Broken (2019) s01e02 Episode Script

Big Vape

You all ready to see some tricks? Hell, yeah! Vaping, once the obsession of eccentric hobbyists, has gone mainstream.
Smokers have been switching over to e-cigarettes at a hell of a rate.
I know you've got a good reason because you're how many months pregnant? Six months now.
Some say it's a public health revolution that could save millions of lives worldwide.
Cigarettes kill half the people that use them.
We have a product that helps people not die.
But in the US, there's one big problem.
- Bella, your locker.
- Oh, yeah.
I hit it maybe 40 times a day around.
There's rarely anyone who would say no to it.
They're doing it in every high school.
This is a nationwide problem.
Their vape of choice: the Juul.
Juul is absolutely against any use of our product or e-cigarettes generally by minors.
It delivers nicotine at higher levels more effectively than any other e-cigarette ever has.
You know that if you can make somebody addicted when they are young, you have a user for life.
Meanwhile, Big Tobacco is poised to take over the industry.
We want to remove combustible cigarettes from the world.
That's what we call a smoke-free future.
Big Tobacco have acquired these brands.
They're gonna continue on dominating the market.
If they think that's where the money is to be made, that's what they'll do.
We face a true epidemic of addicting an entirely new generation just as we're really beginning to turn the corner on cigarette smoking.
It is out of control, like, throughout everyone in my generation.
Where's my old jeans? - Your jeans? - Yes.
I mean, I have my jeans in the laundry room, but I don't know where yours are.
I really like that shirt.
- Thank you.
- You're welcome.
I've tried stopping.
And I really know deep down, like, what it takes is just one day, you've just gotta put it down and just never touch it again.
But, like, the times I have, I'll make it, like, a week, like, two weeks.
When you're just surrounded by, like, your friends doing it I don't know, it just doesn't become as, like, bad of a thing.
It's kind of just something that people are doing.
You're just sort of like, “I might as well.
Like, one more time won't hurt.
” Bella is a 17-year-old high school senior in Milford, Connecticut.
And she is addicted to e-cigarettes.
- Morning, Jose.
- Morning.
- Will you sign that, please? - Bless you.
Yes, I can.
- Thank you so much.
- All right, no emergency.
Thank you.
- Thank you.
You too.
- Have a good day.
My name is Fran Thompson, and I'm the Principal at Jonathan Law High School in Milford, Connecticut.
How are you? The first time I saw an e-cigarette on school property was probably two years ago.
Hi, guys.
I have found theater kids vaping in the bathrooms.
Athletes, brainiacs.
I have Take your pick.
Every group.
Jonathan Law High School is not alone.
Teenagers are vaping in high schools all over America.
Over the last four months, there have been two of the most large-scale studies ever conducted that showed that in the last year, we have seen a rise in youth use of e-cigarettes that is unprecedented in our history.
The CDC reported a 78% increase in vaping among American high schoolers from 2017 to 2018.
And there was one product getting more attention than all the rest: the JUUL.
And the JUUL product itself is small enough to fit in the palm of your hand.
And for most people, you don't realize it's not a flash drive.
So JUUL may not have intended this, but when you look at the product now, almost everything about it appeals to younger users.
It is the same level of convenience and ease and discretion and clean design that they're used to from MacBooks and iPhones.
While e-cigarettes, especially the JUUL, are considered cool among teenagers, regular cigarettes are not.
So in 1996, over 36% of all high school kids smoke.
Today in the United States, less than nine percent of all high school kids smoke.
I have had conversations with kids.
I will say to them, "Would you ever smoke a cigarette?" And they will actually look at me like I was just a crazy, old guy.
And they'll go, "Ew, no!" Oh, my gosh, I would never smoke a cigarette.
I would never smoke a cigarette, and none of my friends have.
I think cigarettes are kind of gross.
- Let's go to school.
- I've never once tried it.
I don't even think I've any of my friends have either, to be honest.
My whole life, since I was in, like, fourth grade, we had so many presentations about how smoking gives you cancer, like, pictures of people's lungs after it.
The worst of the worst.
I remember in middle school, I would run up to my mom and I'd be crying and be like, "Mom, I hope you never, like, smoke cigarettes.
I don't want you to die.
" Cigarettes kill one out of two long-term users.
In the United States today, despite all the progress we've made, it kills close to half a million people a year.
Cigarettes have been big business for over a century.
But their popularity exploded after World War II You know I don't want you to quit.
when tobacco companies launched a barrage of advertising in magazines and on TV.
They promoted relaxation, a cool lifestyle, independence, and even feminism.
In the 1960s, Philip Morris added ammonia to their blend to improve the nicotine absorption, making their cigarettes even more addictive.
But by that time, everyone, including Big Tobacco, was fully aware that cigarettes were deadly.
This is a normal, healthy lung.
And here's what it looks like after 30 years of heavy smoking.
