MASSACHUSETTS ATTORNEY GENERAL Maura Healey on Wednesday filed a lawsuit against the e-cigarette giant JUUL Labs, alleging that the company intentionally created the epidemic of youth vaping by marketing and selling e-cigarettes to minors.

The lawsuit accuses San Francisco-based JUUL of crafting youth-oriented advertising campaigns and illegally shipping e-cigarettes to underage buyers who bought them online.

“This is a public health crisis in Massachusetts and around the country,” Healey said at a press conference announcing the lawsuit. “Today, we’re suing the company that started it all.”

Healey accused JUUL, which controls 75 percent of the national e-cigarette market, of “creating a new generation of nicotine addiction.” Her complaint, filed in Suffolk Superior Court, alleges that “JUUL, more than any other company, bears responsibility for the fact that millions of young people nationwide are now addicted to e-cigarettes, reversing decades of progress in combatting underage tobacco and nicotine use and addiction.”

JUUL, which is 35 percent owned by Altria, one of the world’s largest cigarette companies, has long maintained that its goal is to help adults stop smoking traditional cigarettes, and it has not targeted youth. “Our customer base is the world’s 1 billion adult smokers and we do not intend to attract underage users,” said JUUL spokesman Austin Finan.

Finan said while JUUL has not yet reviewed the complaint, “we remain focused on resetting the vapor category in the U.S. and earning the trust of society” by working with attorneys general, regulators and public health officials to combat underage use. After a spate of severe vaping-related illnesses nationwide, JUUL in November stopped selling all flavored vape products other than tobacco and menthol. It halted its television, print, and digital product advertising and restructured its company.

Former Massachusetts attorney general Martha Coakley, Healey’s predecessor, took a job in government affairs with JUUL in April 2019. Healey said she has not talked to Coakley about the lawsuit, and Coakley “was not the subject of our investigation.”

Similar lawsuits against JUUL have been filed in Arizona, California, Illinois, Minnesota, Mississippi, New York, and North Carolina. Healey’s lawsuit, based on internal company documents and interviews from an investigation that began in July 2018, reveals new details about the company’s marketing efforts and how it shipped e-cigarettes to underage customers.

In late 2014, the lawsuit says, JUUL considered an ad campaign that would have marketed JUUL as a technology company selling a modern alternative to traditional cigarettes.

JUUL rejected that campaign, instead choosing one that presented the product as a “cool, cutting-edge tech lifestyle product” that appeals to fashionable, urban individuals. It featured models that were fashionable, sexy, cool, and young.

JUUL placed ads on websites designed to appeal to children and teenagers, from Nickelodeon to the Cartoon Network, according to the lawsuit. Websites with JUUL ads ranged from game sites for young girls to math sites for middle schoolers to college prep sites.

JUUL solicited celebrities and others with large, young social media followings, such as DJs and fashion bloggers, to promote JUUL products, generally by sending them free e-cigarettes. For example, the company targeted musician Miley Cyrus and actress Cara Delevigne. JUUL held launch parties and published photos featuring young attendees.

Photo from JUUL’s 2015 launch party. (Courtesy of Office of Attorney General Maura Healey)

While JUUL stopped using its initial marketing campaign in 2016, it launched new ads focusing on flavored vapes, which are considered most likely to appeal to teenagers, with flavors like mango, cool cucumber, and crème brulee.

In email marketing, the lawsuit says, JUUL promoted products to a list of people who visited its website, most of whom had not passed its age verification process.

The lawsuit also details the ways JUUL sold products from its website to underage consumers. Between June 2015 and July 2019, Massachusetts consumers spent nearly $6.8 million making 106,000 purchases from JUUL’s website.

Although JUUL had an age verification process in place, the company allegedly let people pass the process even if the information the buyer gave did not match information belonging to a person of legal sales age. JUUL repeatedly changed the process to make it easier to pass, according to the lawsuit.

JUUL let users create accounts using high school email addresses. Someone who created an account could ship e-cigarettes to a different name and address, with no confirmation that the recipient was over 21. High school students, recent graduates, and college freshmen throughout the state were able to order shipments of JUUL e-cigarettes, according to the lawsuit. Deliveries did not require a signature.

In one email sent from a JUUL customer service representative to an underage consumer living in Milton, where the legal age was 21, the representative advised the buyer, “If you have friends or relatives in Quincy, MA, you may use their address as a shipping address for your order.” The legal age in Quincy was 18.

The federal government raised the legal tobacco buying age from 18 to 21 in December 2019. Massachusetts raised the statewide legal age to 21 as of December 31, 2018. Before that, Massachusetts cities and towns had been free to impose their own age restrictions, as long as buyers were at least 18.

JUUL sold its products at retail stores where the FDA had previously issued public warning letters or fines for selling to underage customers. JUUL also conducted its own “secret shopper” program in which it sent underage buyers into stores, but the company then continued to sell products at stores that sold to minors.

The lawsuit, which seeks unspecified monetary damages, alleges that JUUL violated the state consumer protection act by marketing and selling to underage consumers and making false claims about nicotine levels in e-cigarettes; illegally shipping and selling e-cigarettes without age verification; and creating a public nuisance by harming public health and safety through youth nicotine addiction.

Over the last few years, vaping has become increasingly popular among Massachusetts youth. In 2019, an annual state survey of risky behavior among young people found that 32 percent of high schoolers currently use e-cigarettes, while half had tried e-cigarettes at some point.

In an attempt to address youth addiction, Gov. Charlie Baker in November signed a law banning the sale of all flavored tobacco products, except for use in smoking bars.

Matthew Myers, president of the Washington, DC-based Campaign for Tobacco-Free Kids, said the country has seen an unprecedented rise in nicotine addiction among children over the last four years. “It’s remarkable the extent to which a single company drove this train, the extent to which the decisions of that company were knowing, conscious, and intentional with disregard for the health and safety of our kids,” Myers said.

At Healey’s press conference, advocates spoke about the dangers of nicotine addiction to teens.

Dr. Jonathan Winickoff, director of pediatric research at the Tobacco Research and Treatment Center at Massachusetts General Hospital, said he sees children with anxiety, depression, mood disorders, asthma, and lung problems from vaping. He said studies show that e-cigarette use impacts brain development.

Emma Tigerman, a 19-year-old Northeastern University sophomore from California, said she grew up watching her grandfather and father smoke, and always said she would never be like them. In 11th grade, she tried a JUUL. Over time, she grew irritable and shaky when she couldn’t vape, and she was constantly craving a hit, so she carried the device around with her.

Tigerman has been trying to quit for four years, with mixed success. “I’ll have to consider myself an addict for the rest of my life. That’s at the hands of JUUL,” she said.