Broken (2019–…): Season 1, Episode 2 - Big Vape - full transcript

Initially designed for adult use, vaping has addicted teens to nicotine, thanks to hipster ads by startups like Juul. Now Big Tobacco's cashing in.

[joyfully]
You all ready to see some tricks?

[crowd cheering]

[cheering] Hell, yeah!

- [crowd cheering]
- [applause]

[narrator] Vaping, once the obsession
of eccentric hobbyists,

has gone mainstream.

Smokers have been switching over
to e-cigarettes

at a hell of a rate.

[woman] I know you've got a good reason
because you're how many months pregnant?

Six months now.

[narrator]
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.

[narrator]
But in the US, there's one big problem.

- [girl] Bella, your locker.
- [Bella] Oh, yeah.

[narrator] Teenagers.

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.

[narrator]
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.

[narrator] Meanwhile, Big Tobacco
is poised to take over the industry.

[man] We want to remove
combustible cigarettes from the world.

That's what we call a smoke-free future.

[woman] 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.

[man] 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.

[theme plays]

[girl 1] Where's my old jeans?

- [girl 2] Your jeans?
- [girl 1] Yes.

[girl 2] I mean, I have my jeans

in the laundry room,
but I don't know where yours are.

[girl 2] I really like that shirt.

- Thank you.
- You're welcome.

[girl] 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.

[Bella] You're just sort of like,

“I might as well.
Like, one more time won't hurt.”

[uplifting piano music playing]

[narrator] Bella is a 17-year-old

high school senior
in Milford, Connecticut.

And she is addicted to e-cigarettes.

- [principal] Morning, Jose.
- [Jose] Morning.

- [woman] Will you sign that, please?
- [principal] Bless you. Yes, I can.

- [principal] Thank you so much.
- All right, no emergency. Thank you.

- [principal] Thank you. You too.
- [woman] Have a good day.

My name is Fran Thompson,

and I'm the Principal at Jonathan Law
High School in Milford, Connecticut.

[principal] Morning. How are you?

[students speaking indistinctly]

[principal]
The first time I saw an e-cigarette

on school property
was probably two years ago.

Hi, guys.

[principal] Morning.

[principal] I have found theater kids
vaping in the bathrooms.

Athletes, brainiacs. I have...
Take your pick.

Everybody. Every group.

[principal] Morning.

[narrator]
Jonathan Law High School is not alone.

Teenagers are vaping in high schools
all over America.

[man] 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.

[narrator] 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.

[Matthew] 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.

[woman]
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.

[indistinct chatter]

[narrator]
While e-cigarettes, especially the JUUL,

are considered cool among teenagers,

regular cigarettes are not.

[Matthew] 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.

[principal]
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!"

[horn honking]

[Bella] Oh, my gosh,
I would never smoke a cigarette.

I would never smoke a cigarette,
and none of my friends have.

[girl]
I think cigarettes are kind of gross.

- [Bella] 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.

[suspenseful music plays]

[monster screams]

[slams]

[Bella]
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.

[dramatic music plays]

[speaks with effort and hoarsely]

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."

[Matthew] 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.

[suspenseful music plays]

[narrator] Cigarettes have been
big business for over a century.

But their popularity exploded
after World War II...

[actor] You know I don't want you to quit.

[narrator] ...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.

[coughs badly]

But by that time,

everyone, including Big Tobacco,

was fully aware
that cigarettes were deadly.

[doctor]This is a normal, healthy lung.

And here's what it looks like
after 30 years of heavy smoking.

[narrator] 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?
- [hearing attendees] I do.

[attendee]
The data that we have been able to see

has all been statistical data
that has not convinced me

that smoking causes death.

[representative]
Do you believe nicotine is not addictive?

[man 1]
I believe nicotine is not addictive.

Cigarettes clearly do not meet
the classic definitions of addiction.

[man 2] I don't believe that nicotine
for our products are addictive.

[man 3]
I believe nicotine is not addictive.

[man 4]
I believe that nicotine is not addictive.

