An article examining the motivations behind the pending merger between cigarette company Altria and e-cigarette company Juul Labs was released by Georgetown University School of Medicine professor of oncology David Levy on Sept. 4 amid national conversation surrounding the possible dangers of flavored e-cigarettes.

In the merger, Altria, the producer of Marlboro cigarettes, would purchase 35% of Juul Labs, an e-cigarette company, providing Juul with potential legal and regulatory experience and guidance, improved market prospects and increased sales, according to Levy’s article published in the British Medical Journals. However, much remains unknown about the deal’s impact on future cigarette use and Juul. The acquisition should trigger careful oversight of the nicotine delivery market on the part of the Food and Drug Administration, according to the article.

The merger shines light on the urgency of an oversight on the nicotine industry, Levy said in a phone interview with The Hoya.

“Regardless of one’s views on harm reduction, the Altria-Juul Labs deal should serve as a wake-up call on the need to carefully monitor competition in the nicotine delivery market, and evaluate how regulations and policies impact cigarette and noncigarette firms selling alternative nicotine delivery products,” Levy said.

Juul Labs caused harm in their initial marketing strategy in targeting young consumers by marketing a variety of flavors. However, the full health effects of vaping remain unknown and require further research, according to Levy.

“I think vaping is a concern, especially Juul because Juul is really high in nicotine and therefore has more potential to be addictive,” Levy said. “At the same time, we don’t yet know how addictive Juul is, and so I think we need to study what’s going on now.” 

The journal published Levy’s article just days before the FDA condemned Juul Labs in a Sept. 9 press release for their marketing practices, including those targeted toward students. President Donald Trump also announced that his administration would pursue a national ban on most flavored e-cigarettes, excluding tobacco flavors, Sept. 11. 

To address health concerns around vaping, the government should raise the age to purchase all nicotine products to 21 instead of limiting flavor access, according to Levy. Restricting flavor access might discourage those trying to quit cigarettes from switching over to other less harmful e-cigarettes, he said. 

“Until we know more we should be careful, for example, limiting the flavors can do more bad than good but these are things we need to understand better before the government makes policies,” Levy said. “I think the government needs to present better information that vaping is potentially addictive, that is is much less harmful than cigarettes but at the same time, nicotine has more of a harmful effect on youth and young adults.”  

Last year, Georgetown University officials announced that smoking and other tobacco products, including e-cigarettes, will be prohibited on university-owned buildings and grounds effective Aug. 15, 2020. The commitment to a tobacco-free campus came after years of student advocacy to ban the products on campus that led to a 2016 schoolwide referendum on the topic, in which 49.6% of participating voters cast a ballot in favor of the ban. 

Although the university should not expedite its tobacco ban, Georgetown should educate students about vaping health risks, said Casey Kozak (NHS ’20), the Georgetown University Student Association policy chair for student health. 

“I think students should be aware of the possible risks and false advertisements related to vaping, as mentioned above,” Kozak wrote in an email to The Hoya. “I think the vaping industry should be closely monitored and regulated, and that users should stay informed with news and emerging data related to vaping.” 

Georgetown’s tobacco ban initiative, which remains set for next August, aims to support the health of the entire university community, according to Associate Vice President for Benefits, Payroll and Wellness and Chief Benefits Officer Charles DeSantis.

“Our concern is for the whole of our student body, faculty, staff and visitors and the new policy encompasses a place that is free of tobacco and smoke including e-cigarettes like the juul,” DeSantis wrote in an email to The Hoya.   

Last year, 5 million minors reported recent e-cigarette use, and approximately 25% of American high school seniors reported vaping in the past 30 days, according to Health and Human Services Secretary Alex Azar II, up from 20% last year. In 2019, the Centers for Disease Control and Prevention found about 380 confirmed and probable cases of vaping-related illnesses in 36 states and the U.S. Virgin Islands. 

Many of those deaths and illnesses might be connected to e-cigarettes that also dispense marijuana THC and cannabis-related substances, according to health officials in California. Marijuana is more of a health concern than vaping for students, according to Levy. 

“I, for one, view vaping as quite low risk,” Levy said. “Marijuana has addictive aspects also. It is inhaled into the lungs so it is not good for a health standpoint there either and it has clear effects on people’s cognitive abilities than vaping does.”