Association of JUUL System Nicotine Concentration With Nicotine Delivery and Switching Away From Smoking Among Adult Smokers - Nicholas I. Goldenson

It has been suggested that electronic nicotine delivery systems (ENDS) and other alternative nicotine delivery products that more closely mimic the nicotine pharmacokinetics (PK) of cigarettes may facilitate smokers transitioning away from cigarettes. In this presentation we review a JUUL study examining nicotine PK and subjective effects of JUUL System ENDS with three nicotine concentrations compared to combustible cigarettes. Nicotine delivery from JUUL was nicotine concentration dependent, with higher nicotine concentrations giving rise to greater nicotine exposure and relief of craving for cigarettes. In a longitudinal study of adult smokers who purchased JUUL, rates of past 30-day switching 3 and 6 months following purchase were significantly lower in the UK, where nicotine concentrations are limited to 20 mg/mL, than in North America, where smokers were using higher nicotine levels in their JUUL devices. These results suggest availability of ENDS in nicotine concentrations greater than 20 mg/mL may be associated with increased switching among adult smokers.