Abstract
Purpose
The aim of the study was to describe young adult use and perceptions of different
brands of pod-based electronic cigarettes (e-cigarettes) and compare with earlier
types of non-pod-based e-cigarettes (e.g., mods and tanks).
Methods
Data were collected from January to March 2019 and derive from the final wave of a
cohort study recruited in 2013–2014 using a convenience sample from 10 large California
high schools with racially/ethnically and socioeconomically diverse populations. A
total of 445 participants completed an online survey (mean age = 20.1 years [SD =
1.66], 64.8% female [n = 278], 38.8% white [n = 161], 23.9% each for Asian and “more
than one race” [n = 99], 13.5% other [n = 56], and 36.9% Hispanic [n = 160]). The
main outcomes were description of and reasons to use pods, perceived nicotine content,
and use patterns.
Results
Although <25% of participants reported smoking cigarettes and using non-pod-based
e-cigarettes, >25% reported ever use of JUUL. Similarly, <33% of cigarette smokers
and non-pod-based e-cigarette users reported use in the past 30 days, and >50% of
JUUL ever users did. The most agreed upon reason (58%) for using pods was because
they are “easy to hide.” About half of pod users “do not know” if they mix brands
of e-juice and pods, the nicotine concentration in their e-juice cartridges, nor time
to finish a cartridge. Of the 50% of participants who shared their pod, 23 (15%) did
“sometimes,” 20 (13%) “always,” and 16 (11% each) “about half the time” or “often.”
There was no consensus about how to refer to different brands of pods.
Conclusions
Our findings indicate young adults harbor confusion about pod-based e-cigarettes,
including nicotine content, usage patterns, and labeling, and that pod use is largely
because of the ease with which they can “stealth” vape. The findings suggest needed
regulation and education about these products.
Keywords
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References
- Tobacco product use and cessation indicators among adults — United States, 2018.Morb Mortal Wkly Rep. 2019; 68: 1013-1019
- Notes from the field: Use of electronic cigarettes and any tobacco product among middle and high school students — United States, 2011–2018.Morb Mortal Wkly Rep. 2018; 67: 1276-1277
- Electronic cigarette use and progression from experimentation to established smoking.Pediatrics. 2018; 141: e20173594
- E-cigarette initiation and associated changes in smoking cessation and reduction: The population assessment of tobacco and health study, 2013–2015.Tob Control. 2019; 28: 42-49
- Patterns of sustained e-cigarette use in a sample of young adults.Addict Behav. 2019; 92: 28-31
- Cardiovascular risk of electronic cigarettes: A review of preclinical and clinical studies.Cardiovasc Res. 2020; 116: 40-50
- Identifying, tracking, and treating lung injury associated with e-cigarettes or vaping.Lancet. 2019; 394: 2041-2043
- Commissioner O of the. Press announcements - statement from FDA commissioner Scott Gottlieb, M.D., on new enforcement actions and a youth tobacco prevention plan to stop youth use of, and access to, JUUL and other e-cigarettes.(Available at:)https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm605432.htmDate accessed: March 25, 2019
- Surgeon General’s advisory on e-cigarette use among youth | smoking & tobacco use | CDC.(Available at:) (April 9, 2019. Accessed December 2, 2019)
- Vaping versus JUULing: How the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market.Tob Control. 2018; (tobaccocontrol-2018-054382)
- Prevalence and correlates of JUUL use among a national sample of youth and young adults.Tob Control. 2019; 28: 603-609
- High exposure to nicotine among adolescents who use Juul and other vape pod systems (‘pods’).Tob Control. 2019; 28: 676-677
- Juul: Spreading online and offline.J Adolesc Health. 2018; 63: 582-586
- Recognition, use and perceptions of JUUL among youth and young adults.Tob Control. 2019; 28: 115-116
- Adolescents’ and young adults’ use and perceptions of pod-based electronic cigarettes.JAMA Netw Open. 2018; 1: e183535
