The U.S. Food and Drug Administration made the controversial decision to authorize the sale of Juul e-cigarettes, including menthol-flavored varieties, on July 17, stunning the public health world. 

This is the same Juul that helped ignite a youth vaping epidemic, has paid over $1 billion in lawsuit settlements and remains one of the top five e-cigarette brands used among middle and high school students.

This decision is not just a policy misstep — it’s a betrayal of progress. It threatens to undo years of hard-fought gains in youth tobacco prevention and emboldens an industry that has consistently placed profits over public health.

Between 2017 and 2019, Juul’s rise was rapid and devastating. According to the National Youth Tobacco Survey, e-cigarette use among high school students jumped from 11.7% to 27.5% in just two years, leading the U.S. Surgeon General to declare an “epidemic” in the U.S. Juul’s sleek design, discreet vapor and candy-like flavors made it the perfect player to addict a new generation, especially with products delivering massive doses of nicotine.

In the 2024 National Youth Tobacco Survey, 12.6% of current youth e-cigarette users still report Juul as their brand of choice. Among middle schoolers, Juul ranks third. That’s not ancient history — it’s right now.

What makes the FDA’s decision even more baffling is its greenlighting of menthol-flavored Juul products. Tobacco companies have long used menthol to mask the harshness of nicotine, making it easier for youth to begin using and harder to quit. 

Both the Centers for Disease Control and Prevention and the Food and Drug Administration have documented the dangers of menthol: it enhances nicotine’s effects on the brain, increasing addiction potential. That’s why the FDA previously denied applications for other menthol-flavored e-cigarettes, citing their substantial appeal to youth.

So why make an exception now?

As a researcher at Stanford University’s Research into the Impact of Tobacco Advertising Institute, I’ve spent years studying how the tobacco industry targets young minds and the science behind it. Teens are neurologically primed to take risks and seek reward. Their prefrontal cortex, which governs decision-making and impulse control, is still developing. Meanwhile, reward centers like the nucleus accumbens and ventral tegmental area are hyperactive, making them more susceptible to addiction.

When Juul floods the teenage brain with high concentrations of nicotine — often the equivalent of a pack of cigarettes per pod — it wires circuits for dependency. In neuroimaging studies, adolescent nicotine exposure has been linked to long-term changes in brain structure and function, including thinning of the prefrontal cortex and volumetric changes in the amygdala, regions responsible for memory, emotion and cognitive flexibility.

This isn’t just about willpower. It’s about chemistry. And the industry knows it.

Juul’s FDA authorization may be framed as a legal milestone — it followed years of litigation, revised data and marketing restrictions — but it’s a public health failure. A court decision cannot undo the biological reality of addiction, nor the damage already done to a generation that never signed up to be test subjects in a corporate experiment.

The FDA claims these products meet the standard of being “appropriate for the protection of public health.” But how is it protective to reintroduce a brand synonymous with youth addiction? How is it protective to greenlight menthol, the very flavor proven to hook young users?

Now more than ever, we need federal leadership that prioritizes prevention over permission. 

To counter this ruling, we need more than criticism; we need action. 

Congress must follow through with comprehensive bans on flavored nicotine products, including synthetic variants. Federal agencies must step up enforcement, particularly on TikTok, Instagram and other platforms where youth-targeted vape marketing continues to thrive. We need health education that treats teens as capable learners — people who can understand the science of their own brains and the strategies used to manipulate them.

We cannot allow regulatory decisions to be driven by litigation fatigue or industry lobbying. As Yolonda C. Richardson, President and CEO of the Campaign for Tobacco-Free Kids, put it, this decision is “a big step in the wrong direction.”

This is not about punishing Juul. It’s about preventing the next crisis. We’ve already seen what happens when regulatory agencies wait too long, when they let industry define the rules of engagement. We don’t need another generation growing up with irreversible brain changes, mood disorders and dependency. What we need is a regulatory apparatus with a memory — and a spine.

Juul may have won this round, but the fight for public health isn’t over. Not while 1.6 million youth still vape. Not while flavors still lure kids in. Not while science continues to show just how deep this addiction goes.

It’s not too late to course correct, but it will require scientific, moral and political courage. Because this time, the science is already in. The damage has already been done. The only question left is whether we’ll allow it to happen again.

Abhinav Anne is a student through Northwestern’s Center for Talent Development program and a youth advisor to the World Health Organization, where he advises on global initiatives related to nicotine addiction, youth mental health and children’s health equity. He is also a researcher at Stanford University School of Medicine, working with the Stanford Research into the Impact of Tobacco Advertising (SRITA) Institute, where he studies the tactics used by tobacco and e-cigarette companies to market addictive products to adolescents. His work focuses on youth-targeted advertising, regulatory policy and the intersection of public health and behavioral science. He can be contacted at [email protected]. If you would like to respond publicly to this op-ed, send a Letter to the Editor to [email protected]. The views expressed in this piece do not necessarily reflect the views of all staff members of The Daily Northwestern.