E-cigarette flavour enhancers: Flavoured pod attachments compatible with JUUL and other pod-based devices

Cwalina, Sam N; Leventhal, Adam M.; Barrington‐Trimis, Jessica L.

doi:10.1136/tobaccocontrol-2020-055618

Cited by 9 publications

(10 citation statements)

References 4 publications

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“…These popular flavors are still available in many countries and young people continue to discuss ways to acquire ENDS products like JUUL on Twitter, Reddit, etc. Despite regulatory and company efforts to reduce access to flavored ENDS products [ 32 ], considerable research is still needed on the role of flavors regarding the addiction potential of ENDS products [ 13 , 18 , 19 , 33 ]. In particular, since social media can provide timely and rapid information on what is being discussed about a particular ENDS product, continued analysis of social media is an essential early warning surveillance method for identifying addiction and the health risks of JUUL and other products (eg, the NJOY Ace product that has steadily increased in sales).…”

Section: Discussionmentioning

confidence: 99%

Characterizing Social Media Messages Related to Underage JUUL E-Cigarette Buying and Selling: Cross-Sectional Analysis of Reddit Subreddits

Liu

Zhan

et al. 2020

J Med Internet Res

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Background Stopping the epidemic of e-cigarette use among youth has become the common goal of both regulatory authorities and health departments. JUUL is currently the most popular e-cigarette brand on the market. Young people usually obtain and exchange information about JUUL with the help of social media platforms. Along with the rising prevalence of JUUL, posts about underage JUUL buying and selling have appeared on social media platforms such as Reddit, which sharply increase the risk of minors being exposed to JUUL. Objective This study aims to analyze Reddit messages about JUUL buying and selling among the users of the UnderageJuul subreddit, and to further summarize the characteristics of those messages. The findings and insights can contribute to a better understanding of the patterns of underage JUUL use, and help public health officials provide timely education and guidance to minors who have intentions of accessing JUUL. Methods We used a novel cross-subreddit method to analyze the Reddit messages on 2 subreddits. From July 9, 2017, to January 7, 2018, we collected data from the UnderageJuul subreddit, which was created for underage JUUL use discussion. The data set included 716 threads, 2935 comments, and 844 Reddit users (ie, Redditors). We collected our second data set, comprising 23,840 threads and 162,106 comments posted between July 9, 2017, and January 8, 2019, from the JUUL subreddit. We conducted analyses including the following: (1) annotation of users with buying/selling intention, (2) posting patterns discovery and topic comparison, and (3) posting activeness observation of discovered Redditors. Term frequency–inverse document frequency and regular expression-enhanced keyword search methods were applied during the content analysis to extract the posting patterns. The public posting records of the discovered users on the JUUL subreddit during the year after the UnderageJuul subreddit was shut down were analyzed to determine whether they were still active and interested in obtaining JUUL. Results Our study revealed the following: (1) Among the 716 threads on the UnderageJuul subreddit, there were 214 threads related to JUUL sale and 168 threads related to JUUL purchase, which accounted for 53.5% (382/714) of threads. (2) Among the 844 Redditors of the UnderageJuul subreddit, 23.82% (201/844) of users were annotated with buying intention, and 21.10% (178/844) of users were annotated with selling intention. There were 34 users with buying/selling intention that self-reported as being <21 years old. (3) The most common key phrases used in selling threads were “WTS,” “want to sell,” “for sale,” and “selling” (154/214, 72.0%). The most common key phrases used in buying threads were “look for/get JUUL/pods” (58/168, 34.5%) and “WTB” (53/168, 31.5%). (4) The most important concern that UnderageJuul Redditors had in obtaining JUULs was the price (311/1306, 23.81%), followed by the delivery service (68/1306, 5.21%). (5) The most popular flavors among the users with buying/selling intention were mango, cucumber, and mint. The flavor preferences remained consistent on both subreddits. Adverse symptoms related to the mango flavor were reported by 3 users on the JUUL subreddit. (6) In total, 24.4% (49/201) of users wanted to buy JUULs and 46.6% (83/178) of users wanted to sell JUULs, including 11 self-reported underage users, who also participated in the discussions on the JUUL subreddit. (7) Within one year of the UnderageJuul subreddit shutting down, there were 40 users who continued to post 186 threads on the JUUL subreddit, including 10 threads indicating buying/selling willingness that were posted shortly after the UnderageJuul subreddit was closed. Conclusions There were overlapping users active in the JUUL and UnderageJuul subreddits. The buying/selling-related content appeared in multiple venues with certain posting patterns from July 9, 2017, to January 7, 2018. Such content might lead to a high risk of health problems for minors, such as nicotine addiction. Based on these findings, this study provided some insights and suggestions that might contribute to the decision-making processes of regulators and public health officials.

