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COMMONWEALTHOFMASSACHUSETTSSUFFOLK,ss.
SUPERIORCOURTDEPARTMENTOFTHETRIALCOURTRECEIVEDCOMMONWEALTHOFMASSACHUSETTSFEB122020Plaintiff,v.
JUULLABS,INC.
andPAXLABS,INC.
,CivilActionNo.
Defendants.
COMPLAINT1.
TheCommonwealthofMassachusetts,byandthroughAttorneyGeneralMauraHealey,bringsthisactionpursuanttotheMassachusettsConsumerProtectionAct,G.
L.
c.
93A§4.
DefendantsJUULLabs,Inc.
anditscorporatepredecessor,PaxLabs,Inc.
,(together,;JUUL")haveengagedinunfairanddeceptiveactsandpracticesinviolationofG.
L.
c.
93A,§2,and940C.
M.
R.
21.
00etseq.
bywillfullyadvertisingand/orsellingnicotineproductstochildren,adolescents,andotherconsumersyoungerthantheminimumlegalsalesage("underageconsumers").
JUUL'smisconducthascreatedapublichealthcrisisandanepidemicofyouthnicotineuseandaddiction,whichconstitutesapublicnuisanceforwhichJUULisliabletotheCommonwealth.
2.
JUUL,morethananyothercompany,bearsresponsibilityforthefactthatmillionsofyoungpeoplenationwidearenowaddictedtoe-cigarettes,reversingdecadesofprogressincombattingunderagetobaccoandnicotineuseandaddiction.
123.
JUULhasdescribeditselfasa"technologycompany,"butitschieftechnologicalinnovationhasbeenthecreationofane-cigarettethatcandeliverdramaticallyhigherconcentrationsofaharmful,highlyaddictivechemical:nicotine.
4.
BeginningwiththeadvertisingcampaignthatintroducedtheJUULe-cigarettein2015,JUULhasmarketeditse-cigarettetoconsumerswhocannotlawfullypurchasetheproduct.
5.
JUULexplicitlyidentifieditstargetaudienceasthe"coolcrowd,"ademographicofyoungpeoplewhowere"fashionable,urbanwithavibrantlife,"and"enjoy[ed]goingouttoshowsandevents.
"6.
Totargetthisaudience,JUUL'sartisticdirectordevelopedanadvertisingcampaigninspiredbysexuallyprovocativeimagesofyoung,fashionablemodelsandcelebrities.
JUULhiredyouthfulmodelstoappealto"millennialconsumers.
"Flirtatious,playfulphotographsofthesemodelsbecamethecenterpieceofJUUL'sfirstadvertisements.
JUULsupplementedtheseimageswithpicturesoftheyoung"beautifulpeople"itrecruitedtoattenditslaunchparty.
7.
JUULpurchasedadvertisingspacefortheseimagesonwebsitesfrequentedbyunderageconsumers,suchasteen.
comandseventeen.
com;recruitedcelebritiesandsocialmediainfluencerswithlargenumbersofunderagefollowers,suchasMileyCyrusandan18-year-oldconsideredtobe"theinternet'scoolestteenager";andpromoteditsyouth-focusedadvertisementsdirectlyonsocialmediaplatformspopularwithunderageconsumers.
8.
JUULalsodirectlysolditse-cigarettestounderagepersonsthroughitsowne-commercewebsite.
39.
JUULmademorethantenthousandshipmentsofe-cigarettestorecipientsandaddressesinMassachusettsforwhichitconductednoageverificationwhatsoever.
Asaresult,JUULshippeditse-cigarettesdirectlytoadolescents,includingtoindividualsasyoungassixteenyearsold.
10.
Moreover,inatleast38townsandcitiesacrossMassachusetts,consumersyoungerthan21werealreadyprohibitedfrompurchasingtobaccoandnicotinewhenJUULlauncheditsproducts,incontrasttotheotherwiseapplicableminimumlegalsalesageof18.
JUULneverthelesssolditse-cigarettestohighschoolstudentsandcollegestudentsacrosstheCommonwealth,evenwhentheysupplieddatesofbirthtoJUULthatestablishedtheywereyoungerthanthelocalminimumlegalsalesage.
11.
Throughitsyouth-orientedadvertisingandunlawfulsalespractices,JUULcreatedamarketfore-cigarettesamongunderageconsumers.
JUULinspiredcompetitorstolaunchtheirowncopycatJUULproducts,usingJUULhashtagsandcatchphrasestoselle-cigarettesinanarrayofsweetflavorswithever-increasingconcentrationsofnicotine.
12.
E-cigaretteuseisnowanepidemicamongadolescents.
InMassachusetts,51.
2%ofhighschoolstudentsreporthavingtriede-cigarettes,and32%saytheyhaveusede-cigarettesinthepast30days.
1Bycontrast,lessthansixpercentofhighschoolstudentsreportedthattheysmokedconventionalcigarettesin2019.
21MassachusettsDepartmentofPublicHealth,YouthVapingandCessationData,https://www.
mass.
gov/files/documents/2019/11/27/youth-vaping-and-cessation-data-11-26-2019.
pdf.

2CenterforDiseaseControlandPrevention,YouthandTobaccoUseFastFactsandFactSheet,https://www.
cdc.
gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.
htm.
413.
JUUL,meanwhile,madeapproximately$3.
3billioninU.
S.
retailsalesbetweenSeptember2018andAugust2019andcontrolsapproximatelythreequartersofthee-cigarettemarket.
14.
Adolescentsaresubstantiallymoresusceptibletonicotineaddictionthanadults,andnicotineposesparticularriskstotheircognitivedevelopment.
JUULneverthelesswillfullyengagedinanadvertisingcampaignthatappealedtoadolescents,eventhoughJUUL'se-cigarettesarebothillegalforthemtopurchaseandparticularlyunsafeforthemtouse.
ThisconductconstitutesaviolationoftheConsumerProtectionAct,G.
L.
c.
93A,forwhichtheCommonwealthseekstheimpositionofpenaltiesandthepaymentofrestitutiontoconsumers.
15.
JUUL'sactionshave,moreover,createdapublichealthemergencyofe-cigaretteaddictionamongunderageMassachusettsconsumers.
TheCommonwealthmustnowacttoremedytheharmresultingfromJUUL'smisconduct,usingpublicresourcesforaddictiontreatmentandtoaddresstheothernegativehealthconsequencesofyouthe-cigaretteuse.
Worseyet,becauseyounge-cigaretteusersaremorelikelytousecombustiblecigarettes,theCommonwealthwillbeartheincreasedcostoftreatingthedevastatingconsequencesoftraditionaltobaccouse.
Bythetortofpublicnuisance,theCommonwealthseekstoholdJUULaccountableforthecoststheCommonwealthhasandwillincurincombatingthepublichealthcrisisJUULcreated.
I.
JURISDICTIONANDVENUE16.
TheAttorneyGeneralisauthorizedtobringthisaction,inthisCourt,underG.
L.
c.
93A,§4andpursuanttoherauthoritytoassertparenspatriaeclaimsonbehalfoftheCommonwealthanditscitizens.
517.
ThisCourthasjurisdictionoverthesubjectmatterofthisactionbyvirtue,interalia,ofG.
L.
c.
93A,§4.
18.
ThisCourthaspersonaljurisdictionoverDefendantsunderG.
L.
c.
223A,§3,because,amongotherthings,DefendantshaveengagedinbusinesswithMassachusettsbysellingproductstoMassachusettsconsumersandretailers,andbecauseDefendants'actionsandinactionshaveharmedMassachusettsresidents.
19.
VenueisproperinSuffolkCountyunderG.
L.
c.
93A,§4,andG.
L.
c.
223,§5,astheCommonwealthistheplaintiff.
20.
TheAttorneyGeneralnotifiedDefendantsofherintenttobringthisactionatleastfivedayspriortothecommencementofthisaction,asrequiredbyG.
L.
c.
93A,§4.
II.
PARTIES21.
ThePlaintiffistheCommonwealthofMassachusetts,representedbyitsAttorneyGeneral,whobringsthisactioninthepublicinterestpursuanttoG.
L.
c.
93A,§4.
22.
DefendantJUULLabs,Inc.
isacorporationorganizedunderthelawsofDelawarewithitsprincipalplaceofbusinessat56020thStreet,SanFrancisco,California94107.
23.
DefendantPAXLabs,Inc.
isacorporationorganizedunderthelawsofDelawarewithitsprincipalplaceofbusinessat660AlabamaStreet,2ndFloor,SanFrancisco,California94110.
24.
JUULLabs,Inc.
wasacorporatesubsidiaryofPAXLabs,Inc.
until2017.
JUULLabs,Inc.
becameanindependentcompanyin2017.
JUULLabs,Inc.
fileditsfirstSECstatementandfirstofferedsecuritiesin2017.
25.
Since2015,PAXLabs,Inc.
orJUULLabs,Inc.
hasmarketed,advertised,andsolditsproductsinMassachusetts.
6III.
FACTSA.
JUULDevelopedaNewE-CigaretteTechnologytoDeliverHighlyConcentrated,VaporizedNicotine26.
Electroniccigarettes,or"e-cigarettes,"arebattery-poweredelectronicdevicesthatarefilledwithaliquidnicotinesolutionreferredtoas"e-liquid.
"E-cigarettesheatthise-liquiduntilittransformsintoanaerosolorvaporthatusersinhale.
Thisinhaledaerosolcontainsnicotine.
27.
Thefirste-cigaretteswerewidelyavailableforpurchaseintheUnitedStatesinapproximately2007.
28.
Followingtheirintroductiontothemarket,e-cigarettesattractedasignificantbutlimitedgroupofusers,mostlywhousedorformerlyusedtraditional,combustiblecigarettes.
By2014and2015,however,boththeuseandsalesofe-cigarettesintheUnitedStatesweredeceleratingorevendeclining.
29.
E-cigaretteswereoflimitedpopularityatthistimelargelybecausetheycontainedrelativelylittlenicotinecomparedtocombustiblecigarettes.
In2014and2015,moste-cigarettesusedapurifiedformofnicotinecalledfreebasenicotine.
Freebasenicotine,whenturnedintoanaerosolandinhaledbythee-cigaretteuser,hasahighalkalinityandoftenresultsina"harsh"or"bitter"experienceandcausessomeuserstocoughordevelopasorethroat.
Thesenegativeeffectsbecomemorepronouncedathigherconcentrationsoffreebasenicotine.
Theeffectsofinhalinghighconcentrationsoffreebasenicotinearesounpleasantthate-cigarettemanufacturerstypicallyofferedproductswithnicotineconcentrationsof1%or2%.
33RobertJackler&DivyaRamamurthi,Nicotinearmsrace:JUULandthehigh-nicotineproductmarket,28TobaccoControl623(2019).
730.
In2014,JUULachievedatechnologicalbreakthroughthatwouldrevitalizethee-cigaretteindustry.
Insteadofusingfreebasenicotine,JUULdevelopedane-cigarettethatusesnicotineinasaltform,createdbyaddingbenzoicacidtofreebasenicotine.
ThechemicalcompositionofJUUL'snicotinesalteliminatedtheharshqualitiesandnegativeeffectsassociatedwithfreebasenicotine,makinghighnicotineconcentrationspalatabletousersforthefirsttime.
31.
Moreover,usersabsorbthenicotinederivedfromnicotinesaltfarmorerapidlythanfromfreebasenicotine.
Asaresultofthenicotinesalt,theJUULe-cigarettecausesuserstoexperiencearapidriseofnicotinelevelsintheirbloodstreamshortlyafterinhalation,comparabletotherateoftraditionalcombustiblecigarettes.
TheultrafineparticulatescreatedbytheJUULe-cigarettealmostimmediatelypenetratetheuser'sarterialbloodstream,passingtheblood-brainbarrierintothepleasurecenterofthebrain.
Thisphysiologicalexperienceismostoftendescribedbytheuserasa"headbuzz"or"kick.
"32.
TheJUULe-cigarettehasasmall,rectangularshape,resemblingametallicgreyUSBdrive.
ThefollowingisanimageoftheJUULdevice.
33.
TheJUULe-cigaretteusesarechargeablebattery.
TheJUULdevicecanbechargedinatypicalUSBport,includingtheUSBportinalaptopcomputer.
ThebatterylifeofaJUULdevicemaylastauseranentiredaywithmoderateusage.
834.