And well into the 1990s, they lied about what they knew.
If you raise your right hand, do you swear that the testimony you're about to give is the truth, the whole truth, - and nothing but the truth? - I do.
The data that we have been able to see has all been statistical data that has not convinced me that smoking causes death.
Do you believe nicotine is not addictive? I believe nicotine is not addictive.
Cigarettes clearly do not meet the classic definitions of addiction.
I don't believe that nicotine for our products are addictive.
I believe nicotine is not addictive.
I believe that nicotine is not addictive.
I believe that nicotine is not addictive.
And I, too, believe that nicotine is not addictive.
It was so obvious to everybody who was in the room and everybody who saw it on television that they were lying.
Shame! We now know from their own internal documents that they knew that smoking caused cancer and other serious diseases.
And they had known for decades that nicotine was highly addictive, that they manipulated the product to calibrate the delivery of nicotine to the citizens, and that they understood it fully.
Public opinion was turning against Big Tobacco.
People all over the world were also realizing just how hard it is to kick the habit.
I quit smoking once, for a week.
But after a week, I couldn't stand it, and I started smoking again.
There are over a billion smokers in the world today.
And 300 million of them are in China.
It was here that an engineer named Hon Lik took the first step toward a potentially cigarette-free world.
This prototype could be called the embryo of electronic cigarettes.
I was born in Shenyang, Northeast China.
My father smoked.
My father smoked a pack of cigarettes a day.
I started to smoke when I was 18 years old.
At that age, as an educated youth, I was sent from the city to the countryside to work.
It was the 1970s, at the tail end of the Cultural Revolution.
Mao decreed that educated youth should work as laborers on farms to earn the right to study in college.
Hon Lik was sent to the state-owned tobacco fields and factories.
Today, China National Tobacco Corporation supplies 98% of cigarettes to Chinese smokers.
At that time, it wasn't about being cool.
Smoking was a way to relieve exhaustion and loneliness.
While Chinese youth may have smoked for different reasons than their American counterparts, the result was the same: a generation hooked on tobacco.
I think that people who smoke have a common characteristic.
When you are worried or depressed, you smoke more cigarettes.
When you are excited or successful, you smoke even more cigarettes.
But in 2002, Hon Lik received some life-changing news.
As my father got older, at the age of 77 he was suddenly diagnosed with lung cancer.
At that time, the doctors said that smoking was the cause of his disease.
Hon Lik knew he had to quit smoking, this time for good.
So he tried using a nicotine patch.
At first, this product was very effective for me.
But when I saw someone smoking, I couldn't help wanting to smoke.
The patch helped with the nicotine cravings, but he still missed the ritual of smoking.
I wanted to design a device that delivered nicotine to the human body more like a cigarette.
This is the electronic cigarette that I used to experiment in 2003.
Hon Lik's prototype would become the inspiration for all future e-cigarettes, including the JUUL.
They work like this.
A battery heats up a metal coil, which in turn vaporizes the e-liquid, a mixture of nicotine and flavorings.
That vapor is what the user inhales.
Press it and puff on the electronic cigarette once.
Press it and puff once.
Vaping offered a sensation similar to smoking, but without the thousands of chemicals found in cigarette smoke.
Including alkaloids, arsenic, aldehydes, and others.
Many of these are deadly poisons.
And e-liquid typically contains a shortlist of common ingredients, including water, propylene glycol, vegetable glycerin, assorted flavorings, and the key ingredient that smokers crave: nicotine.
This is the first mass-produced electronic cigarette we introduced to the Chinese market.
It was a successful e-cigarette product.
Hon Lik's father lived just long enough to try out his son's new invention.
He felt very happy, very good.
The e-cigarette became a hit in China where more than one out of three of the world's cigarettes are smoked.
And Hon Lik's company went on to sell its patents to another e-cig company for 75 million dollars.
I realized that this product was of great social value and would be important for public health.
It was a meaningful product.
It would take another couple of years before the e-cigarette found its way into the US market.
It's always surreal, seeing the skyline here.
We're going to Vapexpo, Las Vegas.
It's where a lot of the buyers, the vape shop owners, the distributors, the vape companies come together and they show their products.
Good thing I won at blackjack last night.
- How's it going? - Good.
And you, sir? Very well.
Thank you.
Kurt Sonderegger has been in the business for over a decade.
In fact, he was one of the first employees of the company that would go on to become JUUL.
- Thank you.
- Thank you.
It took a while for e-cigarettes to really take off.
It's interesting.
It's more of a bottoms up than a top down.
There is no Apple coming out with the latest, greatest device.
It was actually tinkerers in their garage making improvements on the Chinese e-cigarettes.
I think once they replicated the ritual and they could find a way to eliminate or at least greatly reduce the harm, you got a much better way to attack the smoking problem.
In case you didn't know already, nicotine is addicting.