[man 5]
I believe that nicotine is not addictive.

[man 6] And I, too, believe
that nicotine is not addictive.

[music fades out]

It was so obvious to everybody
who was in the room

and everybody who saw it on television
that they were lying.

[crowd yells] Shame!

[Matthew] 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.

[narrator] Public opinion
was turning against Big Tobacco.

[crowd yelling]

[narrator] People all over the world

were also realizing just how hard
it is to kick the habit.

[melancholic music plays]

[man, in Chinese]
I quit smoking once, for a week.

But after a week, I couldn't stand it,
and I started smoking again.

[narrator] 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.

[Hon Lik, in Chinese]
This prototype could be called the embryo

of electronic cigarettes.

[indistinct chatter, horn honks]

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.

[narrator] 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.

[in Chinese] At that time,
it wasn't about being cool.

Smoking was a way to relieve exhaustion...

and loneliness.

[narrator]
While Chinese youth may have smoked

for different reasons
than their American counterparts,

the result was the same:

a generation hooked on tobacco.

[Hon Link, in Chinese] 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.

[laughs]

[narrator] But in 2002, Hon Lik received
some life-changing news.

[in Chinese] As my father got older,
at the age of 77...

[dramatic organ music plays]

he was suddenly diagnosed
with lung cancer.

At that time, the doctors said that...

smoking was the cause of his disease.

[narrator]
Hon Lik knew he had to quit smoking,

this time for good.

So he tried using a nicotine patch.

[Hon Lik, in Chinese] At first,
this product was very effective for me.

But when I saw someone smoking,
I couldn't help wanting to smoke.

[narrator] The patch helped
with the nicotine cravings,

but he still missed the ritual of smoking.

[Hon Lik, in Chinese]I wanted to design

a device that delivered nicotine
to the human body more like a cigarette.

[in Chinese]
This is the electronic cigarette

that I used to experiment in 2003.

[narrator] Hon Lik's prototype

would become the inspiration
for all future e-cigarettes,

including the JUUL.

[intriguing music plays]

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.

[in Chinese] Press it and puff
on the electronic cigarette once.

Press it and puff once.

[music continues]

[narrator] Vaping offered a sensation
similar to smoking,

but without the thousands of chemicals
found in cigarette smoke.

[man in commercial] Including alkaloids,
arsenic, aldehydes, and others.

Many of these are deadly poisons.

[narrator] 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.

[Hon Lik, in Chinese] This is the first...

mass-produced electronic cigarette
we introduced to the Chinese market.

It was a successful e-cigarette product.

[narrator] Hon Lik's father lived
just long enough

to try out his son's new invention.

[in Chinese]
He felt very happy, very good.

[narrator]
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.

[Hon Lik, in Chinese]
I realized that this product

was of great social value

and would be important for public health.

It was a meaningful product.

[narrator] It would take another
couple of years before the e-cigarette

found its way into the US market.

[music fades out]

[man] 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.

[man]
Good thing I won at blackjack last night.

[passenger laughs]

- [man 1] How's it going?
- [man 2] Good. And you, sir?

[man 1] Very well. Thank you.

[narrator] 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.

- [Kurt] Thank you.
- [woman] Thank you.

[Kurt] 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.

[Kurt] Warning.

[Kurt laughs]

In case you didn't know already,
nicotine is addicting.

[Kurt chuckles]

[woman] So where are we going?

[Kurt]
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.

- [Kurt] So I guess we'll put it...
- [woman] Yeah, just in the middle.

[narrator] They were known as ciga-likes

for the way they mimicked
regular cigarettes.

[Kurt] 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.

[narrator] But then came a key innovation

that almost made up
for the low nicotine levels:

flavors.

[Kurt]
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.

[man]
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.

- [Kurt] 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.

[Kurt] 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.

[guys chattering]

I would say most of the room
is former smokers, at least 90% of them.

[narrator] 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.

[narrator] 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.

[narrator]
But it wasn't just e-cig entrepreneurs

who saw the potential
in this new industry.