TousetheJUULe-cigarette,auserinsertsa"pod"filledwithe-liquidcontainingnicotinesalt,flavoring,andothersubstancesintothedevice.
TheJUULdeviceheatsthee-liquiduntilitturnsintoaerosolthattheuserinhalesintotheirmouthandlungs.
35.
JUULpodscontain59milligramsofnicotinepermilliliterineach0.
7-milliliterpod,whichamountstoaconcentrationof5%nicotinebyweightand5.
9%byvolume.
36.
JUULsimplyadvertiseditse-cigaretteas"5%strength.
"ThisiseffectivelyanunderstatementoftheamountofnicotineinaJUULe-cigarette,sincethetypicalindustrypracticeamonge-cigarettecompanieswastoadvertisenicotineconcentrationbyvolume.
37.
WhenJUULlauncheditse-cigarette,thenicotineconcentrationofitse-cigaretteswasasmuchasthreetimestheconcentrationofnicotinecontainedinmoste-cigarettesforsaleatthattimeintheUnitedStates.
B.
JUULRejectedaTechnology-FocusedAdvertisingCampaignandInsteadChosetoPromoteitsProductswithImagesof"Cool"YoungModels38.
Havingcreatedane-cigarettecapableofrapidlydeliveringmorehighlyconcentratednicotinevaporthanexistinge-cigarettes,JUULbegandevelopinganadvertisingstrategyforsellingitsproduct.
39.
Towardthisend,in2014,JUULengagedaCalgary-basedadvertisingagency,CultCollectiveLtd.
("Cult"),tocompletea"diagnostic"evaluationoftheJUULbrandandtomakerecommendationsregardingthebestadvertisingstrategytomarkettheJUULe-cigarette.
40.
InameetinginCalgaryinDecember2014,CultpresentedtheresultofitsevaluationtoJUUL.
AmongthosepresentatthemeetingwasRichardMumby,whowasorwouldeventuallybecomeJUUL'schiefmarketingofficer.
Cultpresentedanoverall"creative"concepttoJUULthatincludedimages,slogans,andscriptsforaJUULadvertisingcampaign.
CultsuggestedthatJUULshouldpresentitselfas"atechnologycompany,notatobacco9company"thathadachieved"proprietarytechnologicaladvancesinbothphysicsandchemistry.
"ThesetechnologicaladvancesenabledJUULtoofferane-cigarettethatisa"satisfyingalternative"thatis"betterthancigarettes.
"41.
CultrecommendedthatJUULpositionitse-cigaretteitselfasthe"hero"orfocusofadvertisements.
CultpresentedJUULwithadvertisementsthatused"retro"imagesofaboombox,ajoystick,andamobilephonefromthe1980sjuxtaposedagainsttheJUULe-cigarette,captioned"JUUL/Theevolutionofsmoking/Finally,atrulysatisfyingalternative.
"Theseimagesfeaturedproductsthatwerereadilyrecognizablebyolderconsumers–productsthatteenagerstodaymightonlyrecognizefromoldmovies.
Cultpresentedtheseadvertisements,includingthefollowingexamplesbelow,toJUULinDecember2014inpresentationslidesattachedheretoasExhibitA.
1042.
JUULrejectedCult'sproposedadvertisingcampaigninitsentirety.
43.
JUULdecidedtomarketitse-cigaretteinanentirelydifferentfashion.
JUULsetouttoclaim"coolequity"that"combustiblecigarettes…own.
"JUULsoughtto"winwiththecoolcrowdincriticalmarkets"byportrayingtheJUULe-cigaretteasa"cool,cutting-edgetechlifestyleproductthatadvances[auser's]image.
"JUULexplicitlysoughttoappealtoconsumerswhowere"fashionable,urbanwithavibrantlife,"and"enjoy[]goingouttoshowsandevents.
"44.
RichardMumbyengagedStevenBaillieasJUUL'sinterimartisticdirectoranddirectedhimtodevelopanewcreativeconceptforafashion-influencedadvertisingcampaign.
45.
Indevelopingthisnewcreativeconcept,Bailliemademultiple"moodboards,"whichconsistedofcompilationsofimagesdesignedtoillustratehisvisionfortheJUULadvertisingcampaign.
Baillie'smoodboardswerecomposedofpicturesoffashionableyoungpeople,frequentlyinasexuallyprovocativecontext.
Bailliepresentedmoodboardsincludingthe11moodboardreproducedbelowtoJUULinadocumentdatedJan.
13,2015andattachedheretoasExhibitB.
46.
JUULrespondedpositivelytothismoodboardandtoBaillie'syouth-orientedapproachtoadvertisingtheJUULbrandande-cigarette.
47.
JUULdirectedBaillietoproceedwithdevelopinganadvertisingcampaignforthelaunchoftheJUULproductinaccordancewiththisnewcreativeapproach.
Baillieconceivedofthesloganforthislaunchcampaign:"vaporized"(hereinafter,the"VaporizedCampaign").
48.
Havingsettledonanapproachthatwouldfeature"cool"youngmodels,BaillieandJUULsoughtouttheservicesofaphotographerandacastingdirectorforaphotoshootfortheVaporizedCampaign.
1249.
BaillieandJUULselectedanumberofphotographersforconsiderationfortheJUULphotoshootandcompiledrepresentativeimagesfromeachphotographertoassistintheirfinalselection.
ThefollowingisaselectionofimagescompiledbyJUULandBaillieandtakenbythephotographerultimatelychosenfortheJUULphotoshoot.
50.
BaillieandJUULhiredacastingdirectortoidentifymodelsforthephotoshoot.
Thefollowingareimagesfromacompilation,attachedasExhibitC,ofsomeofthemodelsconsideredbyJUULforthephotoshootfortheVaporizedCampaign.
1351.
Ultimately,JUULdecidedtocasttenmodelswho,byJUUL'sdescription,were"NewYorktrendsetterswhoembodytheJUULbrandandspeaktomillennialconsumers.
"52.
JUULprovidedadocument,attachedasExhibitD,toindividualsmanagingandparticipatinginthephotoshoot.
JUULsharedthisdocument,whichincludedthefollowingimages,toguidethehair,makeup,clothing,andgeneralaestheticofthephotoshootfortheVaporizedCampaign.
1453.
Atthephotoshoot,JUULtookphotographsandvideosofmodelsposingwiththeJUULe-cigaretteforuseintheLaunchCampaign.
Thefollowingisaselectionofcreative"assets"generatedfortheVaporizedCampaignusingphotographsfromthephotoshoot.
1554.
JUULknowinglyusedimagesofmodelsthat"registered"orappearedinphotographstobeinappropriatelyorunsuitablyyoung.
JUUL'semployeesanditsboardofdirectorsacknowledgedconcernthatmodelsphotographedfortheVaporizedCampaignappearedtobetooyoung,particularlythemodelsNicoleWingeandPeterGiang.
55.
JUULnonethelessusedimagesofMs.
WingeandMr.
GiangintheLaunchCampaign.
ThefollowingimagesarephotographsofMs.
WingeandMr.
GiangthatJUULusedintheVaporizedCampaign.
1656.
JUULknew,orshouldhaveknown,thattheVaporizedCampaignimageswouldappealtounderageconsumersandwouldinduceunderageconsumerstobuyanduseitse-cigarettes.
57.
JUULfirstoffereditsproductforsaleandinitiatedtheVaporizedCampaigninJune2015.
JUULsolditsproducts,inMassachusettsandotherstates,directlybymeansofitsownwebsiteandthroughphysicalretailstoressuchasgasstationsandconveniencestores.
58.
PlayfulandprovocativephotographsoftheyouthfulmodelsfromthephotoshootweretheprimarysourceofimagesfortheVaporizedCampaign.
JUULusedtheseimagestogeneratenumerousdifferentadvertisementsofvarioussizesandformats.
59.
JUULplacedadvertisementsfeaturingimagesofthemodelsfromthephotoshootonmillionsofwebsites,inmobileapplicationsonsmartphones,andonsocialmediaplatforms.
60.
JUULdisplayedvideosofthemodelsfromthephotoshootinitsproductdisplaycasesatphysicalretailstores.
61.
JUULplacedadvertisementsfeaturingimagesofthemodelsfromthephotoshootinphysical,printmagazines,newspapersandotherpublications.
62.
JUULevenusedimagesandvideosofthesemodelsinanelectronicbillboardinstallationinTimesSquare,NewYorkCity.
C.
JUULPurchasedAdvertisingSpacefortheVaporizedCampaignonMillionsofWebsitesAcrosstheInternet,IncludingWebsitesthatAppealtoChildren63.
HavingdevelopedadvertisementsfortheVaporizedCampaignfeaturingyouthful,fashionablemodels,JUULengagedtheservicesofnumerouscompaniestoplaceadvertisements,includingstatic"banner"advertisementsandvideoadvertisements,onwebsitesacrosstheinternet.
Thesecompanies,knownasprogrammaticmediabuyers,purchased"impressions"(i.
e.
theappearanceofanadvertisementonaparticularwebsitewhenvisitedbyasingleuseror17device)fromonlineadvertisingexchanges.
AdvertisementsfromtheVaporizedCampaignbeganappearingonwebsitesasearlyasJune2015.
64.
AlthoughtheseonlineadvertisementslinkedtoJUUL'swebsite,whereJUULsolditse-cigarettedirectly,theprimarypurposeofinitialonlinemediapurchasesfortheVaporizedCampaignwasnottodrivesalesofe-cigarettesonJUUL'swebsite.
Instead,theprimarypurposeoftheinitialonlinemediapurchaseswastocreate"brandawareness"fortheJUULe-cigarette.
65.
JUULusedtheseprogrammaticmediabuyerstopurchasespaceforJUULadvertisementsonwebsitesthatwerehighlyattractivetochildren,adolescentsinmiddleschoolandhighschool,andunderagecollegestudents.
TheseadvertisementsincludedtheimagesofmodelsfromtheVaporizedCampaign66.
JUULpurchasedadvertisementsonwebsitesdesignedforyoungchildren.
67.
JUULmarketeditsproductsbypurchasingbanneradvertisementsandvideoadvertisementsonnick.
com.
Thecompanyalsopurchasedbanneradvertisementsonnickjr.
com.
ThesetwoNickelodeonwebsitesfeatureshowsandgamesfromtheNickelodeontelevisionnetwork,whichisatelevisionnetworkforchildren.
68.
JUULpurchasedbanneradvertisementsontheCartoonNetwork'swebsiteatcartoonnetwork.
com.
Thiswebsiteofferschildren'stelevisionprogramsandgamesforchildren.
69.
JUULpurchasedbanneradvertisementsonotherwebsitesgenerallydesignedforchildren,includingallfreekidscrafts.
com,hellokids.
com,andkidsgameheroes.
com.
70.
JUULalsopurchasedbanneradvertisementsonwebsitesprovidinggamestargetedtoyoungergirls,suchasdailydressupgames.
com,didigames.
com,forhergames.
com,games2girls.
com,girlgames.
com,andgirlsgogames.
com.
1871.
JUULalsopurchasedadvertisementsonarangeofwebsitesdesignedtohelpmiddleschoolandhighschoolstudentsdeveloptheirmathematicsandsocialstudiesskills.
JUULpurchasedtensofthousandsofimpressionsforvideoandbanneradvertisementsoncoolmath-games.
com.
JUULalsopurchasedadvertisementsonbasic-mathematics.
com,coolmath.
com,math-aids.
com,mathplayground.
com,mathway.
com,onlinemathlearning.
com,andpurplemath.
com.
JUULalsodisplayedvideoadvertisementsonsocialstudiesforkids.
com.
72.
JUULpurchasedbanneradvertisementsonwebsitesdesignedforteenagers,suchasteen.
com,seventeen.
com,justjaredjr.
com,andhireteen.
com.
73.
JUULpurchasedadvertisementsonwebsitesforhighschoolstudentshopingtoattendcollegesuchascollegeconfidential.
comandcollegeview.
com.
74.
JUULtargetedcollegestudentswithitspaidonlineadvertisementsandpurchasedvideoadvertisementsonwebsitessuchascollegehumor.
comandthecollegeprepster.
com,aswellasbanneradsonsurvivingcollege.
com.
75.
Beginningin2015,JUULtrackedconsumerswhovisitedJUUL'swebsitebutdidnotcompleteapurchase.
JUULthenpurchasedadvertisingspaceonotherwebsitesthatthosesameconsumerssubsequentlyvisited.