So where are we going? The early devices were just a simple tube.
They even put a light at the end to kinda make it look like a coal at the end of a cigarette.
- So I guess we'll put it - Yeah, just in the middle.
They were known as ciga-likes for the way they mimicked regular cigarettes.
They're actually not a bad product.
They just didn't deliver an experience that was akin to smoking.
The early devices weren't that efficient.
Yes, you saw vapor coming out, but they didn't really pack a very good punch compared to the nicotine kick you got from smoking.
I think we're pretty much all set.
And a lot of people would try it and they'd go back to smoking because it didn't work for them.
But then came a key innovation that almost made up for the low nicotine levels: flavors.
I think flavor's a really big component.
Because if you can find a flavor that you really enjoy, I think you're going to be much more apt to use that more often and not fall back onto smoking.
It's a safer alternative that tastes good.
I'm gonna make a chocolate milk flavor and a strawberry milk flavor.
Why? Because I'm an adult, and I like chocolate milk.
And I don't want to sit there and vape a dirty cigarette flavor all day.
That’s what I transitioned off of.
- Eric, how's it going man? - Hey, Kurt.
How you doing? We're really big about trying to get people to quit smoking.
You know, that's one of our main goals.
This is our little device.
Vape device, pod system.
I tried to quit many times, unsuccessfully.
I think the longest I went was a couple of months.
And then, eventually, came back to smoking.
The first time I went into a real vape shop and I got a proper device, I literally crushed up the pack of cigarettes I had in my hand, threw it in the basket, and that was it.
And that was May of 2012.
I would say most of the room is former smokers, at least 90% of them.
By 2009, an industry, largely unregulated by the government, had been born.
I've watched this go from kind of an underground, niche culture to a very mainstream, high-volume, high-paced sales machine.
And we haven't lost it.
We've never lost that culture.
It’s still there.
It's still real.
New and improved e-cigarettes popped up left and right, along with accessories and thousands of flavors.
Last time we counted, there was about 22,000 e-liquid brands worldwide.
But it wasn't just e-cig entrepreneurs who saw the potential in this new industry.
Philip Morris International is one of the biggest tobacco companies in the world.
In 2018, they shipped 740 billion conventional cigarettes.
So here on the left, you have the three main varieties of tobacco.
But as more and more people quit smoking, Philip Morris is looking for new ways to profit from the nicotine hidden in these leaves.
In 2009, they spent 120 million dollars to construct a state-of-the-art lab facility called the Cube.
This is the center for research and development.
And the whole building is focused on developing new generation of product to reduce the risk for smokers.
For PMI, the future is pretty clear.
We want to remove combustible cigarettes from the world.
That's what we call a smoke-free future.
We still have a very sizable number of smokers, around one billion, and we believe that these people deserve a better alternative.
Serge Maeder leads the product research group at PMI.
We're developing product that don't burn tobacco, and by avoiding combustion, we can remove a lot of the toxicants associated with smoking that are really the source of smoking-related disease.
So the future is really, as soon as possible, to be able to replace completely combustible cigarette by a better alternative.
If that's the case, why don't you just stop selling combustible cigarettes? If we stopped PMI stopped selling cigarettes, other people would do it.
And today, 87% of our income comes from selling cigarettes.
And a large portion of this income is invested in research and development.
So we can fuel innovation by selling cigarettes.
In reality, only about two percent of PMI's 19-billion-dollar profit from 2018 went toward developing new non-combustible products, like the IQOS, which heats tobacco without burning it.
The IQOS device is being triggered.
And then you can see the puff.
And their version of the e-cigarette, the IQOS MESH.
And we will see now, when a puff is taken, we can see the aerosol being generated by the product and entering a cavity that represents what somebody will get into the mouth when a puff is taken.
The question is, why is a tobacco company investing in these so called "reduced risk" products when there is still a lot of money to be made from regular cigarettes? The answer, it seems, lies in one key ingredient common to all their products: nicotine.
Nicotine is actually not the source of smokers' disease.
It's everything else.
So all the byproduct, toxicants that actually come from combustion of tobacco are the source of smokers' disease.
But not the nicotine.
In fact, some studies have shown adverse effects of nicotine on its own.
But it can't kill you the way the tar and cigarettes can.
What nicotine can do is create an intense addiction that keeps smokers and vapers coming back for more.
In the long term, they see an advantage in dominating the reduced risk tobacco market.
If they think that's where the money is to be made, that's what they're gonna do.
But PMI isn't just developing their own reduced risk nicotine products.
They, and the other big tobacco companies, have actually been buying up the most successful e-cigarette brands.
They get both.
They can sell as many Marlboros as they can possibly sell.
Sell as many e-cigarettes as they can possibly sell.
They get the marketplace either way it moves.
By the end of 2014, many feared the vape industry, once fiercely independent, was being taken over by Big Tobacco.
