Abstract
BackgroundJUUL is the fastest growing and highest selling brand of e-cigarette/vapor products in the USA. Assessing the effect of JUUL vapor products on adult smokers’ use of conventional tobacco cigarettes can help inform the potential population health impact of these products.MethodsOnline surveys assessed past 30-day use of conventional cigarettes, JUUL vapor products, and other e-cigarettes/vapor products, monthly for 3 months, in a non-probabilistic sample of 15,456 US adults (21+ years). Participants were established current smokers of conventional cigarettes and recruited at their first purchase of a JUUL Starter Kit in a retail store or through JUUL’s website. Logistic regression models examined factors associated with participants’ odds of reporting past 30-day abstinence from cigarette smoking at the 3-months assessment.ResultsPast 30-day smoking abstinence at the 3-months assessment was reported by 28.3% of the intent-to-treat (ITT) sample (n = 15,456) and 47.1% of an efficacy subset sample that completed the 3-months assessment (n = 9272). Covariate-adjusted odds for reporting past 30-day smoking abstinence at the 3-months assessment were significantly higher among participants who primarily used Mint or Mango flavored JUULpods (versus Virginia Tobacco flavor) in the past 30 days; exclusively used JUULpods in characterizing flavors (versus tobacco flavors) in the past 30 days; used a JUUL vaporizer on all 30 of the past 30 days; purchased their first JUUL vaporizer in a retail store (versus online); and first purchased a JUUL Starter Kit to help quit smoking completely. Odds for reporting past 30-day smoking abstinence were significantly lower among participants who, at study enrolment, had smoked regularly for ≥ 20 years, smoked ≥ 20 cigarettes per day, and smoked on all 30 of the previous 30 days.ConclusionsAt least 28.3% of adult smokers had quit smoking cigarettes completely after using a JUUL vaporizer for 3 months. More frequent use of a JUUL vaporizer and primary use of JUULpods containing characterizing flavors, particularly Mint and Mango, appears to be important to new JUUL users’ chances of quitting smoking. The impact of banning retail sales of flavored JUULpods on adult smokers’ likelihood of quitting should be closely assessed.
Highlights
JUUL is the fastest growing and highest selling brand of e-cigarette/vapor products in the USA
Through six monthly online surveys of a panel of US adult established current smokers recruited at the point of first purchase of a JUUL vaporizer in a retail store or through JUUL’s e-commerce store, this study examined demographic, smoking-related, and JUUL-related factors associated with self-reported past 30-day abstinence from cigarette smoking after ad libitum use of a JUUL vaporizer for three and six months
1, participants’ adjusted odds of reporting past 30-day abstinence from smoking significantly varied by four JUUL-related variables—primary JUULpod flavor used in the 30 days prior to the 3-month assessment; number of days of JUUL use in the 30 days prior to the 3-month assessment; place of first purchase of a JUUL Starter Kit; and whether or not participants first purchased a JUUL Starter Kit to help them quit smoking cigarettes—three smoking-related variables—number of smoking days in the 30 days prior to the baseline assessment, number of cigarettes smoked per day at the baseline assessment, and lifetime years of regular smoking—and one demographic variable—education level (Table 2)
Summary
JUUL is the fastest growing and highest selling brand of e-cigarette/vapor products in the USA. Electronic cigarettes (e-cigarettes)—hand-held devices that use battery power to heat a solution of propylene glycol, glycerol, and often flavorings and nicotine, to produce an aerosol that the user inhales—have emerged in the past decade with the greatest potential for meeting criteria for definition as tobacco harm reduction products Since their introduction to the US market in 2007, e-cigarettes have rapidly grown in popularity among adults in several countries as an alternative to smoking conventional cigarettes [2,3,4,5,6], and the increasing use of e-cigarettes has been associated with significant increases in rates of smoking cessation at the population level [7,8,9,10]. The magnitude of potential reduced harm to the individual user and the potential impact of e-cigarettes on the health of whole populations, continues to be debated [12]
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