ManyofJUUL'swebsitevisitorswhodidnotcompleteapurchasewereunderageanddidnotcompleteorevenfailedJUUL'sageverificationprocess.
76.
FacebookandInstagram,twoofthelargestsocialmediaplatforms,maintainpoliciesthattheirplatformsdonotacceptpaidadvertisementfortobaccoproducts,includinge-cigarettessuchasJUUL.
Beginningin2015,however,JUULcircumventedtheserestrictionsbypayingonlinepublisherssuchasUrbanDaddyandGawkertopromoteyouth-orientedadvertisingcontentforJUULthroughtheirsocialmediaaccountsonInstagram,Facebook,andYouTube.
1977.
Forexample,in2015,JUULpaidawebsitecalledHypebeastforcustomyouth-orientedInstagramcontentthatassociatedtheJUULdevicewiththefashiondesignerAkomplice.
78.
Finally,JUULmaintaineditsownsocialmediaaccountsonTwitter,Instagram,andFacebookuntilNovember2018.
JUULpostedadvertisementsfromtheVaporizedCampaigntoTwitter,Instagram,andFacebook.
79.
JUULemployednoage-gatingonitssocialmediaaccountstopreventunderageconsumersfromviewingitsadvertisements.
80.
JUULknewthatyoungpeoplevisit,monitor,andusethesesocialmediaplatforms.
NearlyallteenagersintheUnitedStateshaveaccesstoasmartphoneandtheinternet.
Instagramisoneofthemostpopularonlineplatformsamongteenagers.
81.
JUULknew,orshouldhaveknown,thatitsadvertisingonsocialmediawouldbeviewedbyunderageconsumers.
82.
JUULlabelleditssocialmediapostswithhashtagssuchas#juul,#juulvapor,#vaporized,and#juulallnight.
83.
Socialmediauserscansearchforandfollowpoststhatarelabelledwithhashtags.
Usersarealsoabletolabeltheirownpostswithhashtagsoftheirownchoosing,including#juulandJUUL'sotherhashtags.
84.
By2018,JUUL'spremierhashtag,#juul,hadoveraquarterofamillionfollowersandhundredsofthousandsofassociatedposts.
44RobertK.
Jackleretal.
,JUULAdvertisingOveritsFirstThreeYearsontheMarket,StanfordResearchintotheImpactofTobaccoAdvertising1,19(2019),http://tobacco.
stanford.
edu/tobacco_main/publications/JUUL_Marketing_Stanford.
pdf.
2085.
Manyofthepostscontainingthe#juulhashtagorJUUL'sotherhashtagswerecreatedbyunderageconsumersandfeaturedunderageconsumersusingJUULe-cigarettes.
586.
JUULmonitoredtheuseofJUUL-relatedhashtagsandthesocialmediapoststhatcontainedthosehashtags.
87.
JUULknew,orshouldhaveknown,thatunderageconsumerswerefollowingtheirsocialmediaaccounts,advertisingposts,andsponsoredhashtags.
88.
Basedonthephotographs,comments,andothercontentpostedtosocialmediaplatformsfeaturingunderageconsumers,JUULknew,orshouldhaveknown,itsproductwasusedbyandextremelypopularwithunderageconsumers.
89.
JUULalsosoughtoutindividualconsumerswithlargenumbersofFacebookandInstagramfollowerstoparticipateinJUUL's"affiliateprogram.
"JUUL"affiliates"postedcontentpromotingJUULonFacebook,Instagram,YouTube,andothersocialmediaplatformsandprovidedfollowersandotherconsumerswithdiscountstoenticethemtopurchaseJUULe-cigarettesfromtheJUULwebsite.
JUULcompensatedaffiliatesforanyresultingsalescompletedonJUUL'swebsite.
90.
AndyFlynn,whogoesbythenameof"AVANDY"onYouTube,wasaJUULaffiliatewhopromotedJUULe-cigaretteproductsonhispopularYouTubechannel.
ThefollowingisanimageofAndyFlynnpostedtohisYouTubechannel.
5Id.
21D.
JUULSoughttoEnlist"Influencers"WithLargeNumbersofUnderageSocialMediaFollowerstoPromoteJUULProducts91.
TofurtherawarenessoftheJUULbrand,JUULsoughttoenlistcelebritiesorindividualswithlargenumbersofyoungfollowersonsocialmediaplatforms,called"influencers,"topromoteJUULe-cigarettes.
92.
JUULtypicallysolicitedinfluencersbysendingthemfreeJUULe-cigarettesordiscountcodesthatwouldenableinfluencerstoobtainfreee-cigarettesfromJUUL'swebsite.
JUULintendedthat,afterreceivingthesefreeordeeplydiscountedproducts,influencerswouldpromoteJUULe-cigarettesbyusingtheminpublic,postJUUL-relatedcontentontheirsocialmediaaccounts,orotherwisesharepositiveimpressionsregardingJUULwithothers.
JUULmonitoredinfluencersocialmediaaccountsforJUUL-relatedcontentandrepostedJUUL-relatedsocialmediacontentcreatedbyinfluencers.
93.
ThepurposeofJUUL'sinfluencerprogramwastogenerateawarenessoftheJUULbrand,bothwiththeinfluencersthemselvesbutalsowiththeinfluencers'followersonsocialmediaplatforms.
JUULknew,orshouldhaveknown,thatmanyofthesefollowers,includingfollowersinMassachusetts,wereyoungerthantheminimumlegalsalesage.
94.
Inthesummerof2015,JUULrananin-houseinfluencerprogram,sendingfreeJUULe-cigarettestoindividualsJUULidentifiedaspotentialinfluencers.
95.
JUULsentofferstoredeemfreeJUULproductstooverfivehundredindividualsitidentifiedasinfluencers.
96.
JUULtargetedinfluencerswhowerefashionbloggers,stylists,celebrities,andaffiliatedwithcertaintelevisionprograms,networks,ormoviesfilmedorproducedinNewYorkCityandLosAngeles.
2297.
JUULknew,orshouldhaveknown,thatmanyoftheinfluencersittargetedwereyoungandespeciallypopularwithadolescents.
98.
JUUL'sinfluencertargetlistincludedTaviGevinson,whowas19yearsoldinthesummerof2015.
Atage11,TaviGevinsonstartedthefashionblogTheStyleRookie,whicheventuallybecametheonlinemagazineRookieMagazinewhenGevinsonwas15.
Rookie'swebsitestatesthat"Rookiewas…foundedin2011asanonlinemagazineforandbyteenagers…ThankyouforreadingRookie,andforgrowingupwithus.
"6In2014,themagazineRollingStonecalledTaviGevinson"possiblythemostinfluential18-year-oldinAmerica.
"799.
JUUL'sinfluencertargetlistalsoincludedmanycelebritieswithlargenumbersofteenagefans,suchasKristenStewartandRobertPattinson,starsofthefilmadaptationsofthe"Twilight"seriesofyoungadultnovels;andJenniferLawrence,anactresswhostarsinthepopularfilmadaptationofthe"HungerGames"youngadultnovels.
100.
JUUL'sinfluencertargetlistalsoincludedfilmindustryprofessionals,includingindividualsresponsibleforproductplacementsinvarioustelevisionshowsandmoviespopularwithteenagersandyoungaudiences,suchasVideoGameHighSchoolandX-MenFirstClass.
101.
FollowingthelaunchoftheJUULe-cigaretteinJune2015,JUUL'smarketingdepartmenttrackedtheuseofJUULproductsinpublicbycelebrities.
EmployeesofJUULwouldperiodicallyattempttocontactcelebritiesortheirmanagerstoofferthemfreeJUULe-cigarettes.
102.
JUULsentapproximately260peoplefreee-cigarettesbetweenthesummerof2015andAugust2016.
6ROOKIE,About,https://www.
rookiemag.
com/us/.
7AlexMorris,TaviGevinson:APowerTeen'sNewDirection,ROLLINGSTONE(Aug.
14,2014,3:57PM),https://www.
rollingstone.
com/culture/culture-features/tavi-gevinson-a-power-teens-new-direction-232286/.

23103.
JUULinvitedinfluencerstoitslauncheventsduringthesummerof2015.
JUULgaveinfluencersfreeJUULe-cigarettesatthelaunchevents.
104.
JUULalsoseparatelycontractedwithGritCreativeGroup,LLC("Grit")duringtheVaporizedCampaigntoenlistinfluencersbysendingthemfreeJUULe-cigarettes.
105.
GritprovidedfreeJUULe-cigarettestooverone-hundredandfiftyindividualsidentifiedasinfluencers,manyofwhomwereDJs,nightlifepersonalities,fashionbloggers,andstylists.
106.
AllofGrit'seffortstoenlistinfluencerswereconductedatJUUL'sdirectionand/orwithJUUL'sknowledge.
107.
JUULknew,orshouldhaveknown,thatmanyoftheindividualsGrittargetedasinfluencersforJUULe-cigaretteswereveryyoungandthatmanyormostoftheirfollowerswereyoungerthantheminimumlegalsalesage.
108.
Gritprovidedfreee-cigarettesinpersontoLukaSabbat.
Sabbat,knownasthe"theInternet'sCoolestTeenager,"8was,atmost,18yearsoldduringthesummerof2015.
LukaSabbathadapproximately100,000InstagramfollowersatthetimeGritgavehimfreeJUULe-cigarettes.
Inaninterviewpublishedinthesummerof2015,LukaSabbatcommented,"Beingakid,thereareonlytwowaysyoucango:You'reeitheraninfluenceroryou'reinfluenced.
You'reeitheraleaderorafollower.
"9ThefollowingisanimageofSabbatfrom2015.
8AlexisBarnett,WhoIsLukaSabbatMeettheInternet'sCoolestTeenager,COMPLEX(Aug.
17,2015),https://www.
complex.
com/style/luka-sabbat-interview-on-youth-kanye-west-and-fashion.
9Id.
24109.
GrittargetedClaudiaOshryasapotentialinfluencerforJUUL.
Oshrywas21yearsoldduringthesummerof2015.
Oshry'sInstagramaccounthandlewas"girlwithnojob,"andshehadover2.
3millionfollowersonInstagramatthattime.
10110.
Gritalsotargetedcelebritieswithlargenumbersofunderagefans.
GrittargetedthepopularmusicianMileyCyrustobeaninfluencerforJUULe-cigarettes.
Cyrusstarredinatelevisionshowcalled"HannahMontana,"whichairedforfourseasonsontheDisneyChannelandwon8"TeenChoiceAwards,"asvoteduponbytensofmillionsofviewersintheUnitedStatesaged13yearsandolder.
AphotoofMileyCyrusfromthe2015MTVVideoMusicAwards,whichshehosted,appearsbelow.
10ClaudiaOshry,@girlwithnojob,Instagram,https://www.
instagram.
com/girlwithnojob/hl=en.
25111.
GritprovidedtheactressCaraDelevignewithfreeJUULe-cigarettestosolicitherasaninfluencer.
In2015,Delevignestarredinafilmadaptationoftheyoungadultnovel,"PaperTowns.
"ApromotionalimageforPaperTownsappearsbelow.
26E.
JUULHostedPartiestoGenerateBrandAwarenessAmongYoungPeople112.
JUULheldapartyforthelaunchofitse-cigarette(the"LaunchParty")onJune4,2015atJackStudiosinNewYorkCity.
JUULandGritinvitedgueststotheLaunchParty,includinginfluencersemployedinthefashionandmusicindustries,aswellasyoung,"beautifulpeople.
"JUULencouragedguestsattheLaunchPartytoposeforphotographswhileusingJUULproductsandtocompetefortheirimagetobeincludedinadvertisementstobeplacedonbillboardsinTimesSquare.
Thefollowingareselectedphotographs,attachedasExhibitE,ofattendeesattheLaunchParty.
27113.
JUULalsoencouragedtheseveryyoungLaunchPartyattendeestocreateandpostsocialmediacontentfeaturingJUULe-cigarettes.
Over200attendeesfromtheLaunchPartypostedcontentrelatedtoJUULontheirsocialmediaaccounts,whichwereviewedbyapproximately26,000socialmediausers.
114.
ForfourweeksinJuneandJuly2015,JUULplacedadvertisementsonnumerousdigitalbillboardsinNewYorkCity'sTimesSquare,effectivelysaturatingTimesSquarewithvideosandphotographspromotingJUULproducts.
115.
JUULincludedphotographsofLaunchPartyguestsonitsbillboardadvertisementsinTimesSquare.