But in the San Francisco Bay Area, two grad students were about to launch a product that would turn the entire industry upside down.
We were working late into the night and taking a lot of smoke breaks.
And it occurred to us that smoking is incredibly difficult to quit.
We had both tried many times and failed.
Adam Bowen and James Monsees decided to approach the problem with a tech sensibility and build a better, simpler e-cigarette to help them quit smoking.
James and I actually started this as a master's thesisin product design at Stanford about 14 years ago.
It turns out that actually burning tobacco is the real problem.
So They spent the next decade improving the device and the e-liquid formula.
So previously, all e-cigarettes were using nicotine in its free base form, which is just pure molecular nicotine.
Nicotine in this form is harsh on the throat, so most e-liquids kept the concentration low.
Yes, you were getting some nicotine, but not in the same manner as smoking a cigarette.
Combustible cigarettes deliver a super-charged dose of nicotine to the brain while e-liquids at the time offered only a steady low dose.
But James and Adam figured out a more effective way to deliver the nicotine.
One key discovery that we made was in what we call nicotine salt chemistry, which is basically when you combine nicotine with certain organic acids in specific ways, you can deliver nicotine via an electronic cigarette in just the same way that it occurs in regular cigarettes.
These nicotine salts contain benzoic acid, which makes the nicotine less harsh when inhaled as a vapor.
We carefully designed JUUL to deliver on a per puff basis an amount of nicotine that's comparable to a cigarette.
This meant the JUUL packed more nicotine per puff than many of its rivals.
Every aspect of JUUL is designed to make it a complete substitute for smoking.
So it had to hit on these key elements.
The amount of nicotine, the rate of nicotine, the sound that it makes we felt were all important aspects to making a complete and easy replacement for cigarettes.
They made a better mousetrap.
They made a device that really worked.
They made it simple, and they made it satisfying.
They started with four carefully curated flavors in colorful pods and in 2015, the JUUL was ready to launch.
A lot of attention is paid to this initial marketing campaign called Vaporized that had, you know, a pop-up store in the Hampton's, an ad in VICE magazine.
There was a billboard in Times Square.
They used the exact same images that the cigarette companies used in the 1960s and had been forbidden because Big Tobacco knowingly marketed its products to kids.
Bright colors, 20-somethings who could easily pass for 15-somethings.
They had you, know, young people on their Instagram account using JUUL.
The campaigns were soon all over social media.
They were lifestyle ads.
They showed young people in social settings where they were glamorous, sexually attractive, having fun with each other.
And the JUUL was an integral part of all of that.
Our launch campaign in 2015, it was intended for, you know, adult smokers, which has always been our target audience.
But we received some criticism about the campaign and decided to pull it quickly.
It ran for less than six months.
But it may have been too late.
By that time, JUUL already had a brand-new fan base: teenagers.
Hey, friends.
- Bella, your locker.
- Oh, yeah.
There's so many different accounts on Instagram, Twitter, Snapchat that all these kids look at it, and there'll be videos of kids just having fun at parties.
And they'll just want to be like them, and they'll get one.
And then they'll introduce it to their friends.
I feel like that's how it spreads.
My freshman year, so this was, like, three or four years ago, I was at this place in Milford, it's called Lexington Green.
And I was there with a few of my friends.
Someone had this tiny thing, and I was like, "Oh! What is that?" I said, "What are you using?" He just pulled it out of his pocket, this little flash-drive-looking thing.
They were like, "Oh, it's a JUUL.
Like, try it.
Like, it's so cool that I mean, like, it's the new thing.
" They're like, "It's just water vapor, it's so you can do tricks.
" The first time I tried a JUUL, it hurt.
It was really strong in the back of my throat, and I coughed a lot.
And it did make me feel a little lightheaded.
And then I hit it, like, two more times and then I felt that, like, buzz that kids talk about.
That buzz is the same one you get from smoking a regular cigarette.
And it happens when pleasure-causing chemicals in your body, like dopamine and serotonin, are stimulated by nicotine.
And by design, there is a lot of nicotine in the JUUL pod.
Like, a pod is supposedly equivalent to, like, 20 cigarettes, or a pack of cigarettes.
I usually go through about a pod a day.
The more you use it, the longer space between you're gonna get a buzz.
Like, you have to wait longer if you wanna get one.
So I would get excited when I woke up in the morning 'cause I’d be like, "I'm gonna get the biggest buzz now," 'cause I was just sleeping.
When the dopamine and serotonin levels go back down after the buzz, you feel tired and irritable.
Your body wants more of those good feelings.
And that is how the addiction to nicotine begins.
If I would wake up and my JUUL would be dead, I would be really irritated.
I just wanted to rip the JUUL really bad.
And then, when it would die, or when a pod runs out, you, like You know you're addicted when you just get so upset that you will go anywhere, do anything, like, to rip a JUUL.
