In early February, representatives of e-cig giant JUUL Labs showed up at a council meeting of the Cheyenne River Sioux in South Dakota with some free vapes.
They pitched local power-brokers on encouraging members of the tribe to ditch traditional cigarettes and trade them in for their electronic products as part of a so-called "switching program." But the council quickly rebuffed the offer, recalled Rae O'Leary, a public health analyst who works with them, and helps run the Canli Coalition, a group dedicated to raising tobacco awareness among the tribe. (Her husband and children are members, while she belongs to the Turtle Mountain Band of Chippewa in North Dakota.)
The rejection probably shouldn't have come as a surprise. According to the Centers for Disease Control and Prevention, "American Indians/Alaska Natives have the highest prevalence of cigarette smoking compared to all other racial/ethnic groups in the United States," and advocates like O'Leary are concerned any progress made in recent years might vanish thanks to the explosion of JUUL. Now, she's working to help pass a council resolution that would block the tribe from accepting money or sponsorship from any e-cigarette company—a "proactive way," she said, "to prevent any deals with them." It was part of a larger effort to address the fact that e-cig use isn't just a problem in white suburbia, experts and advocates said.
"Anytime part of the tobacco industry targets Native tribes, it raises a lot of alarms," said Natalie Hemmerich, a staff attorney with the Public Health Law Center at the Hamline School of Law in Minnesota who assists the tribe on legal affairs. "It has a history of predatory behavior."
On Wednesday, O'Leary took her case to Washington, testifying on the first leg of a two-day hearing held by the House Oversight Subcommittee on Economic and Consumer Policy looking at JUUL's potential culpability in what the Food and Drug Administration has labeled an "epidemic" of teen vaping. One of JUUL's co-founders, James Monsees, was set to testify Thursday.
The company's tactics toward Native Americans, it should be noted, did not appear to be massively different from its approach to other demographic groups. JUUL has been touting its device largely as a means to get people off traditional tobacco; some advocates explicitly frame it as "harm reduction." But the hearing has helped intensify scrutiny of the brand, with students testifying that JUUL went into their classroom to promote the product as "totally safe."
"This reminds me of how our opioid epidemic started: American companies developing a product and go about trying to make a profit," said David. A Patterson Silver Wolf, an associate professor at Washington University in St. Louis and an expert on drug addiction in Native American communities. "Big Pharma, like Big Tobacco, pays folks to push their product knowing that once people start using that product, a certain percent of them will become addicted to it. Just like Big Pharma targeted vulnerable people in West Virginia, it seems JUUL's business strategy is to target Native American communities. In reality, it is a very small investment for JUUL to pay people in the short run to addict people in the long run."
In the short run, it's been a rough few months for JUUL, at least from a PR standpoint. Last week, Kevin Burns, the company's CEO, apologized on a CNBC documentary to the parents of addicted children. In December, Altria, one of the largest producers of tobacco in the world, bought a 35 percent stake in the company, and with its help, JUUL just spent $1 million in lobbying in a single quarter for the first time, Forbes reported. Meanwhile, a federal judge recently ordered the F.D.A. to review JUUL's application for approval—it remains available for sale only on a provisional basis—much more quickly than planned.
Still, the company's approach to Native Americans seemed to touch a nerve amid centuries-old concerns about colonization and mistreatment of Native Americans at the hands of corporations, not to mention the United States government.
In a statement, Ted Kwong, a spokesperson for JUUL Labs, acknowledged that some employees had met with Native American leaders in regards to the switching program, though he said the company ceased contact this past March with the tribes in question
"Given the high smoking population among Native Americans, particularly compared to the total U.S. population, the intent of these programs was to provide Native American tribal members who were known smokers (21 years or older) with access to JUUL products, for purchase, to facilitate their switch from combustible use," he wrote in an email. "As contemplated, each tribe would have managed their own program, with support from the company. None of these programs was ever implemented."
Though Rae rejected the idea that Native Americans have been ignored amid growing public scrutiny of e-cig use, she said she believed JUUL to be going after those especially susceptible to addiction.
"I have just been skeptical of JUUL's behavior," she said. "They're preying on many at-risk populations, and we just happen to be one of them."
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