ThefollowingisaselectionofimagesdisplayedbyJUULonbillboardsinTimesSquare.
2829116.
JUULusedsuchimagesfromtheLaunchPartyforadvertisementsitpromotedonsocialmediaplatformsandonwebsitesacrosstheinternet.
JUULknew,orshouldhaveknown,thattheseimageswouldbeviewedbyunderageconsumers,wouldappealtothem,andwouldinducethemtobuyanduseJUULe-cigarettes.
117.
Inthesummerof2015,JUULsponsoredadditionaleventsinlocationsinNewYorkCityandLosAngelestopromoteJUULproductsandbrandawarenessamong"cool"influencersandconsumers.
JUULprovidedattendeesatJUULsponsoredeventsJUULproductsforsampling.
JUULencouragedeventattendeestopostaboutJUULonsocialmedia.
118.
Forexample,JUULhostedalauncheventinNewYorkinpartnershipwithInsideHook,alifestylewebsite,ontheHudsonRiver.
ThefollowingphotographisfromJUUL'sInsideHookevent.
30119.
JUUL'sadvertisingstrategyfocusedonNewYorkandLosAngeleswasintendedtocreatestrategicbrand"buzz"thatwouldraisebrandawarenessamongyoungpeopleacrossthecountry,includinginMassachusetts.
F.
JUULKnowinglyAdvertisedtoUnderagePersonsbyEmail120.
FromtheoutsetoftheVaporizedCampaign,JUULcollectedtheemailaddressesofvisitorstoitswebsiteforitsemailmarketinglist.
JUULregularlysentemailstoitsmarketinglistthatpromotedJUULproductsandofferedspecialsanddiscounts.
However,JUULsentthesemarketingemailstoemailaddressesassociatedwithconsumerswhohadfailedJUUL'sageverificationprocessordidnotcompleteJUUL'sageverificationprocessafterputtingJUULe-cigarettesintheironlinecartforpurchase.
121.
Inthesummerof2017,JUULengagedacompanycalledTowerDatatodeterminetheagesofthepersonsassociatedwithemailaddressesonitsemailmarketinglist.
Accordingtothisanalysis,approximately269,000emailaddressesonJUUL'semailmarketinglistwerenotassociatedwitharecordofanindividualwhohad"passed"JUUL'sageverificationprocess.
Additionally,approximately40,000emailaddressesonJUUL'semailmarketinglistwereassociatedwithrecordsofindividualswhohad"failed"JUUL'sownageverificationprocess.
TowerDatainformedJUULthat83%oftheapproximately420,000emailaddressesonJUUL'smarketinglistcouldnotbematchedwiththerecordofanindividualatleasteighteenyearsofage.
122.
JUULneverthelesscontinuedtosendmarketingemailstothislistforafullyear,untilAugust2018,eventhoughitknewthatasubstantialmajorityofthoseonthelisthadnotpasseditsownageverificationprocessorhadfaileditsageverificationprocess.
31123.
OnJuly30,2018,theWashingtonPostpublishedanarticledescribingJUUL'spracticeofsendingmarketingemailstopeoplewhohadnotpassedorwhohadfaileditsageverificationprocess.
Onlyafterpublicationofthisarticle,inAugust2018,didJUULrequireconsumerstocompleteitsageverificationprocessinordertocontinuetoreceiveJUUL'smarketingemails.
G.
InResponsetoCriticism,JUULEmbarkedonaNewAdvertisingCampaignEmphasizingitsFlavoredE-Cigarettes.
124.
PublichealthadvocatesandotherscriticizedJUULin2015foradvertisingitse-cigarettesinamannerappealingtounderageconsumers.
125.
Inresponsetocriticism,JUULremovedthemodelsfromtheVaporizedCampaignfromitsadvertisingcontentinearly2016.
126.
However,JUULcontinuedtoadvertiseitsproductsonyouth-orientedwebsitesandonsocialmediaplatforms.
Moreover,JUUL'snewadvertisingcampaignfocusedonanotherfeatureofitsproductthatisespeciallyappealingtounderageconsumers:itsflavorede-cigarettes.
A2018surveyfoundamongU.
S.
adolescentandyoungadulte-cigaretteusers,60%usedflavoredJUULproducts,comparedto1.
5%whousedtobacco-flavoredJUULproducts.
11127.
Thevastmajorityofchildrenandadolescentswhohaveeverusedane-cigarettestartedwithaflavorede-cigarette.
12Eightintencurrente-cigaretteuserswhoareadolescentsciteflavorsasareasontheyusee-cigarettes,andthree-quartersofadolescentandyoungadultusersreportthattheywouldquitusinge-cigarettesifflavorswereunavailable.
13Asurvey11UCSFTobaccoCtr.
ofReg.
Sci.
etal.
,CommentonYouthTobaccoAddictionandCessation(May31,2019),https://tobacco.
ucsf.
edu/sites/tobacco.
ucsf.
edu/files/wysiwyg/UCSF%20TCORS%20comment%20on%20youth%20tobacco%20addiction%20and%20cessation%20Docket%20No.
%20FDA-2019-N-1107%20May%2031%202019%20%282%29.
pdf(citationomitted).
12Id.
13Id.
32conductedinthetownofWakefield,Massachusettsfoundthat44.
4percentofhighschoolstudentscited"Iwasattractedtotheflavor"asthemainreasontheytriedane-cigaretteoraflavoredcigar.
Morethan65percentoftheWakefieldhighschoolstudentsindicatedthattheywouldnotusee-cigarettesorcigarsifflavoredproductswerenotavailable.
128.
JUULsolde-cigarettesinmultipleflavors,includingmango,fruitmedley,crèmebrulee,cocomint,coolmint,menthol,andcoolcucumber.
Until2018,JUULmarketedtheseflavorswithnonstandardspellings,including"miint,""fruut,"and"brulee.
"129.
JUULmarketeditsflavorede-cigarettesusingadvertisingcontentthatmadeusingflavorede-cigarettesappearcoolandfun.
Theseadvertisementsoftenmadenomentionofnicotine.
130.
JUULknewthatitsflavoredproductsareespeciallypopularwithchildrenandadolescents.
131.
Asaresultofpubliccriticismandanticipatedfederalactionrestrictingthesaleofflavorede-cigaretteproducts,JUULbegantorestrictthesaleofsomeofitsflavorede-cigarettesinretailstoresinNovember2018.
However,JUULcontinuedtosellitsmostpopularflavorede-cigarettes,suchasmango,throughitswebsite.
JUUL'swebsitesalesofflavorede-cigarettesincreasedover400%inMassachusettsaroundthistime.
132.
Inresponsetorestrictedretailaccesstosomeflavoredproducts,manyunderageconsumersinsteadbeganusingmintandmentholJUULe-cigarettes.
Accordingtothe2019NationalYouthTobaccoSurvey,amonghighschoolstudentswhousee-cigarettes,nearly60%favormintormenthol.
1414KarenA.
Cullenetal.
,e-CigaretteUseAmongYouthintheUnitedStates,2019,322JAMANetwork2099(2019).
33H.
JUULSuccessfullyMadeUnderageConsumersAwareoftheJUULBrandandInducedUnderageConsumerstoUseJUULE-Cigarettes133.
Insum,JUULdevelopedadvertisementsfeaturingmodelsthatresembledunderageconsumers;placedtheseadvertisementsonwebsitesdirectedtoordesignedforchildrenoradolescents;promotedtheseadvertisementsonsocialmediaplatformspopularwithunderageconsumers;soughttoenlistcelebritiesandprominentsocialmediauserswhowerepopularwithunderageconsumers;andpromotedmostprominentlytheflavorede-cigarettesmostlikelytoappealtounderageconsumers.
134.
Asaresultofthistargeting,JUULwasextraordinarilysuccessfulinexposingunderageconsumerstoitsadvertisements.
135.
JUUL'sadvertisingeffortsachievedpervasiveawarenessofitsbrandamongchildrenandadolescents.
Thepopulartermamongadolescentsforusingane-cigaretteissimply"JUULing.
"136.
JUUL'spromotionofitse-cigarettesonsocialmediaplatformswasespeciallyattractivetounderageconsumers.
AccordingtoananalysisinajournalpublishedbytheAmericanMedicalAssociation,80.
9%ofTwitteruserswhofollowedtheofficialJUULTwitteraccount,@JUULVapor,werelikelybetweentheagesof13and20;and44.
9%ofJUUL'sTwitterfollowerswerelikelybetweentheagesof13and17.
15WhenJUULsuccessfullydelivereditsadvertisementstounderageconsumers,thoseadvertisementsmadethemmorelikelytouseJUULe-cigarettes.
137.
Exposuretoe-cigaretteadvertisingonsocialmediaplatformsamongyoungconsumerswhohaveneverusede-cigarettesincreasesthelikelihoodofsubsequente-cigarette15Kim.
E.
Anniceetal.
,EstimatedAgesofJUULTwitterFollowers,173JAMAPediatrics690(2019).
34use.
16Indeed,accordingtoastudypublishedbytheBritishMedicalJournal,JUUL'squarterlyretailsaleswerehighlycorrelatedwiththenumberofJUUL-relatedtweetsthatappearedonTwitter.
17138.
Middleandhighschoolstudentswhoarecurrentusersofe-cigaretteshaveseenmoree-cigaretteadvertisingthannonusers.
18Childrenandadolescentsexposedtoe-cigaretteadvertisingalsoperceivee-cigarettestobemoresociallyacceptableandlessharmfultotheirhealththanpeerswhoarenotexposedtotheadvertising.
19I.
JUULSolditsE-CigarettestoUnderageMassachusettsConsumers139.
OnApril1,2005,Needham,Massachusettsbecamethefirsttowninthenationtoraisetheminimumlegalsalesagefortobaccoandnicotineto21yearsold.
Atthetime,theminimumlegalsalesagenationwidewas18yearsold.
140.
ByJune1,2015,aboutthetimeJUULbegansellingitse-cigarettesinMassachusetts,atleast38citiesandtownsinMassachusetts,includingLawrence,Foxborough,andCambridge,hadraisedtheminimumlegalsalesagefortobaccoandnicotineproductsto21yearsold.
16Seee.
g.
,DeepaCamengaetal.
,E-cigaretteadvertisingexposureine-cigarettenaveadolescentsandsubsequente-cigaretteuse:Alongitudinalcohortstudy,81AddictiveBehav.
82(2018),https://www.
ncbi.
nlm.
nih.
gov/pmc/articles/PMC5845830/;PallavPokhreletal.
,Socialmediae-cigaretteexposureande-cigaretteexpectanciesanduseamongyoungadults,78AddictiveBehavior57(2018),https://www.
ncbi.
nlm.
nih.
gov/pmc/articles/PMC5783750/.
17JidongHuangetal.
,VapingversusJUULing:howtheextraordinarygrowthandmarketingofJUULtransformedtheUSretaile-cigarettemarket,28TobaccoControl150(2019).
18MedaE.
Pavkovetal.
,TrendsinHospitalizationsforAcuteKidneyInjury–UnitedStates,2000-2014,67MorbidityandMortalityWeeklyReport289(2018),https://www.
cdc.
gov/mmwr/volumes/67/wr/pdfs/mm6710-H.
pdf.
19Seee.
g.
,BenjaminReinholdetal.
,AssociationsofAttitudestowardselectroniccigaretteswithadvertisementexposureandsocialdeterminants:acrosssectionalstudy,15TobaccoInducedDiseases4-8(2017),https://tobaccoinduceddiseases.
biomedcentral.
com/articles/10.
1186/s12971-017-0118-y.
35141.
ByJanuary1,2017,atleast103Massachusettscitiesandtowns,includingthecityofBoston,hadraisedtheminimumlegalsalesagefortobaccoandnicotineproductsto21yearsold.
142.
EffectiveasofDecember31,2018,theMassachusettsLegislatureimposedaminimumlegalsalesagefortobaccoandnicotineproductsof21yearsstatewide.
143.
JUULlauncheditse-commercewebsiteinJune2015.
OnJUUL'swebsite,consumerswereabletopurchaseJUULe-cigarettesfromJUULdirectly.
TheaddressfortheJUULe-commercewebsitewasoriginallyjuulvapor.
com,butlaterchangedtojuul.
com.
144.
BetweenJune2015andJuly10,2019,Massachusettsconsumerscompletedover106,000purchasesfromtheJUULe-commercewebsite,amountingtoover$6,795,600insales.