When I first started ripping a JUUL, like, I didn't realize that it was highly addictive.
I had no clue at all.
'Cause everybody just got it because of the smaller size.
Like, we weren't Like, didn't realize what an addiction was.
Like, two years ago, no one knew that we'd actually get addicted to it.
There are studies that show that 63% of people who smoke JUUL don't know that it contains nicotine.
Kids didn't even realize they were using e-cigarettes.
They would say, "We're using JUUL.
That's not an e-cigarette.
" Now the warning labels are really big.
But they weren't at the time I was going back and looking at, you know, unboxing videos.
All right, now let's see what's inside this.
Even on close- ups of the initial boxes, you were seeing clean design and, you know, a beautiful product, and you really weren't seeing anything equivalent to the kinds of warnings you see on cigarette labels.
It's just a JUUL and the USB charger.
Let's just take that off.
So if you were going to design a single product to addict a nation of kids, you couldn't have come up with a better one than this.
And some scientists say the nicotine addiction itself poses a serious threat.
Really, the window of opportunity for getting somebody addicted to nicotine is quite narrow.
It's basically between your early teens and your early 20s.
That's a critical time for developing brains.
We know that nicotine binds to some receptors in the brain.
And there is that time in life where it seems that our brain cells are very good at expressing those receptors for nicotine.
And as nicotine reshapes the brain's receptors, the addiction becomes stronger.
The earlier you start being exposed to nicotine in life, the more likely you are to become highly addicted to tobacco products.
That's where the high nicotine content in the JUUL raises some concerns.
There are now multiple studies that show the kids who use e-cigarettes are more likely to go on to using cigarettes themselves.
Public health advocates fear that high nicotine content on a young brain is going to make you more likely to be addicted to nicotine, and then also, you know, to potentially open yourself up to substance abuse problems in the future.
These are actual JUULs.
You can see how they look just like flash drives.
And these are the pods that goes into said JUUL.
Principal Thompson confiscates a couple of e-cigs every week, most of them JUULs.
But that's just a fraction of what's out there.
The reality of it is, that's how infrequent it is to catch somebody with it um because it's so easy to conceal.
Kids are able to hide JUULs so easily, honestly.
They'll keep it in their sleeves.
They'll keep it even in their back pocket, their sweatshirt pocket.
Lots of girls keep it in their bra.
Literally anywhere.
It's really small, so Students are even able to vape in the classroom undetected.
They would, like, put it in their sleeve and kind of just go like this.
Pretend they're, like, resting their head, but they're JUULing.
They even it rip it through their shirt and it'll still work.
People, like, will put it right here and just sit like this.
We call it "zeroing the hit," which is you'll hit it and you'll inhale it all the way that by the time you're releasing, like, the smoke or the air out of your throat, that you won't see any smoke.
Kids were leaving class, and they would be gone for, like, 20 minutes.
And they were congregating in the bathroom.
Boys would start wrestling matches.
Girls would bring in blankets from home.
It was weird! There'd be times where I would walk into the bathroom and there’d be, like, forty people.
I'm not No joke.
Like, all squished in there.
Some people in stalls.
They would bring their pillows, their blankets.
They would be sitting there all comfortable, ripping their JUUL.
I used to say it's the next teenage epidemic, health epidemic.
It is not the next, it is a teenage health epidemic.
It's insidious in that it's become such a pervasive part of a teenager's social fabric.
And it happened so fast.
There's only, like, a select few that I could say that, like, two or three people in my friend group, who I could say, like, have never used it.
The percentage of people that vape here would have to be at least 70%, I would say, about.
Has tried, I would say an easy 95%.
But beyond addiction to nicotine, what really are the long-term impacts? Unlike with combustible cigarettes, we don't have decades of research to turn to.
With the e-cigarettes, we know very, very little about the health effects.
Are these harmful? Potentially, yes.
But we don't know that yet.
So a lot of the research that we need to do is really develop that body of evidence.
Since 2015, Dr.
Navas-Acien and her colleagues have been researching the potential toxicity of all types of e-cigarettes.
You will hear people saying, “Oh, this is just a vapor.
It's very safe to inhale compared to tobacco.
It's a wonderful, new product that is going to help everybody quit.
" But I really wanted to know more what was this device and what was in it, and how was this aerosol being generated.
So, actually it's great that I can see it because I haven't seen the new chamber.
My first question in particular was, “What's happening with the metals in the coils? Are these metals being released as the e-liquid is being transformed into an aerosol?" The aerosol goes from the e-liquid that is here.
It's being vaped.
And the vapor now is collected into the tube.
What they found in early testing was troubling.
We found lead, quite high levels of lead.
And we know that lead impacts IQ in young people.
In addition to cognitive problems, it's also cardio-toxic.
It's bad for the heart.
They also found another metal: manganese.
