After an investigation found the e-cigarette maker Juul Labs deliberately targeted young people using a variety of marketing practices, Tennessee is among the states that will benefit from the court settlement.

Juul has said its aim has been to "transition adult smokers away from cigarettes," but states argued that its advertising showed otherwise. Tennessee is one of 34 states that will share more than $438 million.

In addition to explicit advertising to kids, said Tennessee Attorney General Jonathan Skrmetti, the company is required to stop even so-called "subtle" forms of marketing through social media and other avenues "such as funding education programs, which let them put their name and the existence of their product in front of kids. They're not allowed to use people under the age of 35 in their marketing. So, they can't pay influencers; they can't use celebrities who are younger, who appeal to younger people."

He added that the company can no longer sell flavors that aren't approved by the Food and Drug Administration, or misrepresent the nicotine content in its products. Juul also will have to verify the age of its followers on Twitter and Instagram. Skrmetti said the settlement money will go into the Office of the Attorney General's Reserve Fund, to support ongoing consumer-protection efforts.

Skrmetti said the company's tactics, like those of big tobacco in previous generations, were aimed at creating a new crop of long-term customers.

"If they're adults and they choose to use these products, that is their choice," he said. "But when they're younger - when they're more vulnerable, when they're not in a position to make that informed decision - this settlement will protect them from the subtle manipulation that could otherwise turn them into lifelong consumers."

According to the Centers for Disease Control and Prevention, as of last year, around 2 million middle- and high-school students said they recently had used e-cigarettes.

Hundreds of millions of American young people are exposed to vaping and smoking in popular movies, TV shows and music videos each year, according to the 7th annual "While You Were Streaming" report from the nonprofit Truth Initiative.

Tobacco depictions are down in the most popular Hollywood shows but they are heavily featured in programs like The Bear, Euphoria, and Stranger Things.

Dr. Jessica Rath, a behavioral scientist and senior vice president of Truth Initiative, said youth and young adults are three times more likely to start vaping when exposed to tobacco imagery in shows.

"Animated shows remain a consistent offender," Rath emphasized. "Five out of six of the top 15 animated shows contain tobacco depictions and those are more popular with Gen Z than any other demographic."

The report found in 2023, 70% of binge-watched streaming shows contained tobacco imagery, a 6% increase from the year before. Shows fueling the increase included "American Dad," "Law & Order SVU," "Never Have I Ever," and "South Park."

Rath noted her organization is working with entertainment companies and state attorneys general to get information added before or after the shows, like you might see for suicide prevention.

"Companies can roll advertisements with tested prevention messaging or quit line resources up in the top corner when the content that they're showing contains tobacco," Rath suggested.

The good news is youth vaping is actually at its lowest rate in a decade but smoking in entertainment threatens to reverse progress.

Truth Initiative developed a free resource to help people quit: Text "EXPROGRAM" to 88709.

Kentucky will soon begin licensing retailers who sell nicotine, which advocates have said will help regulate an industry and protect minors from addictive chemicals.

Gov. Andy Beshear signed Senate Bill 100 into law earlier this week.

Griffin Nemeth, a student and coordinator for the iCANendthetrend Youth Advisory Board coordinator at the University of Kentucky, explained the legislation is no different from what's currently in place for retailers who sell alcohol.

"We're really just trying to make sure that tobacco and nicotine products are on par with what is already expected of some of these other establishments," Nemeth explained.

In a state where about 5% of high school students smoke and almost 20% use e-cigarettes, according to The Campaign for Tobacco-Free Kids, advocates said the new regulations are a welcome effort to curb tobacco use among minors. Data show smoking costs the state more than $2 billion every year.

Under the new law, Kentucky will license all retailers who sell tobacco and vape products, empowering the Department of Alcoholic Beverage Control to inspect and enforce rules for the businesses. Nemeth argued licensing is a strong tool to protect youth at the point of sale.

"We're now starting to see an increase in use of alternative nicotine products, like oral nicotine pouches, and we're still seeing pretty significant use of vapes and e-cigarettes," Nemeth observed.

The new law will also fine retailers who sell nicotine products to minors, and give half the money collected to a youth prevention program.

This story is based on original reporting by Sarah Ladd for the Kentucky Lantern.

Nebraska needs to do better when it comes to tobacco use prevention and cessation, according to a newly released report.

In the American Lung Association's 2024 State of Tobacco Control report, Nebraska received an "F" in three of the five areas rated. One is for tobacco prevention and cessation funding.

Michael Seilback, national assistant vice president for state public policy for the American Lung Association, said Nebraska is spending vastly less than what the Centers for Disease Control and Prevention recommends.

"The fact is that the state is taking in these dollars, and we're saying, reinvest just some of them," Seilback explained. "You can easily meet CDC best practices with tens of millions of dollars to spare."

The report showed Nebraska's tobacco-related revenue is nearly $98 million per year. However, for fiscal year 2024, state funding for tobacco control programs is less than $4 million.

On the bright side, the state received an "A" for smoke-free air.

Responding to the report, a spokesperson with the Public Information Office at the Nebraska Department of Health and Human Services pointed to the Nebraska Quitline. It has received more than 100,000 calls since 2000, with Quitline users six to 10 times more likely to still have quit after seven months than those who try to quit cold turkey. The Nebraska Quitline number is 1-800-784-8669, and 1-800-355-3569 for Spanish speakers. Web-based coaching and texting and free "quit medication starter kits" are also available.

The state also received an "F" for tobacco taxes. Seilback called the state's cigarette tax of 64 cents per pack extremely low and supports Gov. Jim Pillen's proposal to increase it by as much as $2 per pack. He added the American Lung Association always pushes for increased tobacco tax dollars to be used for prevention and control and helping people quit.

"To be clear, even if not one dollar was spent -- and we wouldn't encourage it -- on its own, just increasing the price has an impact on the amount of people that use it," Seilback pointed out. "Increasing that price would help prevent kids from starting."

Nebraska's third "F" is on flavored tobacco products, as a result of having no state laws or restrictions.

Seilback commended the state for participating in the multistate lawsuit against e-cigarette manufacturer, JUUL Labs, with the settlement money going to programs to curb addiction.


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