- JUUL and other stealth vaporisers: Hiding the habit from parents and teachers.Tob Control. 2018; https://doi.org/10.1136/tobaccocontrol-2018-054455
- Nicotine arms race: JUUL and the high-nicotine product market.Tob Control. 2019; 28: 623-628
- On the popularity of the USB flash-drive shaped electronic cigarette Juul.Tob Control. 2019; 28: 110-112
- Using electronic audience response technology to track e-cigarette habits among college freshmen.Addict Behav. 2019; 95: 24-27
- Self-reported use of tobacco, e-cigarettes, and marijuana versus urinary biomarkers.Pediatrics. 2019; 143
- Start-up e-cigarette brand aims to “improve smokers’ lives”.BMJ. 2018; 362: k2930
- Use of JUUL e-cigarettes among youth in the United States.Nicotine Tob Res. 2018; https://doi.org/10.1093/ntr/nty237
- On the popularity of the USB flash drive-shaped electronic cigarette Juul | tobacco control.(Available at:)https://tobaccocontrol.bmj.com/content/28/1/110.abstractDate accessed: February 15, 2019
- Adolescents’ attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation.Prev Med. 2017; 94: 65-71
- Adolescents’ perceptions of health risks, social risks, and benefits differ across tobacco products.J Adolesc Health. 2016; 58: 558-566
- Adolescent (mis)perceptions about nicotine addiction: Results from a mixed-methods study.Health Educ Behav. 2016; 43: 156-164
- Establishing consensus on survey measures for electronic nicotine and non-nicotine delivery system use: Current challenges and considerations for researchers.Addict Behav. 2018; 79: 203-212
- STROBE statement: Available checklists.(Available at:)https://www.strobe-statement.org/index.php?id=available-checklistsDate accessed: April 9, 2019
- Standard definitions - AAPOR.(Available at:)https://www.aapor.org/Standards-Ethics/Standard-Definitions-(1).aspxDate accessed: February 27, 2019
- Youth say ads for flavored e-liquids are for them.Addict Behav. 2019; 91: 164-170
- Adolescent cigarette smoking perceptions and behavior: Tobacco control gains and gaps amidst the rapidly expanding tobacco products market from 2001 to 2015.J Adolesc Health. 2017; 60: 226-228
- A cigarette pack by any other color: Youth perceptions mostly align with tobacco industry-ascribed meanings.Prev Med Rep. 2019; 14: 100830
- A primer to bootstrapping and an overview of doBootstrap.Department of Psychology, Stanford University, Stanford, CA2014
- Nicotine salt formulations for aerosol devices and methods thereof.(Available at:)
- Characteristics and toxicant emissions of JUUL electronic cigarettes.Tob Control. 2019; 28: 678-680
- Free radical, carbonyl, and nicotine levels produced by Juul electronic cigarettes.Nicotine Tob Res. 2019; 21: 1274-1278
- E-cigarettes, cigarettes, and the prevalence of adolescent tobacco use.Pediatrics. 2016; 138: e20153983
- Will the debate over e-cigarettes start cooling down?.JAMA Netw Open. 2018; 1: e185945
- E-cigarette users commonly stealth vape in places where e-cigarette use is prohibited.Tob Control. 2019; 28: 493-497
- JUUL and other stealth vaporisers: Hiding the habit from parents and teachers.Tob Control. 2019; 28: 610-616
- Youth access to JUUL online: eBay sales of JUUL prior to and following FDA action.Tob Control. 2019; 28: 617-622
- Severity of dependence and route of administration of heroin, cocaine and amphetamines.Br J Addict. 1992; 87: 1527-1536
- Polytobacco use and risk perceptions among young adults: The potential role of habituation to risk.Addict Behav. 2019; 90: 278-284
- Type of E-cigarette device used among adolescents and young adults: Findings from a pooled analysis of eight studies of 2166 vapers.Nicotine Tob Res. 2018; 20: 271-274
- Experimenter demand effects in economic experiments.Exp Econ. 2010; 13: 75-98
Article info
Publication history
Published online: March 16, 2020
Accepted:
January 8,
2020
Received:
September 25,
2019
Footnotes
Conflicts of interest: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2020 Society for Adolescent Health and Medicine. All rights reserved.
