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U.S. authorities have launched a slew of investigations in warning against Juul for marketing to teens and claiming that e-cigarettes are safe. But Juul has also recently expanded overseas and into some lower-income countries, like the Philippines, that don't have as many regulations. Health advocates there worry that Juul will make up for the clampdown in the U.S. by ramping up what they say are questionable practices. NPR's Nurith Aizenman reports.
NURITH AIZENMAN, BYLINE: Juul launched in the Philippines this past June. Maria Encarnita Limpin says, overnight, the product was popping up in shops all over the capital Manila.
MARIA ENCARNITA LIMPIN: It's really, really alarming because it's like they mushroomed.
AIZENMAN: Limpin is a doctor specializing in lung disease and director of a nonprofit that has helped push through rules preventing the marketing and sale of cigarettes to minors in the Philippines. So she was horrified to see how visible Juul's vaporizers now are.
LIMPIN: You can actually see them in almost any type of stores.
AIZENMAN: At one of Manila's biggest convenience chains, she says, the new Juul displays are right at the entrance. Then, there was the placement of a Juul promotional kiosk.
LIMPIN: Yeah. So it was very near Baskin-Robbins, you know, that famous ice cream company.
AIZENMAN: And she says just like Baskin-Robbins, in its Philippine stores, Juul is offering an assortment of flavors...
LIMPIN: Mint flavor, mango flavor.
AIZENMAN: ...That seem tailor-made to appeal to teens.
Shane MacGuill studies the tobacco industry for the market research firm Euromonitor International. He says when it comes to international expansion...
SHANE MACGUILL: I think that's an important part of the business strategy for Juul.
AIZENMAN: The company is already in 20 countries, pretty much all of them wealthy. But this spring, Juul made its first foray into less well-off nations with its entry into not just the Philippines, but Indonesia. And MacGuill says Juul has been laying the groundwork to launch in many more.
MACGUILL: If you look at where the majority of tobacco and nicotine consumption takes place globally, it is in lower-middle-income markets.
AIZENMAN: MacGuill says, for now, most consumers in those less well-off countries can't afford Juul products. But he says Juul has been banking on the possibility that, eventually, incomes in those countries will rise.
MACGUILL: The strategy was really built around making sure that the brand was in a position to access that sort of potential growth.
AIZENMAN: And with Juul facing new scrutiny in the U.S., Limpin, the health advocate from the Philippines, worries that over the long term, Juul will end up shifting its focus to countries like hers. Already, she says, the company is behaving very differently in the Philippines compared to the U.S.
LIMPIN: They are making the Philippines as their dumping ground.
AIZENMAN: For instance, in the U.S., the Food and Drug Administration is investigating whether Juul's fruit and other nontobacco flavors constitute illegal marketing to kids and should be banned. In response, Juul has already voluntarily pulled these flavors from U.S. stores, but not the ones in the Philippines. Limpin says in her country...
LIMPIN: There's really no good law that will protect us from these kinds of tactics.
AIZENMAN: Also at issue, the messages Juul puts out about the safety of its product. Dr. Albert Rizzo is chief medical officer with the American Lung Association. He notes that vaping involves chemicals.
ALBERT RIZZO: Some of these chemicals are carcinogens very similar to the ones that are in regular cigarettes - now, maybe lower in content and lower in number.
AIZENMAN: But vaping is still a pretty new phenomenon.
RIZZO: So we really don't know what mid-to-long-term effects inhalation of these chemicals would lead to.
AIZENMAN: That means under U.S. law, Juul is prohibited from describing its product as safe or even saying it's safer than smoking. Last month, the FDA warned Juul that some of its marketing does just that, and the agency ordered Juul to stop immediately. But the company faces no such constraints in the Philippines. And Limpin says when her son approached a Juul kiosk in Manila, the salesperson told him that using Juul is safer than smoking because it won't cause cancer and no mention was made of any risks from vaping.
LIMPIN: They're actually marketing it like it's not going to cause any problems.
AIZENMAN: NPR asked officials at Juul why the company's practices around safety messaging and flavors appear to be different in the two countries. In a statement, Juul officials noted that the company recently appointed a new CEO. And they said both he and, quote, "the entire Juul Labs leadership team is continuing a broad review of the company's practices and policies to ensure alignment with its aim of responsible leadership within the industry."
Nurith Aizenman, NPR News.
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