“Big Vape” is well worth reading

As I said in my review of Lauren Etter’s history of Juul, The Devil’s Playbook, my definition of a good book on tobacco is that I learn things I didn’t already know from reading it. Even after reading Etter’s book, Jamie Ducharme’s Big Vape is a good book.

While all the key major events appear in both books, the focus of the narratives is different. Ducharme focuses on the details of what went on inside Juul. She in particular has more details on the company’s evolving culture and the fits and details the fits and starts in the process of actually developing the product.

One important detail in the book was Juul co-inventor James Monsees‘ work on two-way communication with the Juul device that would allow Juul to collect data on details of user puffing patterns. The communication would allow Juul to remotely adjust the device to make it more addictive.   Ducharme reports that the new Altria-installed management stopped that work to avoid further controversy, it is not gone.  (Philip Morris’ heated tobacco product IQOS has bluetooth capability.) When Monsees (I think) and another Juul executive, Ashley Gould, met with Pam Ling and me as part of their charm offensive on kids, they asked what we thought of programming the device not to work in schools.  That means they can sense where it is and remotely control it.  Very scary.  I told them it was like Facebook merging with the Medellín cartel.

Indeed, on September 26, 2021 Vapebeat reported that the new Juul 2 will have bluetooth technology; Juul claimed it was “evaluating new technologies and features to help keep JUUL out of the hands of young people.” As noted above, Juul could do a lot more with the data to increase addiction, sales and profits.

She also describes changes to the pods (to prevent leaking) as well as changes to the Juul device and software to improve performance that were made after the FDA deeming rule took effect and so only could be legally sold with FDA authorization. Juul did not disclose these changes to the FDA and the FDA has turned a blind eye to Juul flaunting the law.

Ducharme also includes details of how Juul interacted with people in the public health community who supported e-cigarettes for harm reduction. She also talks about people who were more skeptical, including me, but her sympathies seem more with the optimists.

She has some discussion of the research on health effects of Juul (and e-cigarettes), but it does not reflect the full range of research out there. (See, two major literature reviews that sum up hundreds of papers.) While it is not reasonable to expect any book to describe everything in detail, a little more would have strengthened and balanced the presentation.

The most interesting split among the people who thought Juul could be a good idea was around the issue of kids. As youth use took off, some, such as Cheryl Healton, became increasingly strong in telling the company that they needed to stop selling flavored products that were appealing to kids. When Juul repeatedly failed to take this advice, these people cut off engagement with Juul. Others remained engaged, viewing the tradeoff with youth as worth accepting because they believed in Juul for adult harm reduction

(A detail not in the book: I also had a long conversation with one of Juul’s top managers — I think it was CEO Kevin Burns — in a bar at the Society for Research on Nicotine and Tobacco meeting just as the youth issue was starting to explode where I told him the same thing: Leaving aside the question about whether or not e-cigs were a good thing for adults, the only chance that Juul had to deal with their “kid problem” was to get rid of flavors. And if they didn’t do that, public opinion would turn against them.)

The most shocking thing in the book was the fact that Iowa Attorney General Tom Miller, who has been a leader in fighting the cigarette industry, was participating in an advisory committee to Juul. I knew that Miller was sympathetic to e-cigarettes, but serving on such a committee was a surprise.

Anyone interested in the e-cigarette discussion should read Big Vape.

My one criticism: It would have been great for the book to have an index.

Published by Stanton Glantz

Stanton Glantz is a retired Professor of Medicine who served on the University of California San Francisco faculty for 45 years. He conducts research on tobacco and cannabis control and cardiovascular disease/

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