We know it's related to Parkinson's disease with very well-known neurological effects.
So effects affecting the brain.
So I think the consequences of these early health effects to youth are extremely serious that we need to really look very carefully.
According to the 2017 Minnesota Youth Tobacco Survey, about 40% of all high school kids in Minnesota have tried an e-cigarette like this one.
This is absolutely an epidemic.
I've never seen a tobacco-related product spread across this country as fast among young people as this product.
With media coverage of the teen vaping phenomenon blowing up, pressure was mounting on JUUL to act.
The New York Times said that it was brought to your attention early, it said teenagers had started picking up this product.
And that JUUL actually didn't respond right away.
Is that how you remember it? Is that true? No, in any instance where we were made aware of underage usage or, you know, concerning content online, we took action immediately.
We reached out to Instagram and all the social media sites to try to get their help in taking down this content, which could serve as a form of peer-to-peer kind of advertising for the product or for e-cigarettes.
JUUL was scrambling to clean up their online presence, but they were about to come under even more scrutiny.
There's an epidemic spreading.
Scientists say it can change your brain.
It can release dangerous chemicals, like formaldehyde, into your bloodstream.
It can expose your lungs to acrolein, which can cause irreversible damage.
It's not a parasite, not a virus.
It's vaping.
That's how you get through to kids.
Kids are going to experiment and engage in risky behavior.
Adults are not supposed to see that ad.
This ad is aimed at at-risk, vulnerable 12 to 17-year-olds.
For years, the Food and Drug Administration rules around e-cigarettes were pretty loose.
But in 2018, with the so-called teen e-cig epidemic raging across the US, the FDA launched a campaign of shock ads and clever PR initiatives.
Wherever kids are consuming media, they're gonna see these kinds of messages.
Don't get hacked.
Including in high school bathrooms.
Yes, your Food and Drug Administration is putting posters in high school bathrooms that say, “Strangely enough, some students come in here to put crap into their bodies.
” The FDA also started putting pressure on the teenagers' brand of choice.
The government has taken a new step in cracking down on the e-cigarette company JUUL.
In September 2018, agents from the FDA raided the JUUL offices in San Francisco, seizing more than 1,000 documents.
They wanted to find out if JUUL had deliberately marketed to teenagers.
What was their role in these social media campaigns? Whether or not they knew they were happening, whether they were instigated by the company, whether money changed hands, and whether they noticed the impact.
Six weeks after the raid, JUUL announced that they were shutting down their social media accounts and voluntarily removing certain flavors from retail stores.
We are absolutely against any use of our product by minors.
We have taken increasingly strict measures to try to drive those usage numbers down.
And we're committed to helping do so.
The FDA, while investigating JUUL, was also deciding how to regulate the industry as a whole.
The idea is, this shouldn't be an on-ramp for kids, but what about e-cigarettes being an off-ramp for adult cigarette smokers and helping addicted cigarette smokers switch? They considered an outright ban on flavors, which many believe attracted young vapers.
You know, the studies where kids say, "Flavors or nicotine?" They often don't even realize they're being asked to make a choice.
All they're telling you is that they like flavors.
But there are over 7,000 flavors.
The one thing we know is that virtually none of them had been studied for whether or not they help smokers quit.
But others were certain that flavored e-cigs were the key to quitting regular cigarettes.
My youngest customer is 21.
My oldest customer is 86.
I carry 33 flavors in my store.
I don't carry them in there because they don't sell.
A pack-a-day smoker will sit there and use strawberry shortcake.
And it took me a year total to get her 100% off of cigarettes.
But that's the flavor that worked.
Finally, in November of 2018, the FDA announced their plans.
The agency announced new guidelines for retailers selling flavored e-cigarettes.
They decided against a total ban on flavors in favor of a more measured approach limiting flavored e-cigarette pods and liquids to vape shops or stores with age restricted areas.
Meaning no more JUUL pods at the corner gas station.
We'll be going in to these retail establishments to see if the products are still being sold to kids at the same levels that we've seen in the past.
But if we don't see a change in the marketplace, we'll have to take additional steps.
In the US, the FDA had chosen a kind of middle road of regulation.
But just across the Atlantic we find an entirely different approach.
When you see somebody vaping, you either see a nicotine addict getting their fix, or you see a smoker who isn't smoking.
I've worked in public health for 30 years.
It makes my heart sing every time I see a smoker not smoking.
Britain has long been a country of smokers.
So the biggest cause of preventable death in England is smoking.
We have about six million smokers and about 70,000 deaths per year.
And worst of all, it affects our most disadvantaged communities hardest.
But in the last five years, smoking rates have fallen by about a quarter.
Gruesome PSAs on cigarette packs, high taxes, and a blanket no advertising policy have contributed to this decline.
And so have e-cigarettes.
In 2014, Louise Ross was a smoking cessation advisor with Britain's National Health Service.
