Abstract
In order to curb increasing youth electronic cigarette (e-cig) use, the United States Food and Drug Administration (FDA) banned the sale of flavored cartridge/pod-based products in February 2020. This mixed-methods study aimed to evaluate the impact of the FDA ban on adult JUUL users. The samples of current adult JUUL users were surveyed via Amazon Mechanical Turk at three time-points n = 76 (Sample 1); n = 128 (Sample 2); n = 86 (Sample 3) before and after the FDA flavored/pod ban. The participants were asked to report the JUUL flavored pod used most often and answer questions on purchasing generic pods or refilling (Quantitative). JUUL users were then interviewed in order to explore their perceptions and behaviors related to the FDA ban of flavored cartridge/pod-based products (Qualitative; n = 16). Quantitative data analysis evaluated the differences in variables by time-point. Qualitative data were coded into themes while using the constant comparative method. We found a significant decrease in the use of mint pods (43.4%, 22.7%, 16.3%) (p < 0.01), while there was a significant increase in the use of menthol pods (6.6%, 26.6%, 37.2%) (p < 0.01). Themes that emerged from the qualitative data included switching from mint to menthol pods, refilling pods, and switching to other products that are available in the desired flavors, such as generic pods or disposable e-cigs. Future research is needed in order to evaluate the impact of these behaviors on public health.
Highlights
Electronic cigarettes (e-cigs) are a diverse class of tobacco products that aerosolize a nicotine-containing liquid that is directly inhaled by the user
One study reported that 77.9% of adolescent and 90.3% of young adult users in the United States reported appealing flavors as a reason for e-cig use [28]. These findings suggest that flavored products available with devices that are capable of delivering large amounts of nicotine may be driving youth e-cig use
Among adult JUUL users, we found that the use of flavored JUUL pods was significantly impacted by the removal of flavored JUUL pods from the market, and the later Food and Drug Administration (FDA)
Summary
Electronic cigarettes (e-cigs) are a diverse class of tobacco products that aerosolize a nicotine-containing liquid that is directly inhaled by the user. The most recent evolution of e-cigs, which are referred to as pod-mods, are small, discrete devices that utilize interchangeable pods to house the nicotine-containing liquid, typically in a salt form, which is less harsh [2]. These devices have a sleek design, user-friendly functionality, and an array of flavor options [3]. They are known to deliver nicotine in doses that are higher than many earlier devices [4,5,6]. This type of device was made popular by the market leader called
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