145.
JUULclaimstocomplywithstateandlocallawsregardingtheminimumlegalsalesagefortobaccoandnicotineproducts.
146.
Thisisuntrue.
Infact,JUULhas,throughitswebsite,solde-cigarettestochildrenandadolescentsacrosstheCommonwealth.
Moreover,JUULknew,orshouldhaveknown,thatconsumersyoungerthantheminimumlegalsalesagewerepurchasingJUULe-cigarettesthroughitswebsite.
i.
JUULEmployedanInadequateAgeVerificationProcess147.
JUULclaimstouseanageverificationprocessthatensuresthatconsumersseekingtopurchasee-cigarettesdirectlyfromitswebsiteareoftheminimumlegalsalesageinthejurisdictioninwhichtheyarelocated.
148.
JUULoutsourcedtheageverificationofprospectiveonlinepurchaserstoacompanycalledVeratadTechnologies,LLC("Veratad").
VeratadpurportedtoprovideageverificationservicestoJUULfromthestartofitse-commercewebsitelaunchinJune201536throughtheendof2018.
JUULcontractedwithVeratadtoprovideaservicecalled"AgeMatch"from2015throughtheendof2018,andtoprovidedigitaldocumentverificationservicesforashortperiodin2017.
149.
InordertocompleteapurchaseonJUUL'se-commercewebsite,aconsumerhadto"pass"anageverificationprocess.
150.
From2015throughtheendof2018,thisageverificationprocesstypicallyconsistedofthefollowing:a.
JUULpromptedprospectivepurchaserstosubmitcertainpersonalidentifyinginformation,suchastheirname,address,anddateofbirth.
b.
JUULforwardedaconsumer'spersonalinformationtoVeratad.
Veratadthenattemptedtomatchallorsomelimitedpartoftheconsumer'sinformationtoapersonoftheminimumlegalsalesageinitsdatabase,whichconsistedofinformationdrawnfromgovernmentalrecordsandothersources.
IfVeratadwasabletolocateasufficientmatchoftheprospectivepurchasertoapersonoftheminimumlegalsalesageinitsdatabase,thenitwouldreturna"pass"resulttoJUUL.
IfVeratadwasunabletomakesuchamatch,Veratadreturneda"fail"resulttoJUUL.
c.
IfVeratadreturneda"fail"resulttoJUUL,ratherthandeclinetheperson,JUULwouldprompttheconsumertoenteran"alternate"address.
IfVeratadstillcouldnotfindamatchbasedonthisalternateaddress,JUULwouldprompttheconsumertoenterthelastfourdigitsofhisorhersocialsecuritynumber.
37d.
IfVeratad,suppliedwiththelastfourdigitsofaconsumer'ssocialsecuritynumber,stillcouldnotmatchtheconsumertoapersonoftheminimumlegalsalesageinitsdatabase,JUULwouldprompttheconsumertouploadanimageorphotographofhisorherdriver'slicenseoranothergovernmentalidentificationdocument.
AJUULemployeewouldthenconductapersonalreviewoftheimageanddecidewhethertheconsumerwasoftheminimumlegalsalesage.
151.
Crucially,JUUL,notVeratad,decidedhowcloselyaprospectivepurchaser'spersonalinformationhadtomatchrecordsinVeratad'sdatabaseinorderto"pass"theageverificationprocess.
Forexample,JUUL,notVeratad,decidedwhetheraprospectivepurchaser'saddresshadtomatchexactlytherelevantaddressinVeratad'sdatabaseorwhetheritwouldbesufficientformerelythezipcodetomatch.
152.
Similarly,JUUL,notVeratad,suppliedtheapplicableminimumlegalsalesagefortheageverificationprocess.
153.
BetweenJune2015andAugust2017,JUULdirectedVeratadto"pass"prospectivepurchasersevenifcertainportionsofthepurchaser'spersonalinformationdidnotmatchtheinformationcorrespondingtoapersonoftheminimumlegalsalesageinVeratad'sdatabase.
Forexample,JUULdirectedVeratadto"pass"aprospectivepurchaserundercertaincircumstancesevenwheretheprospectivepurchaser'sstreetaddressordateofbirthdidnotmatchtheinformationcorrespondingtoapersonoftheminimumlegalsalesageinVeratad'sdatabase.
154.
Similarly,betweenJune2015andAugust2017,JUULdirectedVeratadto"pass"aprospectivepurchaserundercertaincircumstancesevenwhentheprospectivepurchaser'syear38ofbirthdidnotmatchtheinformationcorrespondingtoapersonoftheminimumlegalsalesageinVeratad'sdatabase.
155.
Asaresultoftheselaxrequirements,underageconsumerscould"pass"JUUL'sageverificationprocessandpurchaseJUULe-cigarettesdirectlyfromJUUL'swebsite,simplybyusingtheirparent'sname,homeaddress,andaveryapproximatedateofbirth.
156.
Evenwiththeselaxrequirements,VeratadreportedtoJUULthatonlyapproximately70%ofprospectivee-cigarettepurchasersonJUUL'swebsite"passed"theageverificationprocess.
157.
JUULrepeatedlysoughttomakechangestotheageverificationprocesssothatmoreprospectivepurchaserswould"pass"theprocess.
JUULdidsoinanefforttoincreasedirectsalesofitse-cigaretteswithoutregardtowhetheritslessstringentageverificationprocesswouldpermitmoreunderageconsumerstopurchaseitse-cigarettes.
158.
InresponsetocriticismregardingtheuseofJUULe-cigarettesbyunderageconsumers,inSeptember2017,JUULdirectedVeratadtorequirethataprospectivepurchaser'syearofbirthmatchexactlytheyearofbirthcorrespondingtoapersonoftheminimumlegalsalesageinVeratad'sdatabase.
Asaresultofthischange,VeratadinformedJUULthatitsageverification"passrate"dropped5-8%.
159.
JUULdidnotdirectVeratadtorequirethattheyearofbirthandlastfourdigitsofthesocialsecuritynumbermatchexactlytheinformationcorrespondingtoapersonoftheminimumlegalsalesageinVeratad'sdatabaseuntilAugust2018.
39ii.
JUULCompletedOverTenThousandShipmentsofE-CigarettestoMassachusettsConsumersWithoutVerifyingtheAgeoftheRecipient160.
Inordertopurchasee-cigarettesfromJUUL'swebsite,JUULrequiredconsumerstocreateanaccount.
161.
Theprocessofcreatinganaccountrequiredconsumerstosupplytheiremailaddress,chooseapassword,andsupplypersonalidentifyinginformation.
162.
JUULpermittedconsumerstocreateJUULaccountsusingemailaddresseswhosedomainnameswereassociatedwithhighschoolsandcolleges.
JUULallowedmorethan1,200JUULaccountstobeestablishedforMassachusettsconsumersusingschoolemailaddresses,includingemailaddressesassociatedwithhighschoolsinBeverly,Malden,andBraintree,morethan200accountsendingin"bu.
edu"(thedomainassociatedforBostonUniversity),andover250accountsendingin"umass.
edu"(thedomainassociatedwiththeUniversityofMassachusetts).
JUULonlydisallowedaccountsassociatedwithschoole-mailaddressesstartingin2018.
163.
Afterconsumerssuppliedtheiremailaddress,password,andpersonalinformation,JUULperformedtheageverificationprocessdescribedabove,usingthe"AgeMatch"servicesuppliedbyVeratad.
164.
OnceaconsumersuccessfullyestablishedanaccountontheJUULwebsite,anypersoncouldusethoseaccountcredentialstopurchaseJUULe-cigarettesandshipthemtoanyrecipientandtoanyaddress.
165.
However,from2015throughtheendof2018,JUULonlyperformedtheageverificationprocessusingthepersonalinformationsuppliedbyaconsumerattimetheycreatedanaccount.
40166.
WhenaconsumerusedaccountcredentialstopurchaseandshipJUULe-cigarettestoadifferentrecipientoraddressthanthenameandaddressassociatedwiththeaccount,JUULneverthelessdidnotverifytheageofthenewrecipientanddidnotconfirmthatthenewaddresscorrespondedtoapersonoftheminimumlegalsalesage.
167.
Between2015and2018,JUULshippede-cigarettestoovertenthousandrecipientsandaddressesinMassachusettsthatdidnotmatchthenamesandaddressessuppliedbyconsumersatthetimetheycreatedtheiraccounts.
168.
Accordingly,JUULsente-cigarettestoovertenthousandrecipientsandaddressesinMassachusettsforwhichJUULperformednoageverificationwhatsoever.
169.
Asaresultoffailingtoconductanyageverificationofshippingrecipientsoraddresses,JUULshippede-cigarettestonumerousunderageconsumersinMassachusetts,includingmanywhowereundereighteenyearsoldandasyoungassixteenyearsold.
170.
JUULshippede-cigarettestounderagehighschoolstudents,includingstudentsattendingCambridgeRindgeandLatinSchool,FalmouthHighSchool,LowellHighSchool,andNewtonNorthandSouthHighSchools.
iii.
JUULSoldE-CigarettestoUnderageHighSchoolStudents,UnderageCollegeStudents,andRecipientswithObviouslyFabricatedNames171.
Asresultofitsinadequateageverificationpractices,andinviolationofMassachusettslaw,JUULsolditse-cigarettesdirectlythroughitswebsitetounderageconsumersthroughoutMassachusetts.
172.
AccordingtoJUUL'sownsalesrecords,JUULsolde-cigarettesthroughitswebsitetoMassachusettsconsumerswhoprovideddatesofbirththatindicatedtheywereyoungerthantheminimumlegalsalesageinthecityortowntowhichJUULshippeditse-cigarettes.
41173.
JUULshippede-cigarettestounderagehighschoolstudentsacrosstheCommonwealth,includingstudentsenrolledinLongmeadowHighSchool,WestonHighSchool,Bridgewater-RaynhamRegionalHighSchool,BishopFenwickHighSchoolinPeabody,andNortheastMetroRegionalVocationalTechnicalHighSchoolinWakefield.
174.
JUULshippede-cigarettestounderagerecenthighschoolgraduates,includingrecentgraduatesfromBrooklineHighSchool,HanoverHighSchool,MountEverettHighSchoolinSheffield,andtheTri-CountyRegionalVocationalTechnicalHighSchoolinFranklin.
175.
JUULshippede-cigarettestounderagecollegefreshmenatnumerousMassachusettscolleges,includingBabsonCollege,BostonCollege,BostonUniversity,NortheasternUniversity,StonehillCollege,SuffolkUniversity,TuftsUniversity,andtheUniversityofMassachusettsAmherst.
176.
JUULcompletednumerouse-cigaretteshipmentstounderagestudentslivinginschoolbuildingsassociatedwithmanyMassachusettscolleges,includingBabsonCollege,BostonCollege,HarvardUniversity,HolyCrossCollege,LasellCollege,NortheasternUniversity,StonehillCollege,TuftsUniversity,WorcesterPolytechnicInstitute,andtheUniversityofMassachusettsatAmherst.
JUULdeliveredmanyofthesee-cigaretteshipmentstocollegedormitoriesormailrooms.
177.
JUULcustomerservicerepresentativesevenprovidedconsumerswithadviceonhowtoevademinimumlegalsalesrestrictionrequirementsbyshippingJUULProductstoanotherpersonwithanaddressinatownwithalowerminimumlegalsalesage.
Inanemailfromsupport@juulvapor.
comdatedFebruary21,2018,"Don"fromthe"JUULCareTeam"toldaconsumerwhoseorderhadbeencancelledduetoanageverificationfailure,"Thelegalageto42purchasenicotineproductsinMilton,MAis21yearsoldandabove.
IfyouhavefriendsorrelativesinQuincy,MA,youmayusetheiraddressasashippingaddressforyourorder.
"178.
JUULalsodeliverede-cigarettestorecipientswhosenameswereplainlyfabricatedorintentionallyomitted,suchas"PodGod,"PrepaidGiftCard,"and"GiftRecipient.
"179.
Insum,JUULdisplayedabrazendisregardforitsobligationtopreventunderageconsumersfrompurchasingitsproducts.
Instead,JUULsolde-cigarettestonumerousunderageMassachusettsconsumers.
J.
JUULPartneredwithRetailStoresthatSoldTobaccoandNicotineProductstoUnderageConsumers180.
Beginningin2015,JUULauthorizedphysicalretailstores,suchasgasstationsandconveniencesstores,tosellJUULproducts.
