertising that their products are a safe form of smoking cessation. But e-cigarettes have not been shown to work better than existing cessation options, and present many unique health harms. Juul’s ex-CEO admitted they don’t know what the risks are, and from their actions, they don’t care. Growing research shows how harmful vaping can be to our hearts, and lungs, and nicotine addiction poses other health risks. Most recently, carcinogens banned in our foods have been found in vaping components. Dartmouth researchers estimate up to 80 young people will progress to smoking for every adult who uses vaping to quit smoking.

The current outbreak of lung illnesses linked to vaping is likely only the tip of a growing list of health risks, and that research continues. We do know that while only about 3% of adults are vapers, it has exploded among younger people – who are not using it to quit tobacco. And in fact, the vaping industry never intended smoking cessation as their primary market. As one of Juul’s own developers admitted in an internal email, we “don’t think a lot about addiction here because we’re not trying to design a cessation product at all.”

For real “harm reduction” one must reduce net harms. The vaping industry could find out the truth about their products by allowing FDA review, but instead they fight it every step of the way, “spending money like a drunken sailor” as the SF Weekly put it. What are they afraid of?

San Francisco voters have already been subjected to an avalanche of “Yes on C” propaganda, all paid for by Juul. We suggest voters look at who the “teams” represent. On the “Yes” side is Juul, now also owned by Big Tobacco. On the “No” side is a long list of medical and public health groups, including the American Heart Association, American Cancer Society, American Lung Association, the American Academy of Pediatrics, California and American Medical Associations, Mayor London Breed, Senator Dianne Feinstein, Speaker Nancy Pelosi, among many more.

The San Francisco Marin Medical Society called for regulation and scientific review of vaping products almost a decade ago, even before it became clear how dangerous vaping can be. India and China recently joined Japan, Hong Kong, and Thailand among others who have already instituted vaping bans. Numerous states in America are now doing likewise, and public health officials are strongly advising that no one vape. Over 27% of high school students have tried vaping, leading Governor Newsom and President Trump to issue proposals to curtail youth, which Gavin Newsom aptly termed as a “public health crisis.” An FDA scientific review of vaping that was supposed to happen long ago, and might have prevented this crisis and suffering. We can’t let Big Vaping continue to avoid required FDA regulation while exposing ever more people to dangerous products and practices.

We can expect more deceptive marketing of Proposition C with the funds they’ve already committed, but don’t be fooled by Big Tobacco/Vaping, and VOTE NO ON PROPOSITION C.

Kimberly Newell Green is a pediatrician and president of the San Francisco Marin Medical Society. John Maa, a general surgeon, is a past-president of the SFMMS. Steve Heilig is on the staff of the SFMMS, a medical ethicist, and former co-chair of the San Francisco Tobacco-Free Coalition.

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