High exposure to nicotine among adolescents who use Juul and other vape pod systems (‘pods’)

Goniewicz, Maciej Ł.; Boykan, Rachel; Messina, Catherine R.; Eliscu, Alison; Tolentino, Jonatan

doi:10.1136/tobaccocontrol-2018-054565

Cited by 208 publications

(155 citation statements)

References 4 publications

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“…concerning as it may expose individuals to higher levels of nicotine and toxicants compared with single product users [12,30]. Future longitudinal research is also needed to evaluate whether JUUL use increases the risk of smoking, as substantial evidence indicates that ENDS use is a significant predictor of the initiation of smoking behaviors among youth and young adults [31,32].…”

Section: Discussionmentioning

confidence: 99%

Who is JUULing and Why? An Examination of Young Adult Electronic Nicotine Delivery Systems Users

Case

Hinds

Creamer

et al. 2020

Journal of Adolescent Health

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Purpose: The purpose of this study was to compare characteristics of usual JUUL users versus other electronic nicotine delivery systems (ENDS) users, examine differences in reasons for use and perceptions across ENDS user groups, and identify significant correlates of usual JUUL use. Methods: This study used data from 510 young adult ENDS users (ages 18e29 years) from Wave 7 (Spring 2018) of the Marketing and Promotions Across Colleges in Texas Project (Project M-PACT). Chi-Square analyses, independent t-tests, and mixed-effects logistic regression analyses were conducted to identify factors associated with usual JUUL use. Four separate regression analyses were conducted based on independent variables of interest; all models included demographics and ENDS/other tobacco use behaviors as covariates. Results: Compared with other ENDS users, usual JUUL users were more likely to be male, younger, smoke cigarettes, reported a higher socioeconomic status (SES), used ENDS on more days in the past 30 days, and reported nicotine "hit" as a reason for use. Usual JUUL users had a higher prevalence of perceiving JUUL/pod vapes as addictive compared with other ENDS users, although perceived addictiveness was not significant in the multivariable models nor were the cessation and dependence measures different between ENDS user groups. Conclusions: Results highlight concerns about the dual use of JUUL and cigarettes and raise additional concerns about the high nicotine concentration of JUUL. Future longitudinal research is needed to determine if usual JUUL users are more likely to develop symptoms of nicotine dependence compared with other ENDS users.

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Section: Discussionmentioning

confidence: 99%

Who is JUULing and Why? An Examination of Young Adult Electronic Nicotine Delivery Systems Users

Case

Hinds

Creamer

et al. 2020

Journal of Adolescent Health

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“…Currently, the 'pod' type e-cigarettes including JUUL are the most popular e-cigarette device in the rapidly increasing U.S. e-cigarette market, especially among teenagers [27], capturing over 72.1% of the e-cigarette market [28]. Very little is known about chemical composition of aerosols produced by the pod devices [9,29].…”

mentioning

confidence: 99%

Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

Son

Bhattarai

Samburova

et al. 2020

IJERPH

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Dangerous levels of harmful chemicals in electronic cigarette (e-cigarette) aerosols were reported by several studies, but variability in e-cigarette design and use patterns, and a rapid development of new devices, such as JUUL, hamper efforts to develop standardized testing protocols and understand health risks associated with e-cigarette use. In this study, we investigated the relative importance of e-cigarette design, power output, liquid composition, puff topography on e-cigarette emissions of carbonyl compounds, carbon monoxide (CO), and nicotine. Four popular e-cigarette devices representing the most common e-cigarette types (e.g., cig-a-like, top-coil, ‘mod’, and ‘pod’) were tested. Under the tested vaping conditions, a top-coil device generated the highest amounts of formaldehyde and CO. A ‘pod’ type device (i.e., JUUL) emitted the highest amounts of nicotine, while generating the lowest levels of carbonyl and CO as compared to other tested e-cigarettes. Emissions increased nearly linearly with puff duration, while puff flow had a relatively small effect. Flavored e-liquids generated more carbonyls and CO than unflavored liquids. Carbonyl concentrations and CO in e-cigarette aerosols were found to be well correlated. While e-cigarettes emitted generally less CO and carbonyls than conventional cigarettes, daily carbonyl exposures from e-cigarette use could still exceed acute exposure limits, with the top-coil device potentially posing more harm than conventional cigarettes.

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“…Research from JUUL Labs indicates that this product can deliver nicotine in cigarette-like quantities (Wynne, Waaka, & Cohen, 2018). In addition, a recent study of adolescent "pod mod" users showed higher levels of the nicotine metabolite cotinine, compared to a separate study of regular adolescent cigarette smokers (Goniewicz, Boykan, Messina, Eliscu, & Tolentino, 2018). As described earlier, adolescents, as well as pregnant women, are more likely to be negatively impacted by nicotine due to the effects of nicotine on the developing brain, and thus, JUUL use is particularly alarming.…”

Section: How Could New Ecigs Like Juul Affect Pregnant Women?mentioning

confidence: 84%

Electronic nicotine delivery systems and pregnancy: Recent research on perceptions, cessation, and toxicant delivery

Breland

McCubbin

Ashford

2019

Birth Defects Research

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Electronic nicotine delivery systems (ENDS), which includes e‐cigarettes (ECIGs), are a rapidly‐expanding class of products that heat a liquid (which may or may not contain nicotine) to produce an aerosol. The variation of ECIG components is extensive as are their effects on users. Epidemiological data show that while both adults and youth use ECIGs, use among youth has increased dramatically in recent years. Other epidemiological data show that women of reproductive age and some pregnant women are also using ECIGs. The goal of this article is to provide readers with background information about ECIGs, with a focus on recent findings about ECIG use in pregnancy and potential implications. Among pregnant women, correlates of ECIG use include current cigarette smoking, among other factors. Regarding pregnant women's perceptions of ECIG use in pregnancy, two themes emerge from the literature: many pregnant women perceive ECIGs to be safer than conventional cigarettes, and that ECIGs can aid with smoking cessation. In contrast to these perceptions, there is little concrete evidence that ECIGs help smokers quit. In addition, there are concerns about ECIG nicotine and other toxicant delivery. Nicotine is a toxicant of particular concern for pregnant women, as nicotine is known to harm a developing fetus. There are many limitations to existing research, and the literature is scant in this area. Further, new “pod mod”‐style ECIGs such as JUUL present new challenges. Overall, with limited evidence of their effectiveness, and concerns about developmental toxicology, the authors do not recommend that pregnant women use ECIGs.

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High exposure to nicotine among adolescents who use Juul and other vape pod systems (‘pods’)

Cited by 208 publications

References 4 publications

Who is JUULing and Why? An Examination of Young Adult Electronic Nicotine Delivery Systems Users

Who is JUULing and Why? An Examination of Young Adult Electronic Nicotine Delivery Systems Users

Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

Electronic nicotine delivery systems and pregnancy: Recent research on perceptions, cessation, and toxicant delivery

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