Dr. Scott Gottlieb, commissioner of the US Food and Drug Administration, announced Tuesday a "blitz" on retailers for violations related to sales of Juul and other e-cigarettes to minors.
Forty warning letters were sent to brick-and-mortar retailers as a first step toward stopping underage use of e-cigarettes, the FDA said. The government agency also said it sent Juul Labs, the maker of an e-cigarette popular among teens, a request to submit documents related to product marketing and research, including information about "youth initiation and use."
"We don't yet fully understand why these products are so popular among youth," Gottlieb wrote in the public statement. "But it's imperative that we figure it out, and fast. These documents may help us get there."
Juul spokeswoman Victoria Davis said the company "agrees with the FDA that illegal sales of our product to minors are unacceptable. We already have in place programs to prevent and, if necessary, identify and act upon these violations at retail and online marketplaces, and we will announce additional measures in the coming days."
Electronic cigarettes (also called e-cigarettes or e-cigs), vapes, vaporizers and hookah pens are among the terms used to describe electronic nicotine delivery systems. These products use an "e-liquid" that may contain nicotine as well as flavorings and other ingredients. The liquid is heated into an aerosol that the user inhales. Some products resemble conventional cigarettes, but others look like pens or other ordinary items. Juul resembles an everyday flash drive, which may explain its popularity among teens.
The FDA has conducted 908,280 inspections of tobacco retailers, issued 70,350 warning letters and initiated about 17,000 civil money penalty cases in its efforts to fight the sale of e-cigarettes and other tobacco products to minors, it said Tuesday. For the current "blitz," the agency said, it also contacted one online retailer, which removed listings for Juul products and then voluntarily implemented policies to prevent future listings.
More than 2 million middle and high school students described themselves as current users of e-cigarettes in 2016 (the most recent year studied), according to a government report: about 11% of high school students and 4.3% of middle school students. Overall, e-cigarette use by high school students increased 900% from 2011 to 2015, according to a separate 2016 report from the US surgeon general.
In a recent Johns Hopkins Bloomberg School of Public Health survey, 81% of minors who currently vape said their primary reason for doing so is "availability of appealing flavors."
"Widespread reports of youth use of JUUL products are of great public health concern," Gottlieb said in the announcement. "Youth may not understand the nicotine or other characteristics of JUUL."
On March 20, the FDA issued a warning that it would act to end the use of e-cigarettes among minors.
Juul Labs' website tells the story of two founders, smokers and product designers who had become "increasingly dissatisfied with the health and social impacts of cigarettes" but could find no viable alternative and so created their own -- with "adult smokers in mind."
"We are working with the FDA, lawmakers, parents and community leaders to combat underage use, and we will continue working with all interested parties to keep our product away from youth," Davis said on behalf of the company.