MINNEAPOLIS — When Minnesota Attorney General Keith Ellison first announced a lawsuit against e-cigarette maker Juul in 2019, students and leaders with Minnesota's Tobacco Free Alliance stood behind him.
Though it's taken that case four years to make it to trial, that group hasn't just been standing around to see that fight play out in court.
"Students know now that (e-cigarettes) are not just flavors and water, which is how it was seen when Juul came on the market," said Elyse Levine Less, the executive director of the Tobacco Free Alliance. "They now know that there's a lot of nicotine in this."
At the time the lawsuit was filed four years ago, the number of kids and teens who reported using e-cigarette products had never been higher. According to the 2019 Minnesota Student Survey, more than one in four (26%) Minnesota 11th graders and one in 10 (11%) eighth graders reported using an e-cigarette in the past 30 days. By 2022, those numbers were nearly cut in half, falling to just 14% of 11th graders and 6% of eighth graders.
Lavine Less says the lawsuits from Minnesota and other states helped put a spotlight on the issue and prompted more federal oversight. She says learning shifts during the pandemic and student education efforts have also played a role.
Still, she says the Minnesota trial still comes at a critical time.
"It's going down, I think that's great, but there's still a lot of work to be done," Lavine Less said. "Juul opened a Pandora's box of problems."
She doesn't have to reach far for an example.
"This is a Mango Juul pod," Lavine Less said, picking up an orange-tipped cartridge. "This is no longer allowed to be sold, but the action that the FDA took was a very tiny Band-Aid on a huge problem."
While the FDA banned most flavored e-cigarette pods made by Juul and others, she says it wasn't long before other companies exploited loopholes.
"We still have 15,000 flavored vape products on the market today that are not pod-based," Lavine Less said. "They are disposable, and they are now the most popular products among kids and teens."
She says many of the disposable devices also contain more nicotine.
"This one is a rainbow candy vape," she said, picking up one device. "The Juul had about 300 puffs in it - of nicotine - and this one has over 5,000 puffs of nicotine. So now you have products on the market that are so much higher in nicotine than the Juul ever was."
The rise of those products means that, even as fewer Minnesota kids report trying them, a greater percentage seem to be getting hooked. According to the 2020 Minnesota Youth Tobacco Survey, a third of students who vape used an e-cigarette on at least 20 of the past 30 days - an 80% increase in frequent vaping since 2017. And despite the FDA's efforts to crack down on flavored pods, the same survey found that nearly nine in 10 students who currently use e-cigarettes (87.1%) reported using a flavored e-cigarette in the past 30 days.
"I've had kids say, 'I didn't realize how dangerous this was until... I just couldn't stop,'" Lavine Less said. "That's why we still have so much to do. You need cessation funding for kids that are already hooked; you need education and you need policy change."
To address all three of those areas, the Tobacco Free Alliance is pushing for legislation in the Minnesota legislature this year that would ban all flavored tobacco products and commit any money from this Juul lawsuit to prevention and treatment programs.
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