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Section: Discussionmentioning

confidence: 99%

Characterizing Social Media Messages Related to Underage JUUL E-Cigarette Buying and Selling: Cross-Sectional Analysis of Reddit Subreddits

Liu

Zhan

et al. 2020

J Med Internet Res

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“…The need for such a fast turnaround and assessment of new 'variants of interest' is especially evident in light of the swift expansion of JUUL in the USA and the launch and proliferation of HTPs. [8][9][10][11] However, for its maximum potential to be reached, the issue of on March…”

Section: Increasing the Evidence Base On Tobacco Product Constituents...mentioning

confidence: 99%

“…The EU-CEG, while highly complex and challenging to use in day-to-day regulatory work at the EU MS level, is an exceptional monitoring tool as it may allow EU MS to swiftly respond to product evolutions or upcoming ‘outbreaks’ of newly evolved tobacco products or ‘variants of interest’ across the EU MS markets as they emerge. The need for such a fast turnaround and assessment of new ‘variants of interest’ is especially evident in light of the swift expansion of JUUL in the USA and the launch and proliferation of HTPs 8–11. However, for its maximum potential to be reached, the issue of ensuring sustainable staff capacity working on tobacco control in the EU MS would need to be addressed.…”

Section: Main Textmentioning

confidence: 99%

European Tobacco Products Directive (TPD): current impact and future steps

Vardavas

2022

Tob Control

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Efforts to reduce the toll of tobacco-related morbidity and mortality in the European Union are spearheaded by the Tobacco Products Directive (TPD), a legal act implemented during 2016–2021, with the overall aim to reduce tobacco consumption by 2% in Europe. Within this time frame, several core tobacco control measures were implemented, the impact of which is outlined within this manuscript. Key successful legislative actions implemented in this time frame led to greater availability of information and further regulation of additives, the banning of mentholated cigarettes, enhanced pictorial package warnings and a regulatory framework for e-cigarettes. While repeated cross-sectional data indicated a 12.5% relative reduction in smoking prevalence after implementation of the TPD, the differential regulation of cigarettes and roll-your-own tobacco compared with other products, such as cigarillos, e-cigarettes and heated tobacco products, may have also led to product displacement. Moreover, as the TPD could not keep up with the ever-changing nicotine product landscape, further adaptations may be needed.

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“…Additionally, this ban only applied to the flavored cartridges for use in pod-style EVP devices and does not apply to manufacturers of any other flavored e-liquid that is attached to the mouthpiece of JUUL ® and other brand pod-style EVP devices. It is noteworthy that other manufacturers have developed the flavored e-liquid pods that are attached to the mouthpiece of JUUL ® and other brand pod-style EVPs ( 75 ). However, adequate research on the physical characteristics of the particles, such as PSD emitted from the pod-style EVPs, has until now been lacking and this information is necessary to understand regional lung depositions.…”

Section: Discussionmentioning

confidence: 99%

“…Though some JUUL ® flavors are restricted from sale in the USA, the currently available Menthol and Virginia Tobacco JUUL ® flavors can potentially lead to considerable health damages ( 76 ). Additionally, the aerosolization of flavored e-liquids using refillable blank pod-style EVPs can be as harmful as JUUL ® flavors ( 75 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Puffing Behavior on Particle Size Distributions and Respiratory Depositions From Pod-Style Electronic Cigarette, or Vaping, Products

Ranpara

Stefaniak

Fernández

et al. 2021

Front. Public Health

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The current fourth generation (“pod-style”) electronic cigarette, or vaping, products (EVPs) heat a liquid (“e-liquid”) contained in a reservoir (“pod”) using a battery-powered coil to deliver aerosol into the lungs. A portion of inhaled EVP aerosol is estimated as exhaled, which can present a potential secondhand exposure risk to bystanders. The effects of modifiable factors using either a prefilled disposable or refillable pod-style EVPs on aerosol particle size distribution (PSD) and its respiratory deposition are poorly understood. In this study, the influence of up to six puff profiles (55-, 65-, and 75-ml puff volumes per 6.5 and 7.5 W EVP power settings) on PSD was evaluated using a popular pod-style EVP (JUUL® brand) and a cascade impactor. JUUL® brand EVPs were used to aerosolize the manufacturers' e-liquids in their disposable pods and laboratory prepared “reference e-liquid” (without flavorings or nicotine) in refillable pods. The modeled dosimetry and calculated aerosol mass median aerodynamic diameters (MMADs) were used to estimate regional respiratory deposition. From these results, exhaled fraction of EVP aerosols was calculated as a surrogate of the secondhand exposure potential. Overall, MMADs did not differ among puff profiles, except for 55- and 75-ml volumes at 7.5 W (p < 0.05). For the reference e-liquid, MMADs ranged from 1.02 to 1.23 μm and dosimetry calculations predicted that particles would deposit in the head region (36–41%), in the trachea-bronchial (TB) region (19–21%), and in the pulmonary region (40–43%). For commercial JUUL® e-liquids, MMADs ranged from 0.92 to 1.67 μm and modeling predicted that more particles would deposit in the head region (35–52%) and in the pulmonary region (30–42%). Overall, 30–40% of the particles aerosolized by a pod-style EVP were estimated to deposit in the pulmonary region and 50–70% of the inhaled EVP aerosols could be exhaled; the latter could present an inhalational hazard to bystanders in indoor occupational settings. More research is needed to understand the influence of other modifiable factors on PSD and exposure potential.

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E-cigarette flavour enhancers: Flavoured pod attachments compatible with JUUL and other pod-based devices

Cited by 9 publications

References 4 publications

Characterizing Social Media Messages Related to Underage JUUL E-Cigarette Buying and Selling: Cross-Sectional Analysis of Reddit Subreddits

Characterizing Social Media Messages Related to Underage JUUL E-Cigarette Buying and Selling: Cross-Sectional Analysis of Reddit Subreddits

European Tobacco Products Directive (TPD): current impact and future steps

Effect of Puffing Behavior on Particle Size Distributions and Respiratory Depositions From Pod-Style Electronic Cigarette, or Vaping, Products

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