When she first heard about e-cigarettes as a way to quit smoking, she was wary.
I had these fears that it would re-normalize smoking, that young people would get hold of them and start using them and become, you know, addicted to nicotine.
She's one of these rare people in public health.
She's a person who changed her mind about e-cigarettes.
The more I found out about vaping and e-cigarettes, the more I realized that my fears were unfounded.
That actually this was gonna be a hugely beneficial way of helping people to stop smoking.
So she took a radical step.
Louise and her team at the Leicester Stop Smoking Service would offer free e-cigs to help smokers quit.
Morning, chaps.
- How are you? - Ladies.
- Morning.
- How are you? Yeah, good.
You? Stopping smoking is one of the most difficult things that you can actually do.
People who smoke are acutely addicted to nicotine.
Our own Public Health England is putting out the information that electronic cigarettes are over 95% safer.
Now, that is huge.
- Thank you.
How are you? - Nice to meet you.
And you.
So I'm Tina.
I'm here to help you stop smoking.
Can you tell me why you want to stop smoking? Health.
My health.
- Really? - I can't breathe.
- Really? - I've smoked since I was 11.
I've done it for 31 years now, and I've just had enough.
I really need to give up.
With our standard care, our usual care of, say, nicotine replacement therapy and behavioral support, about half of our service users would actually quitat four weeks.
With e-cigarettes, we saw a significant increase in success.
So it was between 65 and 70 percent success rate.
And I thought that was remarkable.
The British model measures success as the transition from cigarettes to vaping.
And they're pragmatic about what this means.
E-cigarettes aren't completely safe.
Nobody in their right mind says that e-cigarettes are completely safe.
But compared to smoking, compared to something where half of lifelong users of a product will die directly as a result, plainly, vaping is much less harmful than smoking.
Tina is a specialist advisor for pregnant smokers.
And 20-year-old Chloe is one of her patients.
It's peer pressure, really.
All my friends were older than me, so they smoked.
I started my first puff at ten and never stopped until now.
The most I was smoking was when I was pregnant with my daughter, and I was smoking between Forty to sixty fags, if a bad day.
Thirty, forty fags, good day.
Chloe is now pregnant with her second baby, and she's been working with Tina for the last six weeks.
- Do you love your vape? Yeah.
- Yeah.
- Which flavors do you like the best? - Blueberry and blackjack.
- Oh, and banana split.
- Banana split? Cor blimey, the amount they have is unbelievable.
- So, you've not had a cigarette since? - Nope.
I know you've got a really good reason.
- You're how many months pregnant? - Six months.
It's important to you 'cause, look, - whatever you have, Baby has.
- Yep.
And smoking, you're giving Baby loads of chemicals.
And that's not fair.
- No.
- And the baby has no choice, whereas you do.
When we see pregnant women, we are desperately trying to stop them smoking because when you take smoke or carbon monoxide into your lungs, basically it goes to your baby.
So, if we can stop that, then that baby is going to be born with healthier lungs, a healthier heart.
It is really important because it's helping people stop the harmful part of the addiction.
There is some early evidence that nicotine may adversely affect the developing fetus.
But in the UK, that risk is always weighed against the risks of smoking cigarettes, which are much greater.
So, can we do your carbon monoxide monitor? Carbon monoxide is one of the most harmful chemicals in cigarette smoke.
It's linked to low birth weight, stillbirth, miscarriage, and sudden infant death.
Take a deep breath in now.
Hold it.
Blow when it says "nought.
" This test is a way for Tina to make sure that Chloe has truly quit smoking.
Oh, my, look at that! Nought.
Your baby's in nought as well.
So isn't that fantastic? Nothing nasty inside your baby, 'cause you haven't either.
So well done.
- So, do you know what you're having? - Girl.
A girl.
What does your fella want? - He wanted a boy.
- He wanted a boy.
- Yeah, but Yeah.
- You only get what you're given.
I think there are some people who, no matter how strong the evidence, will always find a reason not to encourage people to vape.
So you said you liked blackjacks.
I'm going to put a blackjack flavor on here for you.
They're very averse to the idea of recreational nicotine.
- See what you think to that one.
- You know at the end of this day, are you likely to go home and open a bottle of wine, or pour yourself a beer, or have a strong coffee? - That's quite nice.
- Yeah.
People are realizing that, yes, you know, they've got their own vices.
And I think there's something deeply moralistic about this distaste for nicotine.
I say to advisors in Stop Smoking Services, "We are a stop smoking service.
We're not a stop nicotine service.
" Look, if the choice is between e-cigarettes and fresh air, choose fresh air.
If the choice is between e-cigarettes and smoking, choose e-cigarettes.
The British approach has helped around one-point-five million people kick the habit so far.
But unlike in the US, there's no teen vaping problem.
In the UK, they're not allowed to advertise these products at all.