JUULpromotedtheseretailersthroughafeatureonitswebsitethatallowedconsumerstolocateanauthorizedretailerclosesttotheconsumer'slocation.
181.
Accordingtoa2019surveybytheMassachusettsDepartmentofPublicHealth,43.
8%ofhighschoolstudentswhousee-cigarettesobtainthemfromaretailstore.
182.
JUULalsosoldlargequantitiesofJUULe-cigarettestoretailersinMassachusettsthroughtheJUULwebsitewithoutofficiallyauthorizingretailerstoresellJUULproducts.
JUULconductednooversightofthese"unofficial"retailerswhoresolde-cigarettespurchasedfromtheJUULwebsite.
183.
JUULpermittedconsumerstopurchaselargenumbersofitse-cigarettesorpodscontainingitse-liquidsthroughitswebsite.
JUULknew,orshouldhaveknown,thatsuch"bulk"purchaseswereoftenresoldtounderageconsumers.
184.
JUULprovidedauthorizedretailerswithspecificdirectionsregardingthewayinwhichJUULe-cigarettesshouldbedisplayedandadvertised.
JUULdirectedretailerstodisplay43JUULe-cigarettesinaclearcaseontopoftheirsalescounter,neartheircashregister,todrawtheattentionofconsumersinthecheck-outline.
TheseproductdisplayunitsfeaturedavideodisplaythatplayedJUULadvertisements,includingadvertisementsfromtheVaporizedCampaign.
JUULalsoprovidedretailerswithadvertisingmaterialstopromoteJUULproductawareness,including"takeawaycards"andgasstation"pumptoppers.
"185.
JUULconductedtrainingswithstoremanagersandstaffforauthorizedretailerstodevelop"brandambassadors"fortheire-cigarettes.
186.
TheFederalFoodandDrugAdministration("FDA")regularlyconductsundercoverinspectionsoftobaccoretailerstodeterminewhetherthoseretailersareadequatelypreventingsalesoftobaccoandnicotineproducts,includinge-cigarettes,toindividualsyoungerthantheminimumlegalsalesage.
187.
Duringtheseinspections,atrainedunderageconsumer,workingwithanFDAinspector,attemptstopurchaseatobaccoproduct.
Iftheunderageconsumerissuccessfulinpurchasingatobaccoproduct,theFDAissuesawarninglettertotheretailstoreand/orimposesacivilmonetarypenalty.
ThenamesofretailstoresinspectedandtheresultofFDAinspections,includingwarninglettersandpenalties,arepubliclyavailableontheFDA'swebsite.
188.
JUULauthorizedapproximately850retailstoresinMassachusettstosellitsproducts,eventhoughtheFDAhadalreadysentapublicwarninglettertotheseretailstoresand/orassessedapenaltyagainstthemforsellingtobaccoproductstounderageconsumersduringanundercoverinspection.
189.
Forexample,JUULauthorizedtheRacingMart,aretailstorelocatedat475St.
JamesAvenueinSpringfield,tosellJUULproducts.
TheFDAissuedwarningletterstoRacingMartinJuly2016andJune2017andassessedcivilmonetarypenaltiesinMay2018andOctober442018forsellingcigarettestounderageconsumersduringFDAinspections.
JUULneverthelessauthorizedtheRacingMarttosellJUULe-cigarettesinDecember2018.
190.
JUULauthorizedWheeler'sConvenienceStore,aretailstorelocatedat954StateStreetinSpringfield,tosellJUULe-cigarettes.
TheFDAissuedawarninglettertoWheeler'sConvenienceStoreinOctober2014,andassessedcivilmonetarypenaltiesinMay2015,May2016,andApril2018forsellingcigarettesandcigarstounderageconsumersduringFDAinspections.
JUULneverthelessauthorizedWheeler'sConvenienceStoretosellJUULproductsinAugust2018.
191.
JUULauthorizedOakStreetConvenienceStore,aretailstorelocatedat350OakStreetinBrockton,tosellJUULe-cigarettes.
TheFDAissuedawarninglettertoOakStreetConvenienceStoreinAugust2015andassessedcivilmonetarypenaltiesinApril2017,January2018,andAugust2018,forsellingcigarettesande-cigarettestounderageconsumersduringFDAinspections.
JUULneverthelessauthorizedOakStreetConvenienceStoretosellJUULe-cigarettesinSeptember2018.
192.
Beginningin2017,JUULbeganconductingitsown"secretshopper"inspectionsofitsauthorizedretailers.
Duringtheseinspections,JUULdeterminedthatunderageconsumerswereabletopurchaseJUULe-cigarettesatmanyofitsauthorizedretailersinMassachusetts.
Nevertheless,JUULcontinuedtoauthorizeretailerstosellJUULe-cigarettesafterstoresfailedinsomecasesmultipleinspections.
193.
Forexample,theFDAissuedawarninglettertoaJUUL-authorizedretailer,NewEnglandMeatMarketinPeabody,inJanuary2017forsellingcigarettestoanunderageconsumerduringanFDAinspection.
JUULauthorizedthestoretosellJUULe-cigarettesinOctober2018.
JUULconducteditsowninspectionofNewEnglandMeatMarketinJanuary452019,duringwhichitobservedstorepersonnelattemptingtosellJUULe-cigarettestoanunderageconsumer.
JUULneverthelesscontinuedtoauthorizeNewEnglandMeatMarkettosellitse-cigarettes.
K.
JUULMadeThousandsofShipmentsofE-CigarettestoMassachusettswithoutRequiringanAdultSignatureatReceipt194.
BeginningonSeptember25,2015,Massachusettslawmandatedthe"useofamethodofmailing,shipping,ordeliverythatrequiressignatureofapersonwhoisoftheMinimumLegalSalesAgebeforetheshippingpackageisreleased"foranyonlinesaleofe-cigarettes.
940CMR21.
04(4).
195.
JUULdeliveredthevastmajorityofitse-cigaretteshipmentstoMassachusettsusingtheUnitedStatesPostalService("USPS").
196.
JUULknewthatUSPSwasnotproperlyobtainingadultsignaturesupondeliveryofJUULe-cigarettes.
InanemaildatedAugust14,2015,JUULemployeeKellyLongwrotetohercolleagues,"USPSdoesnotseemtobedeliveringadultsignaturepackagesconsistentlyorfollowingthelaw…Reportswherethemailmandidn'tacquiresignatureandleftondoorsteps.
Afewreportswherethemailmansignedforithimself(!
)leftinmailboxes.
"197.
JUULretainedUSPSmailcarriernotesfromdeliveriesofitse-cigarettesinMassachusetts.
198.
NotesfromUSPSdeliveriesofJUULe-cigarettetoMassachusettsaddressesroutinelyfailedtoindicatethenameoftherecipientorconfirmthatapersonoftheminimumlegalsalesagesignedforthedelivery.
USPSnotesfordeliveriesinSeptember2017include:a.
"Youritemhasbeendeliveredtothemailroomat12:55pmonSeptember9,2017inMEDFORD,MA02155.
TheitemwassignedforbyJFRONTDESK;"46b.
"Youritemwasdeliveredinoratthemailboxat10:44amonSeptember13,2017inROXBURYCROSSING,MA02120;"c.
"Youritemwasdeliveredinoratthemailboxat12:54pmonSeptember25,2017inMALDEN,MA02148.
"199.
Otherdeliveryservices,suchasFedExandUPS,alsoofferdeliveryservicesthatrequirethesignatureofapersonovertheageof21uponreceipt.
Nevertheless,JUULdidnotusetheseotherservicesdespiteknowingthatUSPSwasnotproperlyobtainingadultsignatures.
JUULcontinuedtouseUSPSforthevastmajorityofitsdeliveriesofe-cigarettestoMassachusetts.
200.
JUULalsodeliveredthousandsofpackagestoconsumersinMassachusettswithoutobtaininganysignatureupondelivery.
201.
JUULpermittedconsumerstosignupforregular,periodicautomaticdeliveriesofe-cigarettes,whichJUULdescribedas"auto-ship"deliveries.
Whenconsumerssignedupfor"auto-ship"deliveries,JUULdidnotrequirethesignatureofapersonoftheminimumlegalsalesageupondeliveryoftheconsumers'periodicshipmentsofe-cigarettes.
202.
Asaresult,JUULsentthousandsofpackagesofe-cigarettestoMassachusettsthroughits"auto-ship"programwithoutrequiringthesignatureofapersonoftheminimumlegalsalesage.
203.
Moreover,whenconsumerspurchasede-cigarettesfromJUUL'swebsite,theysometimesenteredashipping"address"and"zipcode"inMassachusettsbuta"state"otherthanMassachusetts.
Intheseinstances,JUULdidnotrequirethesignatureofapersonoftheminimumlegalsalesageupondeliveryinMassachusettsofitsshipmentofe-cigarettes.
47204.
Asaresultofthispractice,JUULmadenumerousshipmentsofe-cigarettestoMassachusettswithoutrequiringthesignatureofpersonoftheminimumlegalsalesage.
L.
AsaResultofJUUL'sAdvertisingandSalestoUnderageConsumers,MillionsofUnderageConsumersUseJUULandOtherE-Cigarettes205.
JUUL'sadvertisingeffortswerepervasivelyappealingtoandtargetedatunderageconsumers.
JUULalsosolditse-cigarettesdirectlytounderageconsumers.
Asanentirelyforeseeableresult,millionsofunderageconsumersinMassachusettsandnationwideuseJUULe-cigarettes.
206.
Adolescentsnowusee-cigarettesinextraordinarilylargenumbers.
Accordingtoa2019surveyconductedbytheNationalInstituteonDrugAbuse,oneinfourU.
S.
highschoolseniorshasusede-cigarettesinthelast30days.
20ThesamesurveyshowsthatmorethanoneinnineU.
S.
highschoolseniorsusee-cigarettesonadailyornear-dailybasis,anindicationofnicotineaddiction.
21Similarly,a2019studypublishedintheJournaloftheAmericanMedicalAssociationfoundthat27.
5percentofU.
S.
highschoolstudentsand10.
5percentofU.
S.
middleschoolstudentssaytheyhaveusede-cigarettesinthepastmonth.
22207.
InMassachusetts,theuseofe-cigarettesamongchildrenandadolescentsisevenmoreprevalent.
Accordingtothe2019MassachusettsYouthHealthSurveyconductedbytheMassachusettsDepartmentofPublicHealth,51.
2%ofMassachusettshighschoolstudentsreportthattheyhaveusede-cigarettesand32%haveusede-cigarettesinthelast30days.
23Recentlocalsurveysshowsimilarresults.
Forexample,inthetownofBedford,Massachusetts,2820RichardMiechetal.
,TrendsinAdolescentVaping,2017-2019,381NewEng.
J.
ofMed.
1490(2019),https://www.
nejm.
org/doi/full/10.
1056/NEJMc1910739.
21Id.
22Cullenetal.
,supraat14.
23Mass.
Dep'tofPub.
Health,YouthVapingandCessationData(2019),https://www.
mass.
gov/files/documents/2019/11/27/youth-vaping-and-cessation-data-11-26-2019.
pdf.

48percentofhighschoolstudentsreportedcurrentuseofe-cigarettesin2018,24andinasurveyofnineschooldistrictsinandaroundFranklinCounty,approximately32percentofeighth,tenth,andtwelfthgradersreportedthattheywerecurrente-cigaretteusersin2019.
25Whilethesesurveysindicatealarmingratesofe-cigaretteusebyadolescentsinMassachusetts,theylikelyunderestimatetherateofe-cigaretteusebecauseyoungpeopleunderreporttheiruseofe-cigarettes.
208.
Whenunderageconsumersusee-cigarettes,theire-cigarettebrandofchoiceisoverwhelminglyJUUL.
Amongcurrente-cigaretteusers,almost60percentofU.
S.
highschoolstudentsand55percentofU.
S.
middleschoolstudentsnamedJUULastheirusuale-cigarettebrand.
26209.
TheratesofJUULusebyadolescentsfarsurpassthoseofadults.
AccordingtoastudybytheTruthInitiative,15-to17-year-oldsare16timesmorelikelytobecurrentJUULusersthan25-to34-year-olds.
27210.
JUUL'spracticeshaveinspiredcompetinge-cigarettecompaniestosellcopycatJUULe-cigarettesandtousetheJUULbrandtoadvertisethosee-cigarettestounderageconsumers,furtheramplifyingJUUL'sappealtoandimpactonunderageconsumers.