[dramatic music plays]

Philip Morris International

is one of the biggest tobacco companies
in the world.

In 2018, they shipped
740 billion conventional cigarettes.

[man] So here on the left, you have
the three main varieties of tobacco.

[narrator]
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.

[man] 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.

[beeping]

[narrator] Serge Maeder leads
the product research group at PMI.

[Serge] 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.

[interviewer] 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.

[intriguing music plays]

So we can fuel innovation
by selling cigarettes.

[narrator]
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.

[compressed air blowing]

[Serge]
The IQOS device is being triggered.

And then you can see the puff.

[narrator] And their version
of the e-cigarette, the IQOS MESH.

[Serge]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.

[narrator] 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.

[Serge] 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.

[narrator] 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.

[swiveling mechanism running]

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.

[narrator] 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.

[Matthew] 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.

[narrator] By the end of 2014,
many feared the vape industry,

once fiercely independent,
was being taken over by Big Tobacco.

[seabirds chirping]

[lively guitar music plays]

But in the San Francisco Bay Area,

two grad students
were about to launch a product

that would turn
the entire industry upside down.

[man] 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.

[narrator]
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.

[Adam in video] It turns out that actually
burning tobacco is the real problem. So...

[narrator] They spent the next decade
improving the device

and the e-liquid formula.

[Adam] So previously, all e-cigarettes
were using nicotine

in its free base form,
which is just pure molecular nicotine.

[narrator] 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.

[narrator] 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.

[narrator]
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.

[narrator] This meant the JUUL packed
more nicotine per puff

than many of its rivals.

[Adam]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.

[narrator] They started with four
carefully curated flavors in colorful pods

and in 2015, the JUUL was ready to launch.

[upbeat music plays]

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.

[Nitasha] Bright colors,

20-somethings who could easily pass
for 15-somethings.

They had you, know, young people
on their Instagram account using JUUL.

[narrator] The campaigns
were soon all over social media.

[Matthew] 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.

[music fades out]

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.

[narrator] But it may have been too late.

[school bell tone ringing]

By that time, JUUL already had
a brand-new fan base:

teenagers.

[Bella] Hey, friends.

- [girl] Bella, your locker.
- [Bella] Oh, yeah.

[girl] 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.

[Bella] My freshman year, so this was,
like, three or four years ago,

I was at this place in Milford,
it's called Lexington Green.

[seabirds chirping]

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."

[Cali] They're like, "It's just
water vapor, it's so you can do tricks."

[Ally]
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 [laughing] kids talk about.

[suspenseful music plays]

[narrator] 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.

[Cali] 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.

[narrator] 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.

[Ally] 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.

[music fades out]

[Bella]
When I first started ripping a JUUL,

like, I didn't realize that it was
highly addictive. I had no clue at all.

[girl] '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.

[Nitasha] There are studies that show
that 63% of people who smoke JUUL

don't know that it contains nicotine.

[Matthew] 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.

[man in video] All right, now let's see
what's inside this.

[Nitasha]
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.

[man in video]
It's just a JUUL and the USB charger.

Let's just take that off.

[Matthew] 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.

[narrator] And some scientists say
the nicotine addiction itself

poses a serious threat.

[woman] 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.

[narrator] That's a critical time
for developing brains.

[Dr. Navas-Acien] 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.

[narrator] 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.

[narrator] That's where the high nicotine
content in the JUUL raises some concerns.

[Matthew] 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.

[school bell tone rings]

[narrator] 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.

[chattering]

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...

[narrator] 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.

[principal] 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.

[laughing] 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.

[dramatic music plays]

[principal] 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.

[chattering]

[Bella] 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.

[Ally] Has tried, I would say an easy 95%.

[narrator]
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.

[Dr. Navas-Acien] 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.

[narrator] 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.

[narrator] What they found
in early testing was troubling.

[Dr. Navas-Acien] 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.

[narrator] They also found another metal: manganese.

[Dr. Navas-Acien] 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.

[Matthew] 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.