So that the kind of social media marketing that JUUL used, that led to such massive use of this product, wouldn't be permitted.
There's also a limit to the amount of nicotine allowed in the e-liquid.
When JUUL launched in the UK in the summer of 2018, it did so with less than half the nicotine of its US launch.
And that might be part of the reason why we haven't seen the same increase in e-cigarette use among young people in the UK.
To young mom Chloe, quitting smoking has been life changing.
My heath is better.
My asthma is better.
I've got more energy.
I feel clean.
I don't feel like I have to wait ages for my daughter to play with me.
I can play with her.
Everything is better.
So, there are important lessons to be learned.
One of them is that there is a potential for reducing death and disease from tobacco by introducing harm-reducing products in controlled environments delivered by doctors, delivered after scientific research, and with serious constraints on the marketing of the product.
What we've also learned is that in the absence of that, of those kinds of regulation, the kind of Wild West we have seen in the United States, you see a very different result.
A Big Tobacco company is buying a 13-billion-dollar stake in San Francisco e-cigarette maker JUUL.
In 2018, Altria, the company that spun off Philip Morris International, placed a massive bet on e-cigarettes.
The merger between one of the biggest tobacco companies and the biggest maker of e-cigarettes comes just two days after the surgeon general declared that e-cigarette use among teens is officially an epidemic.
This makes total sense from Altria's standpoint.
It gains access to the most successful e-cigarette product and the product that probably has the greatest potential to eat into its cigarette market.
Its a win-win.
We see this as a very powerful partnership.
We will have access to their shelf space at retail locations, which is otherwise off-limits to us, because it's tied up under years-long contracts with Altria.
So we will be able to place JUUL right next to Marlboro.
In addition, we are going to have advertisements for JUUL inside and on the cover of packages of Marlboro.
So we'll be able to market to smokers, the very target audience that we're hoping to address, in a hyper-targeted way with Altria's help.
The Altria deal for JUUL is a real ethical loss.
They positioned themselves as in opposition to these dangerous, stodgy cigarette companies.
However, the financial incentives are absolutely clear.
With the Altria deal, JUUL's valuation more than doubled overnight.
Altria says that its investment will boost JUUL's value to 38 billion dollars, making it more valuable than Ford, Delta Airlines, or Target.
They get access to a sophisticated lobbying arm, logistics, distribution.
You know, being insulated from scrutiny by this company that has been successful for decades.
But if you claim that your product cares about public health, how could you possibly justify that? If you're over 18 and you're out of high school, then I don't care who JUULs.
I don't care who vapes.
To be honest with you, good luck.
But if you're 16 years old, it's just not right.
The e-cigarette was created to save smokers from the deadly business of Big Tobacco.
But now, Big Tobacco has essentially co-opted their biggest rival.
Let's be honest, JUUL's largest single outside shareholder is now a cigarette company.
And with that, kids today are putting money into the same pockets that their parents and grandparents did generations before them.
The worst part about it really is, like, just the money part, honestly.
That's what people complain about the most.
I'm still confused on how I afforded paying for a JUUL when I was a sophomore.
I was given a little amount of allowance.
So, basically, I would spend, like, all the money I had on pods.
Like, there's friends of mine who probably go through, like, five pods in a week.
That's probably the average, I would say, for people that are actual JUULers.
I'm gonna just do it.
So five times five $25.
Times 52 weeks.
Oh, my God.
For, like, someone who rips the JUUL that much, that's 1,300 dollars for a year.
Like, that's insane.
For kids our age, like, that's insane.
He kinda looks like a younger version of Justin Bieber.
- Like, when Justin Bieber was younger.
- Are you serious? For these teenagers, the excitement of the JUUL has long worn off, and they're looking to kick the habit.
I honestly don't think it's possible to quit now in this environment, because of just how many there are around, and when you see it in front of you and see people ripping in front of you, you're going to have the urge to do it.
Me and Lisa always talked I did quit for about a month or two, just because I hated spending the amount of money.
And I realized it was kinda dumb just to be using a JUUL all the time.
But just seeing it around everywhere you go, like, you just kinda get drawn back into it.
I honestly only vape because I think that I'm addicted.
I don't like it besi I just really don't like it.
I wish I did not do it.
It's just so hard to just stop for good.
The damage is already done to an entire segment of this generation.
And so what are we gonna do to help them? I wonder if you know of any initiatives.
I mean, just like helping the kids that now are addicted to JUUL to quit? So, I think that that's best left in the hands of people who work in public health to help families and teens with substance dependence issues.
Parents and teachers have a vitally important role.
But it's unfair for us to ask parents to solve a problem if the government doesn't step in and do its job.
A mother and father shouldn't have to be up against mango-flavored social media advertising.
If we give parents a level playing field, I have confidence that they will win.
But that's our job, is to make sure the playing field is even, and it's not today.

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