24BedfordYouthandFam.
Serv.
,SummaryofResultsfromthe2018BedfordYouthRiskBehaviorSurvey(2018),https://www.
bedfordma.
gov/sites/bedfordma/files/uploads/bedford18_summarybrief_2pg.
pdf.
25CommunitiesthatCareCoalition,YouthHealthSurveys,http://www.
communitiesthatcarecoalition.
org/surveys.
26Cullenetal.
,supraat14.
27TruthInitiative,BehindtheexplosivegrowthofJUUL(Jan.
3,2019),https://truthinitiative.
org/research-resources/emerging-tobacco-products/behind-explosive-growth-juul.
49M.
TheHighly-ConcentratedNicotineinJUUL'sE-CigarettesisEspeciallyAddictiveandHarmfulforUnderageConsumers211.
JUUL'se-cigarettescauseunderageconsumerstoabsorblargeamountsofnicotine,atoxicandaddictivesubstancethatisespeciallydetrimentaltothehealthofadolescentsandyoungadults.
212.
Nicotineisacentralnervoussystemstimulantand,onceingested,travelsquicklytothebrain,whereittriggersthereleaseofchemicalsandultimatelyfeelingsofreward.
28Asaresult,userscometoassociatenicotinewithpleasurablefeelings.
29AsBonnieHalpern-Fisher,professorofpediatricsatStanfordUniversity'smedicalschoolputsit,"[r]atherthanyourbraingettingpleasurefromexercisingorrelationships,yourbrainbecomesrewiredtogetpleasurefromnicotine.
"30Nicotineaddictionisthemostcommonandmostharmfuleffectofnicotineuse.
Regularuseofnicotineleadstouncomfortablesymptomsuponwithdrawal,which,inturn,perpetuatecontinueduseregardlessofadverseconsequences.
31213.
Nicotinecreatesstrongerfeelingsofrewardinadolescentsthaninadultsand,asaresult,adolescentsmokersaremorelikelythanadultsmokerstobecomedependentonnicotine.
3228Ctr.
onAddiction,UnderstandingandAddressingNicotineAddiction:AScience-BasedApproachtoPolicyandPractice(Oct.
2015),https://www.
centeronaddiction.
org/addiction-research/reports/understanding-and-addressing-nicotine-addiction-science-based-approach(citationsomitted).
29Id.
30ChrisKirkham,Juuldisregardedearlyevidenceitwashookingteens,REUTERS(Nov.
5,2019,11:00AM),https://www.
reuters.
com/investigates/special-report/juul-ecigarette/.
31CenteronAddiction,supraat28.
32LucindaJ.
Englandetal.
,NicotineandtheDevelopingHuman:ANeglectedElementintheElectronicCigaretteDebate,49Am.
J.
ofPreventativeMed.
286,290(2015)(citationsomitted).
50214.
Ayoungpersonmaybecomeaddictedtonicotinebyabsorbingapproximately5mgofnicotineperday.
ByconsumingjustonequarterofaJUULe-cigarettepodperday,ayoungpersonmayexceedthethresholdfornicotineaddiction.
33215.
Duetotheprevalenceofthehigh-nicotineconcentratione-cigarettespioneeredbyJUULandtheeaseoftheiruse,manyteenagerswhousee-cigaretteshavehigherlevelsofnicotineintheirbodiesthanteenagerswhosmokecombustiblecigarettes.
34216.
Onceaddicted,manyyoungpeoplearedriventousetheirJUULe-cigarettesfromthemomenttheywakeupuntiltheygotosleep,sometimesevenwakinginthemiddleofthenighttofeedtheiraddiction.
35217.
Moreover,humanbraindevelopment,includingareasofthebraininvolvedinhighercognitivefunction,suchastheprefrontalcortex,continuesthroughoutadolescenceandwellpasttheageof20.
36AccordingtotheCenterforDiseaseControl,"[u]singnicotineinadolescencecanharmthepartsofthebrainthatcontrolattention,learning,mood,andimpulsecontrol.
"37218.
Perhapsmostdisturbing,e-cigarettescanleadusers,especiallyadolescentusers,toinitiateuseoftraditionalcombustiblecigarettesorotherdangeroussubstances.
38Underage33Jackler&Ramamurthi,supranote3,at626.
34StonyBrookU.
News,AdolescentUsersofE-CigarettesExposedtoNearlyasMuchNicotineasSmokers(Sept.
7,2018),https://news.
stonybrook.
edu/newsroom/adolescent-users-of-e-cigarettes-exposed-to-nearly-as-much-nicotine-as-smokers/.
35SeeJanHoffman,ThePriceofCool:ATeenager,aJuulandNicotineAddiction,N.
Y.
TIMES(Nov.
16,2018),https://www.
nytimes.
com/2018/11/16/health/vaping-juul-teens-addiction-nicotine.
html.
36Englandetal.
,supraat32(citationsomitted).
37Ctr.
forDiseaseControlandPrevention,QuickFactsontheRisksofE-cigarettesforKids,Teens,andYoungAdults,https://www.
cdc.
gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.
html.
38Seee.
g,KathleenStrattonetal.
,Nat'lAcad.
ofSci.
,Eng'g,andMed.
,PublicHealthConsequencesofE-Cigarettes(2018),https://doi.
org/10.
17226/24952.
51consumerswhouseJUULproductsaremorelikelytouseorbecomeaddictedtotraditionalcigarettes.
39Thisincreasedriskoftransitionfromvapingtosmokingistrueevenforlow-riskyouth,heighteningconcernsthatJUULandothere-cigarettecompaniesarecontributingtotherenormalizationofsmokingbehaviorsoncethoughtpasséandreversingdecadesofprogressinmovingyoungpeopleofftobacco.
40Theincreasedriskisdramatic:amongyoungpeoplewithnopriornicotineuse,thosewhobecomee-cigaretteusersarefourtimesmorelikelytostartsmokingcigarettes.
41219.
YouthwhobecomeaddictedtonicotinethroughJUULproductsexperiencearangeofnegativesocial,emotional,behavioral,andphysicaleffects.
Teenagersdescribewildmoodswings,violentoutbursts,shouting,andemotionalconfrontationswithfamilyandfriends.
42Theyexpressfeelingsofself-hatredforbeingdependentonaJUULdeviceandintenseanxietyatthethoughtofdoingwithoutit.
43Youngpeoplealsoresorttostealingfromtheirparentsorsellinge-cigaretteparaphernaliaorclothingitemstosupporttheirhabits.
Theyalsofindthemselvesfeelingwinded–coined"JUULlung"–andunabletokeepupwiththeirregular39KaitlynM.
Berryetal.
,AssociationofElectronicCigaretteUseWithSubsequentInitiationofTobaccoCigarettesinUSYouths,2JAMA1(2019);RichardMiechetal.
,E-cigaretteuseasapredictorofcigarettesmoking:resultsfroma1-yearfollow-upofanationalsampleof12thgradestudents,26TobaccoControl106(2017),https://tobaccocontrol.
bmj.
com/content/26/e2/e106;JessicaL.
Barrington-Trimisetal.
,E-CigarettesandFutureCigaretteUse,138Pediatrics1(2016),https://www.
ncbi.
nlm.
nih.
gov/pmc/articles/PMC4925085;JonathanFielding,Thee-cigaretteepidemic–recognizingBigTobacco'sTrojanhorse,THEHILL(Feb.
11,2019,6:30PM),https://thehill.
com/opinion/healthcare/429484-the-e-cigarette-epidemic-recognizing-big-tobaccos-trojan-horse;TruthInitiative,BehindtheexplosivegrowthofJUUL(Jan.
3,2019),https://truthinitiative.
org/research-resources/emerging-tobacco-products/behind-explosive-growth-juul;Nat'lAcad.
ofSci.
,Eng'g,andMed.
,supranote38.
40Berryetal.
,supranote39.
41Barrington-Trimisetal.
,supranote39;Berryetal.
,supranote39;Miechetal.
,supranote39.
42MoriahBalingit,Inthe'Juulroom':E-cigarettesspawnaformofteenaddictionthatworriesdoctors,parentsandschools,WASH.
POST(July26,2019,7:00AM),https://www.
washingtonpost.
com/local/education/helpless-to-the-draw-of-nicotine-doctors-parents-and-schools-grapple-with-teens-addicted-to-e-cigarettes/2019/07/25/e1e8ac9c-830a-11e9-933d-7501070ee669_story.
html;Hoffman,supranote35.
43Hoffman,supranote35.
52physicalactivity.
44YoungJUULusersreportincreasedanxietyandphysicalsymptomssuchasuncontrollableshakingwhenwithdrawingfromnicotine.
45220.
YouthwhobecomeaddictedtonicotinethroughJUULuseareharmedinotherways,includingbyalteringschoolandsocialschedulesinordertouseJUULdevicesanddivertingtheirlimitedresourcestopayforJUULdevicesandpods.
46AJUULaddictioncancauseseriousharmtoschoolperformanceandgrades.
47221.
Familiesofyoungpeopleaddictedtoe-cigarettesstruggletoidentifytreatmentoptions,mustrespondtoschooldisciplinarymatters,andmonitortheirchildrentoensurethattheyarenotcontinuingtousee-cigarettes.
Somefamiliesexpendsignificantsumsofmoneytoplacetheirchildreninprivatedrugtreatmentprograms.
222.
ThefullextentofnegativehealtheffectstounderageconsumersfromwidespreaduseofJUULe-cigarettesisstillunknown.
Scientistswarnthatthelong-termhealtheffectsofJUULandothere-cigarettesmaynotbeknownfordecades.
48223.
Whilethefullrangeofhealtheffectsisstillunknown,theexistingandgrowingbodyofresearchandclinicalobservationsshowcauseforsignificantconcern,particularlyrelatedtolunghealth.
Studies,observationsbyspecialistsatBoston-areahospitals,andanecdotalreportsincreasinglyindicatethattheuseofJUULandothere-cigarettesmayhaveaseriousandnegativeimpactonlungsandlungfunction.
224.
Exposuretosecondhandaerosolisanotherconcern,thehealthimpactsofwhich44Id.
45Id.
46Id.
47Kirkham,supranote30.
48Seee.
g.
,JeffreyE.
Gottsetal.
,Whataretherespiratoryeffectsofe-cigarettes,366BMJ1(2019),availableathttps://doi.
org/10.
1136/bmj.
l5275.
53arelargelyunknown.
49Whilethenumberofyoungpeopleexposedtosecondhandsmokehasdecreased,theexposuretosecondhandaerosolproducedbye-cigaretteshasincreased.
50Fumesfrome-cigarettescontainchemicalssuchasnicotine,aerosols,toxins,andflavoringsubstancesthatmayposeahealthrisktobystanders,especiallyyoungpeople.
Arecentstudyshowedthatteenswithasthmawhodonotvapeandareexposedtosecondhandaerosolaremorelikelytohaveanasthmaattack.
51Pastresearchproveslinksbetweennicotineexposureandsuddeninfantdeathsyndrome,attentiondeficithyperactivitydisorder,earinfections,pneumonia,andinfluenza.
52N.
ThereareInsufficientTreatmentsAvailableforNicotine-AddictedYouthinMassachusetts225.
Massachusettsadolescentsandyoungadultswhoareaddictedtoe-cigarettesstruggletoquit.
MattMurphy,ateenagerfromReading,whostartedusingJUULproductsinhighschool,describedthechallenge:"OnceIrealizedIwasbrutallyaddicted,Iwantedtoquit–andthenyoucan'tquit.
"53Hisquesttoquittooktwoyearsandmanyfailedattempts.
54226.
Resourcesavailablefortreatingunderagenicotineaddictionfrome-cigaretteuse49MichaelO.
Schroeder,SecondhandVaping:WhatRisksDoesAerosolFromE-CigarettesPoseforKids,U.
S.
News(Jul.
9,2019,12:11PM),https://health.
usnews.
com/conditions/articles/secondhand-vaping-risks-for-kids;WVLTNews,1in3teensbreathesecondhande-cigarettevapors(Oct.
15,2019,10:59AM),https://www.
wvlt.
tv/content/news/1-in-3-teens-breathe-secondhand-e-cigarette-vapors--563135011.
html.

50AndyS.
L.
Tanetal.
