JUUL: Spreading Online and Offline

Chu, Kar-Hai; Colditz, Jason B.; Primack, Brian A.; Shensa, Ariel; Allem, Jon Patrick; Miller, Elizabeth; Unger, Jennifer B.; Cruz, Tess Boley

doi:10.1016/j.jadohealth.2018.08.002

Cited by 76 publications

(64 citation statements)

References 31 publications

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“…The brand had reached a market share of about 40% in the US by the end of 2017 (Huang et al 2019) with high popularity among adolescents (Hammond et al 2019;Krishnan-Sarin et al 2019). This is likely due to viral marketing and the spreading of the product via social media and YouTube (Allem et al 2018;Brett et al 2019;Chu et al 2018;Czaplicki et al 2019;Kavuluru et al 2019;Ramamurthi et al 2019). The product design is flat and the vapor generation is low, which allows unsuspicious "stealth" vaping that even went viral as an internet challenge (Ramamurthi et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Mallock

Trieu²,

Macziol³

et al. 2020

Arch Toxicol

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The popularity and the high nicotine content of the American pod e-cigarette JUUL have raised many concerns. To comply with European law, the nicotine concentration in the liquids of the European version, which has been recently released on the market, is limited to below 20 mg/mL. This limit can possibly be circumvented by technological adjustments that increase vaporization and consequently, elevate nicotine delivery. In this study, we compare vapor generation and nicotine delivery of the initial European version, a modified European version, and the original American high-nicotine variant using a machine vaping setup. Additionally, benzoic acid and carbonyl compounds are quantified in the aerosol. Further, concentrations of nicotine, benzoic acid, propylene glycol, and glycerol, along with the density and pH value of JUUL e-liquids have been assessed. Whereas the initial European version did not compensate for the low nicotine content in the liquid, we provide evidence for an increased vaporization by the modified European version. As a consequence, nicotine delivery per puff approximates the American original. Notably, this is not associated with an increased generation of carbonyl compounds. Our data suggest a similar addictiveness of the enhanced European version and the original American product.

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Section: Introductionmentioning

confidence: 99%

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Mallock

Trieu²,

Macziol³

et al. 2020

Arch Toxicol

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“…We assume that NVPs lead to a net decrease in smoking initiation rates (i.e., α S < 1). However, the downward trend in youth and young adult smoking has been especially great since 2017, at the same time vaping devices such as JUUL gained popularity (Chu et al 2018 Public health estimates are sensitive to the smoking cessation parameter in the NVP Scenario. As a conservative estimate, we assume that the smoking cessation multiplier was 100%, but cessation may be higher than in the No-NVP Scenario to the extent that NVPs are an effective smoking cessation alternative ( Government regulations could dramatically in uence the uptake, use, and risks of NVPs.…”

Section: Discussionmentioning

confidence: 99%

“…In the NVP Scenario, SAD_smoker a,t and SAD_former a,t are calculated in the same manner as above except using their respective prevalence rates in the NVP scenario. Vaping-attributable deaths for current exclusive NVP users (VADs) and for former NVP users (FNVP) are measured by two similar equations (15) and (16 (19) Summing over ages in a particular year obtains the LYLs in that year.…”

Section: Figure 1 Herementioning

confidence: 99%

Public Health Implications of Vaping in the US: The Smoking and Vaping Simulation Model

Levy

Tam

Sánchez-Romero

et al. 2020

Preprint

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Background Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), which estimates the public health implications of NVPs in the US. Methods SAVM adopts a cohort-approach and is available on an Excel platform. We derive public health implications by comparing smoking- and NVP-attributable deaths under a No-NVP and an NVP Scenario. The No-NVP Scenario projects current, former and never smoking rates via smoking initiation and cessation rates, and incorporates excess risks of smoking. The NVP Scenario allows for NVP relative excess risks, switching from cigarette to NVP use, separate NVP and smoking initiation rates, and separate NVP and smoking cessation rates. The model is validated against recent US survey data on smoking and vaping prevalence. Results The SAVM projects that under current patterns of US NVP use and substitution, NVP use will translate into 5.8 million premature smoking- and vaping-attributable deaths avoided and 96.4 million life years gained between 2013 and 2100. Sensitivity analysis shows that parameters for NVP relative risks, NVP-related switching and smoking cessation are particularly influential in gauging public health impacts. Discussion The SAVM shows potential benefits of e-cigarette use over a wide range of parameters. However, there is a high degree of uncertainty regarding key parameters. Policymakers, researchers and other public health stakeholders can apply the SAVM to estimate the potential public health impact of NVPs in their country or region using their own data sources.

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“…The rapid rise of JUUL also demonstrates the important role of online marketing in adolescent use of this product, and its role in adolescent health. This was established by Chu et al [11] who present evidence in this issue on the role of Twitter in the promotion of JUUL, including among adolescents. Using a novel strategy to assess who is retweeting JUUL-related tweets, they found a substantial proportion to be adolescents.…”

mentioning

confidence: 82%

Promotion of JUUL on Twitter

Burton

Soboleva

2018

Journal of Adolescent Health

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There is considerable literature on the relative advantages and disadvantages of e-cigarettes/electronic nicotine delivery systems (hence ''e-cigarettes'') [1−4]. Proponents have argued that e-cigarettes are a safer alternative to traditional smoked tobacco [5]. Conversely, opponents have argued that they can encourage nonsmokers to begin smoking tobacco and/or expose nonsmokers (and potentially, those nearby) to the risks associated with inhaling e-cigarette vapour, with uncertain long-term consequences [6−8]. The first argument-that e-cigarettes can promote smoking cessation-positions these devices as a quitting aid. This approach corresponds with marketing e-cigarettes as relatively more advantageous than smoked tobacco due to lower health risks. The argument also implies that e-cigarettes should be marketed with information on how users can decrease nicotine intake over time to facilitate nicotine withdrawal, devoid of glamourised promotion. Conversely, marketing e-cigarettes with glamour, youthful images, and reference to multiple flavours weakens their position as a quitting aid and strengthens their position as a lifestyle device. This approach potentially increases the interest of nonsmokers and/or young people, who are likely to be exposed to the risks associated with e-cigarettes, without benefiting from reduced tobacco-smoking. Consistent with the different potential methods of marketing e-cigarettes discussed above, how e-cigarettes are marketed is likely to change their relative risks and benefits. If e-cigarettes are marketed as a lifestyle device, with the potential to attract the interest of nonsmokers and/or young people, the associated risks are likely to increase. Conversely, if e-cigarettes are largely marketed as a quitting aid, this can minimise the associated risks by not encouraging their use among nonsmokers. Among e-cigarettes, JUUL recently achieved prominence due to its rapid increase in market share, high-levels of brand recognition and use among adolescents [9]. With only moderate marketing expenditure, JUUL was transformed from a littleknown brand to the largest retail e-cigarette brand in the United States. This followed innovative, engaging, and widereaching campaigns on Twitter, Instagram, and YouTube [10]. The rapid growth of JUUL, largely due to social media promotion, makes JUUL particularly problematic, since non-smoking adolescents who use JUUL or other e-cigarettes would be exposed to the associated risks, without any benefit from reduced tobacco-smoking.

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JUUL: Spreading Online and Offline

Cited by 76 publications

References 31 publications

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Public Health Implications of Vaping in the US: The Smoking and Vaping Simulation Model

Promotion of JUUL on Twitter

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