(CNN)A new study on Juul-related Instagram posts makes the case for stricter regulation on e-cigarette marketing -- especially when it comes to social media sites popular with younger crowds.
Looking at nearly 15,000 posts from March through May of 2018, the study found that more than a third of posts were promotional in nature -- containing branded marketing messages or links to websites where users could purchase vapes. More than half of the posts also featured content related to "youth culture and lifestyle."
That's important, the researchers say, because "the tobacco industry has historically used lifestyle and social acceptability appeals to market tobacco products, particularly to youth."
Many of these posts were generated not by Juul, but by social media users and other vape companies seeking to draw in business.
In a statement Tuesday, Juul spokesman Ted Kwong said, "At the time of this study, third-party users generated well over 99.999 percent of the Instagram content related to JUUL products." He cautioned against conflating the company's own posts during that period with "wholly unaffiliated third-party content, including content from entities we are actively suing for their inappropriate and unauthorized activities."
The study, published in the BMJ journal Tobacco Control, was funded by the Truth Initiative, an anti-tobacco advocacy group. David Dobbins, the group's chief operating officer, said the US Food and Drug Administration should "use its power to restrict e-cigarette manufacturers from using social media to market to young people." He also called on social media platforms to "adopt and enforce policies against the promotion of any tobacco products to young adults."
Juul, the company with the lion's share of the e-cigarette market, has come under increasing scrutiny by public health experts and the FDA for its popularity among youth. Some of this scrutiny has focused on the company's marketing, which has been the focus of lawsuits and other investigations into whether Juul deliberately targeted teens.
The company's marketing and social media code says it does "not feature images or situations intended for a youth audience."
Since the time when the authors of the new study collected their data, Juul has phased out much of its social media in the United States, shutting down its Facebook and Instagram accounts in November and scaling back its use of Twitter and YouTube. The company said in a statement last year that it has "a dedicated internal team focused on reporting inappropriate content to social media companies," such as third-party accounts that use the Juul name to sell products to underage users.
"We agree these types of posts are a serious problem and that is why we employ a social media monitoring team dedicated to submitting takedown requests of exactly the type of inappropriate third-party social media content the authors cite as problematic," said Kwong, adding that this team has resulted in the removal of "31,889 social media listings, including 25,405 individual Instagram posts, and an additional 1,251 Instagram accounts."
'Hashtag-Juul lives on'
Dr. Robert Jackler, founder of the Stanford Research into the Impact of Tobacco Advertising, previously told CNN it's a "good thing" that Juul cut back its social media, but that the response was "very late in the game."
Jackler said he doesn't necessarily believe Juul intentionally targeted underage kids with its marketing, but its appeal to kids was obvious early on, and the company didn't take early steps to prevent that.
"The company claims that they didn't know" that the product appealed to underage kids who began using it in large numbers, Jackler said.
"I don't believe that, not for a minute, because they're also a very digital, very analytical company," he added. "They know their market. They know what they're doing."
Ashley Gould, chief administrative officer at Juul Labs, told CNN last year that "we were completely surprised by the youth usage of the product."
Previous research has documented an earlier spread of vaping and Juul-related content on social media.
According to a study published last year, "the number of JUUL-related tweets exploded in 2017 ... 17 times the 2016 levels." A separate study last year estimated that 25% of users retweeting the company, mostly during 2017, were under age 18.
When it comes to paid advertisements, Instagram and Facebook's policy says that "ads must not promote the sale or use of tobacco products and related paraphernalia. Twitter's advertising policy also "prohibits the promotion of tobacco products, accessories, and brands globally."
Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, previously told CNN that the ripple effect set in motion by Juul's early social media popularity "just keeps going."
"Once you get kids doing it, you don't have to pay for it," he said. "It takes off on its own, and you continue to get the financial benefit."
Jackler agreed, saying that the company fostered a social media phenomenon in its early days that took on a life of its own, and continues to introduce young people to its product.
"Hashtag-Juul lives on," he said.
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Officials have put social media front and center in going after e-cigarette companies.
The FDA and the Federal Trade Commission announced last month they were going after companies that paid social media "influencers" to promote vaping products. The agencies sent warning letters to four companies for infractions including omitting a required warning about nicotine's addictiveness. Juul was not one of the companies.
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A CNN investigation in December shed light on Juul's influencer program and identified several of the social media users who participated. At the time, a representative for Juul said that the company had abandoned that program, describing it as small and "short-lived."
Kwong also said that "JUUL Labs did not sponsor any 'influencer' activities on any social media platform, including Instagram," during the period referenced in the new study. "As a result, this study does not measure the company's social media presence as alleged, but instead provides a snapshot of the social media content perpetuated by others, including manufacturers of illegal and potentially dangerous compatible products which aggressively promote their products on social media to youth."
The company says it has taken aggressive action to curb its products from getting into minors' hands.