,TrendsinthePrevalenceofExposuretoe-CigaretteAerosolinPublicPlacesAmongUSMiddleandHighSchoolStudents,2015to2018,2JAMANetworkOpen1(2019),availableathttps://jamanetwork.
com/journals/jamanetworkopen/fullarticle/2749049utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=082819.
51JenniferE.
Baylyetal.
,SecondhandExposuretoAerosolsFromElectronicNicotineDeliverySystemsandAsthmaExacerbationsAmongYouthWithAsmtha,155CHESTJournal88(2019),availableathttps://journal.
chestnet.
org/article/S0012-3692(18)32584-4/fulltext.
52SeeWinickoffAff.
28,Doc.
No.
39,atEx.
I(filedAugust28,2018)inAmericanAcademyofPediatricsv.
FoodandDrugAdministration,CivilActionNo.
18-cv-00883(D.
Md.
2018).
53CBSBoston,TeensHelpingPeersKickVapingHabitAsUse&SuspensionsSpike(Sept.
4,2019,5:16PM),https://boston.
cbslocal.
com/2019/09/04/teen-vaping-quitting-use-suspensions-spike/.
54Id.
54areextremelylimited.
227.
Multipleyearsintotheepidemic,youth-focusedscreeningandtreatmentguidelinesforyouthnicotineaddictionareonlyjustbecomingavailableandhavenotbeenwidelyadopted.
PhysiciansatBostonMedicalCenterandtheUniversityofMontrealpublishedpreliminaryguidelinesinDecember2019tohelpcliniciansscreen,counsel,andtreatyouthfore-cigaretteuse.
55TheMassachusettsDepartmnetofPublicHealthandtheUniversityofMassachusettsMedicalSchoolareintheprocessofdevelopingandprovidinginterventiontrainingforschoolnursesacrossMassachusetts.
228.
ThereareinsufficienttreatmentfacilitiesorprogramsfocusedsolelyonyouthnicotineaddictiontreatmentinMassachusettstomeettheexplodingneed.
Cognitivebehavioraltherapy(CBT)offersoneoftheleadingformsoftreatmentfornicotineaddiction,butthereislimitedavailabilityofCBTprovidersinthestatewiththeappropriateexperienceorspecialization.
56229.
Theresearchregardingthetreatmentofyoungpeopleaddictedtoe-cigarettesislimited.
Whilecessationoptionslikethenicotinepatchandvareniclinehaveproveneffectivewithadultsseekingtoquit,thereislittleevidencethattheyareeffectivecessationoptionsforyoungpeople.
5755ScienceMagazine,GuidelinesForCliniciansToAddressYouthVaping(Dec.
19,2019),https://scienmag.
com/guidelines-for-clinicians-to-address-youth-vaping/.
56SeeWinickoffAff.
28,Doc.
No.
39,atEx.
I(filedAugust28,2018)inAm.
Acad.
ofPediatricsv.
FoodandDrugAdmin.
,CivilActionNo.
18-cv-00883(D.
Md.
2018).
57Balingit,supranote42.
55O.
YouthNicotineAddictionBurdensMassachusettsSchools230.
JUUL'sadvertisingandsalespracticescreatedamarketfore-cigarettesamongyoungpeople,addictingtensofthousandsofstudentsinMassachusettstoe-cigarettesandcausingsubstantialharmtoMassachusettsschools.
TeachersandschooladministratorsareexpendingvaluableandlimitedtimeandresourcestostopstudentsfromusingJUULe-cigarettesonschoolgrounds.
58231.
Massachusettsschooladministratorsandstudentsreportthattheuseofe-cigarettesinschoolsisdisruptive.
Administratorsreportthatmoreandmoreoftheirtimeisconsumedbytheproblemofe-cigaretteuseinschoolandthattheyarestrugglingtomanagetheproblem.
Forexample,intheFoxboroughschooldistrict,81percentofseventhgradersand80percentofeighthgraderssaidthate-cigaretteusewasaproblemduringtheschoolday.
59Thenumbersdeclinedonlyslightlyatthehighschoollevel.
60InFoxborough,studentsidentifiedbathrooms,thegymlockerrooms,andtheschoolparkinglotsasareaswherestudentvapingtypicallyoccurs.
61232.
StudentsacrossMassachusettsrefertoschoolbathroomsasthe"JUULlounge,"andsomestudentsreportthattheyavoidthebathroomsbecauseoframpantJUULuse.
Administratorsarespendingupwardsof$995perunitonvapingdetectiondevicesor"vape58DenisaR.
Superville&AriannaProthero,TheStudentVapingCrisis:HowSchoolsAreFightingBack,EducationWeek(Aug.
27,2019),https://www.
edweek.
org/ew/articles/2019/08/28/the-student-vaping-crisis-how-schools-are.
html;JulieBosman,AtSchool,'EveryoneVapes,'andAdultsAreinCrisisMode,N.
Y.
TIMES(Sept.
20,2019),https://www.
nytimes.
com/2019/09/20/us/Vaping-Schools.
html;PatEaton-Robb,DisciplineortreatmentSchoolsrethinkingvapingresponse,Boston.
com(May26,2019),https://www.
boston.
com/news/local-news/2019/05/26/discipline-or-treatment-schools-rethinking-vaping-response.
59JeffPeterson,Surveyfindsdifferingopinionsoverresponsestobullying,vaping,studentsupportinFoxboroschools,SUNCHRONICLE(Oct.
13,2019),https://www.
thesunchronicle.
com/news/local_news/survey-finds-differing-opinions-over-responses-to-bullying-vaping-student/article_b16afa98-7716-5540-bd0f-40b0f337f136.
html.
60Id.
61Id.
56detector"forplacementinschoolbathrooms.
62Thestate'sFiscalYear2020budgetearmarked$50,000forthepublicschoolsinHaverhilltopurchasevapingsensorsandrelatedtechnology.
63Someschooldistrictsareapplyingforandreceivinggrantfundingtohelpsupportthecostofsuchtechnology.
Whenavapedetectoristriggered,anadministratorreceivesatextore-mailmessageandmustimmediatelydeploytothelocationofthedetector,interruptingwhateverotherschoolactivitywasoccurringatthetime.
Detectorscansoundupto10or20timesduringtheschoolday.
64Otherschooldistrictsconductrandombathroomchecks65orhavepurchasedsubstancedetectionkitsthatcandeterminewhetherthesubstanceinaJUULcartridgeisnicotineortetrahydrocannabinol(THC),themainpsychoactivechemicalcompoundinmarijuana.
66AdministratorsinMassachusettsschoolsareconfiscatingJUULandothere-cigaretteproductsinlargequantities,buttheyarestillcontendingwiththeproblemonadailybasis.
233.
StudentscaughtwithaJUULdevicemaybesuspendedfromschoolbecauseofaviolationoftobaccoorchemicalhealthpolicies.
Punishmentsescalatefromin-schoolsuspensionforafewhoursordaystoshort-andlong-termout-of-schoolsuspension.
Theratesofsuspensionsrelatedtoe-cigaretteusearespiking.
Forexample,thetownofBrooklinehadnoe-62MaryMarkos,Massachusettsschoolsinstallingdetectorstoaddressgrowingvapeproblem,BOSTONHERALD(updatedMay31,2019,11:03AM),https://www.
bostonherald.
com/2019/05/30/ma-schools-installing-detectors-to-address-growing-vape-problem/.
63FY2020FinalBudget,ActsCh.
41,191stGeneralCourt(Mass.
2019),https://malegislature.
gov/Budget/FinalBudget.
64Markos,Massachusettsschoolsinstallingdetectorstoaddressgrowingvapeproblem,supranote62.
65MaryMarkos,NorthShoreschoolscombatvapingcraze,SALEMNEWS(Jan.
14,2018),https://www.
salemnews.
com/news/local_news/north-shore-schools-combat-vaping-craze/article_af7ac530-4f6e-516d-a5bd-368d0a854771.
html("Thefruityscentofvapepenstrickedmanyschooladministratorsintothinkingthejanitorsweredoingafabulousjobcleaningthebathrooms,onlytolaterrealizethatstudentswere"Juuling,"orsmokingelectroniccigarettesbehindthestalls.
").
66ElaineThompson,CentralMass.
schools,healthofficialsclampdownonteenvaping,Telegram.
com(updatedSept.
7,2019,4:05PM),https://www.
telegram.
com/news/20190903/central-mass-schools-health-officials-clamp-down-on-teen-vaping/1.
57cigarette-relatedsuspensionsinthe2015-16schoolyearand33inthe2018-19schoolyear.
67Hollistonhadasimilarincrease,withonesuspensioninthe2015-16schoolyearand45inthe2018-19schoolyear.
Notonlydodisciplineprocessesrequiremeaningfultimeandattentionofschooladministrators,butstudentswhoareexcludedfromschooloftenfallbehindtheirpeersand,unsupervised,mayengageinthesamebehaviorforwhichtheywereexcluded.
68234.
Recognizingthatstudentsareoftenunawareofthehealthconsequencesandaresometimesgrapplingwithaddiction,schoolsarealsoworkingtodevelopalternativestosuspension,suchasmandatoryeducationprograms.
Someschooldistrictshavecontractedwithprivate,for-profitprogramstorune-cigarettecessationeducationandsupportprograms.
69235.
Schoolshavehiredadditionalpersonnelanddevotedsubstantialstaffingresourcestoworkwithstudentstoaddresstheirneeds.
Forexample,theWorcesterPublicSchoolshiredadrugandhealtheducatortoeducatestaff,parents,andstudentsasyoungasthirdgradeaboutthedangersofe-cigaretteuse.
70Schoolpersonnelreportthatstudentsshowupintheirofficesunexpectedlyandsometimeshighlyemotionalabouttheirinabilitytostope-cigaretteuse,requiringsubstantialstafftime.
236.
Schoolsarealsodevelopingmaterialsandworkingtodisseminateinformationtoeducatestudentsandfamiliesontheharmsofe-cigaretteuse.
Schoolofficials,teachers,andhealthprofessionalsholdparentinformationeventsduringoff-schoolhours,draftanddistribute67CBSBoston,supranote53.
68Id.
69SamChaseetal.
,YouthRiskBehaviorSurvey:Presentationof2019Results,MonomoyRegionalHighSchool(Oct.
7,2019),https://www.
monomoy.
edu/site/handlers/filedownload.
ashxmoduleinstanceid=7089&dataid=9315&FileName=Youth%20Risk%20Survey%20Parent%20Presentation%202019%20Annotated%20PowerPoint%20-%20srcfinal-jj-10.
4.
19.
pdf.
70Thompson,supranote66.
58informationflyersandelectroniccommunications,andrespondtooutreachfromparentsdesperateforhelpfortheirchildren.
237.
JUULpodslitterthegroundsoflocalschoolyards,parks,andplaygrounds.
WhileJUULpodsareoftendiscardedaslittermuchlikecigarettebutts,theyraiseadditionalconcernsbecauseoftheirchemicalcomponents,whichcanleachintothewaterandgroundandposeabiohazardrisk.
71Expertssuggestthatusedpodsshouldbetreatedlikehazardouswasteandthatproperdisposalrequireseitherbringingthemtohazardouswasteorrecyclingcenters72orrinsingthemuntilallresidueisremovedandwrappingtheminascrapofbiodegradablematerial.
73OtherJUULcomponents,includingthebattery,constituteelectronicwasteandthreatenenvironmentalhealth.
ThereiscurrentlynolegalwaytorecycleJUULproducts,74andexpertssaythat"noneofthe[e-cigarette]companiessofarhavetakenthenecessaryaction,"suchasaproductdepositsystem.
75P.
TheCommonwealthBearstheCostofYouthNicotineAddiction238.
TheCommonwealthmustnowrespondtothepublichealthcrisiscausedbyJUUL.
TheCommonwealthhasborneandwillcontinuetobearthecostsofdeveloping71CarolynCrist,E-cigarettepolicyshouldconsiderenvironmentaleffects,expertsays,REUTERS(Oct.
29,2018),https://www.
reuters.
com/article/us-health-ecigarettes-waste/e-cigarette-policy-should-consider-environmental-effects-expert-says-idUSKCN1N403P;JohnDaley,Don'tTossThatE-Cig:VapingWasteIsAWholeNewHeadacheForSchoolsandCities,NPR(Nov.
29,2019,7:01AM),https://www.
npr.
org/sections/health-shots/2019/11/29/780865248/dont-toss-that-e-cig-vaping-waste-is-a-whole-new-headache-for-schools-and-cities.