Researchers and academics say e-cigarette companies have largely borrowed from Big Tobacco’s playbook and employed many of the same advertising tactics, such as targeting youth and making dubious health claims. Although it took decades to expose cigarette companies’ deceptive marketing, the recent surge in teen vaping and the emergence of vaping-related illnesses have prompted health officials, lawmakers and the general public to respond with more urgency this time around.
Two young women, smiling and wearing jackets, pose suggestively with their left hands on their hips.
Both hold a small, skinny item in their right hands.
One woman is shown in a 1993 print advertisement for a cigarette company; the other in an e-cigarette ad from 2015.
Twenty-two years apart, the similarities are easy to spot.
"Why reinvent the wheel?” asked Dr. Robert Jackler, a head and neck surgeon and founder of Stanford University Research into the Impact of Tobacco Advertising. "The e-cigarette market uses very similar themes to traditional tobacco."
Researchers and academics say e-cigarette companies have largely borrowed from Big Tobacco’s playbook and employed many of the same advertising tactics, such as targeting youth and making dubious health claims.
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Although it took decades to expose cigarette companies’ deceptive marketing, the recent surge in teen vaping and the emergence of vaping-related lung illnesses have prompted health officials, legislators and the general public to respond with more urgency this time around.
The similarities between the two approaches of the very intertwined products have allowed people to "have a frame of reference" as to what might be happening, said Desmond Jenson, an attorney with the Public Health Law Center in Minnesota.
"There was a colossal level of deception that (cigarette companies) proffered for decades,” said Jenson, who specializes in tobacco-related issues. "That was the beginning of the sea change in the American consciousness about our expectations for companies.
"The shift probably is not the sole reason, but fast-forward to today and you see a company like Juul — what’s happening on social media, youth use and it does not take a huge leap. I do see echoes."
One of the most alarming is the marketing campaigns targeting youth, experts and health-care professionals say.
Sarah Milov, an assistant professor of history at the University of Virginia who has written a book about the tobacco industry, said, "it was very well-documented" that officials at cigarette companies recognized the importance of attracting young people.
"They all knew the brand at initiation (when they first started smoking) was very important," she said, "and the initiation age was before age 18."
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Ads targeting youth included the Camel company’s "Joe Cool" campaign in the 1980s, using a camel with sunglasses and a leather jacket.
In recent years, the e-cigarette companies have marketed flavors such as bubble gum and gummy bears, which experts say clearly are aimed at young people.
And those efforts have been effective. According to the federal Centers for Disease Control and Prevention, one in five high-schoolers had vaped in the past month. And in mid-2017, the number of e-cigarette users 25 and younger surpassed the number of older users.
That has spurred health officials to look more closely at the issue.
In 2014, the Food and Drug Administration funded 14 research centers nationwide, including Ohio State University’s Center of Excellence in Regulatory Tobacco Science (the FDA funding ended in 2018 and it has been renamed the Center for the Advancement of Tobacco Science. It's currently being funded by the Ohio State University Comprehensive Cancer Center).
"One area (the FDA) specifically called out is they need information on how the tobacco industry is marketing and advertising, particularly to adolescents,” said Amy Ferketich, an OSU professor of epidemiology who works at the center.
Ferketich and her group have produced several reports illustrating how e-cigarette companies use themes similar to those in cigarette ads, mainly sex appeal and social acceptance, and their effectiveness in reaching teens.
Milov also pointed out the striking similarities between cigarette and e-cigarette advertising when it comes to making health claims.
For example, a 1946 ad stated, “More doctors smoke Camels than any other cigarette.” A 2013 ad for Vape Club e-cigarettes features a smiling man in a white lab coat and stethoscope, with the claim that its product contains none of the 4,000 harmful chemicals found in cigarettes.
“The idea is that they are getting close to making a medical claim,” Milov said. “They are not saying doctors are suggesting that you make the switch (to e-cigarettes), but they are trading on the idea that e-cigarettes are supposedly less harmful.”
E-cigarette companies have said their products are intended for adult smokers who want to switch to a less harmful product, or help wean them off tobacco altogether — and that they never marketed to youth.
Though JUUL's earliest ad campaign in 2015 ("Vaporized") was intended for smokers ages 25 to 34, a JUUL Labs spokesman said the campaign, which lasted less than six months, was perceived differently and they've worked to avoid further misconceptions in an effort to keep nicotine out of youths' hands.
"Our recent marketing efforts exclusively featured adult smokers who shared their personal experiences about switching to JUUL products from combustible cigarettes — all conveyed in a style, tone and message tailored to current adult smokers," an emailed statement from JUUL said.
Milov said that the claim e-cigarettes are only for adult smokers who want to switch has kept legislators from reacting more quickly to regulate e-cigarettes.
“I think policymakers were hopeful that the promises that e-cigarette makers made were true,” she said. “They wanted to believe that e-cigarettes could be a cessation tool.
“Unfortunately, they did not consider the obvious — that is when you are advertising cotton candy and black cherry flavors, that is not about hardened smokers needing to make the switch.”
In November 2018, Juul ceased sales of all flavorings except mint and menthol in retail stores and more recently did the same online (United States only). Earlier last year, it also suspended social-media promotion of its products. In September, the company stopped all broadcast, print and digital product advertising in the United States.
Jackler, the surgeon and professor from Stanford, has been studying the impacts of tobacco advertising for 15 years: His collection of tobacco ads, which is housed at the Smithsonian's National Museum of American History, spans roughly a century and contains more than 50,000 pieces.
He began archiving them after his mother, a smoker, was diagnosed with lung cancer. He wanted to learn why she began smoking.
“She said it was popular, sophisticated, and the thing to do,” Jackler said. “If you weren’t smoking, then you weren’t cool. I wanted to learn, ‘How did we create this culture?’”
Many of the ads in Jackler's collection appeal to young people, he said, and do not specifically target the older smokers that e-cigarettes should address.
Rampant use by youths is what is driving officials to address vaping, said Jenson, of the Public Health Law Center.
And he’s hoping the spotlight on e-cigarettes brings a renewed interest in looking at the entire tobacco industry: 35 million Americans still smoke cigarettes and they’re still the largest cause of preventable death in the country, with a half-million people dying from them annually, according to the CDC.
“My silver lining with all of this,” he said, “is that we as a nation take a look at tobacco use as a whole and finally end that epidemic.”