[narrator] With media coverage
of the teen vaping phenomenon blowing up,

pressure was mounting on JUUL to act.

[interviewer] 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.

[narrator] JUUL was scrambling
to clean up their online presence,

but they were about to come under
even more scrutiny.

[female speaking on advert]
There's an epidemic spreading.

Scientists say it can change your brain.

[suspenseful background effects on advert]

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.

[clicks]

It's vaping.

[man]
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.

[narrator] 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.

[male speaking on advert]
Don't get hacked.

[Mitch]
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.”

[chattering]

[suspenseful action music plays]

[narrator]
The FDA also started putting pressure

on the teenagers' brand of choice.

[news reporter]The government has taken
a new step in cracking down

on the e-cigarette company JUUL.

[narrator]
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.

[Nitasha] 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.

[music fades out]

[narrator] 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.

[narrator]
The FDA, while investigating JUUL,

was also deciding how to regulate
the industry as a whole.

[Mitch] 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?

[narrator] They considered
an outright ban on flavors,

which many believe
attracted young vapers.

[Matthew] 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.

[narrator] 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.

[suspense music continues]

[narrator] Finally, in November of 2018,

the FDA announced their plans.

The agency announced
new guidelines for retailers

selling flavored e-cigarettes.

[narrator] 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.

[narrator] In the US, the FDA had chosen
a kind of middle road of regulation.

[dramatic violin music plays]

But just across the Atlantic...

...we find an entirely different approach.

[Martin] 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.

[dramatic music plays]

[narrator] 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.

[narrator] 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.

[narrator] 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.

[Louise]Morning, chaps.

- [man1] How are you?
- [Louise] Ladies.

- [man 2] Morning.
- [man 1] How are you?

[Louise] 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.

- [Tina] Thank you. How are you?
- [woman] Nice to meet you.

[Tina] 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.

- [Tina] Really?
- I can't breathe.

- [Tina] 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.

[Louise] 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.

[narrator]
The British model measures success

as the transition
from cigarettes to vaping.

And they're pragmatic
about what this means.

[Martin]
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.

[narrator] Tina is a specialist advisor
for pregnant smokers.

And 20-year-old Chloe
is one of her patients.

[girl] 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.

[narrator] 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.
- [Chloe] 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.

[Tina] 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.

[narrator] 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.

[Tina] So, can we do
your carbon monoxide monitor?

[narrator] 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."

[narrator] This test is a way for Tina

to make sure that Chloe
has truly quit smoking.

[Tina] Blow. Hard.

Excellent.

[Tina speaks cheerfully]
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.

[Tina laughs]

[dramatic music plays]

[Louise]
I think there are some people who,

no matter how strong the evidence,
will always find a reason

not to encourage people to vape.

[man] So you said you liked blackjacks.

I'm going to put a blackjack flavor
on here for you.

[Louise] They're very averse to the idea
of recreational nicotine.

- [man] See what you think to that one.
- [Louise] 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.
- [man] Yeah.

[Louise] 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.

[narrator] 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.

[Matthew] 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.

[narrator] 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.

[Martin]
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.

[narrator] To young mom Chloe,
quitting smoking has been life changing.

[Chloe] 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.

[Matthew] 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.

[suspenseful music playing]

[newsman] A Big Tobacco company is buying
a 13-billion-dollar stake

in San Francisco e-cigarette maker JUUL.

[narrator] 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.

[Matthews] 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.

[Adam] 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.

[narrator] 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.

[Nitasha] 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?

[principal] 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.

[narrator] 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.

[Matthew]Let's be honest,

JUUL's largest single outside shareholder
is now a cigarette company.

[narrator] 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 [chuckles]

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.

[girl] He kinda looks
like a younger version of Justin Bieber.

- Like, when Justin Bieber was younger.
- [Ally] Are you serious?

[narrator] For these teenagers,

the excitement of the JUUL
has long worn off,

[girls chattering]

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...

[Ally] 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.

[Bella] 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?

[interviewer] 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.

[Matthew] 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.

[seabirds chirping]