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Emerging Vaping Products

Tobacco Free Mass Policy Forum

Youn Ok Lee, PhD

Vaping nicotine harms young brains

Youth can vape many different kinds

• f vaping products

New products are changing the market and exposing youth to nicotine

Schools around the country are sounding the alarm on JUUL

The rise of JUUL and the pod mod

JUUL’s company website emphasizes that its product is for adult smokers

https://www.juul.com/ Accessed 9/4/2018

Cigarette companies have responded with products to compete with JUUL

https://www.markten.com/ https://vusevapor.com/ Accessed 9/4/2018

Other independent brands have also emerged with similar looking nicotine pod mod devices

https://phixvapor.com/ Accessed 9/4/2018

Other pod-based products feature “open” refillable pods

https://www.suorinusa.com/ Accessed 9/4/2018

Open pod devices can look like JUUL but be designed to deliver cannabis as well

https://www.kandypens.com/ Accessed 9/4/2018

Some open pod brands feature cannabis product lines

https://www.kandypens.com/ Accessed 9/4/2018

Cannabis pod products can closely resemble JUUL

https://www.paxvapor.com/ Accessed 9/4/2018

Emerging research on JUUL

JUUL is now the #1 vaping product brand in the U.S.

Total sales for JUUL

“In the short 3-year period 2015–2017, JUUL has transformed from a little-known brand with minimum sales into the largest retail e-cigarette brand in the USA, lifting sales of the entire e-cigarette category.”

Pod mods like JUUL can operate very differently than previous vaping products

“JUUL and other pod mods use protonated nicotine formulations derived from the nicotine salts in loose-leaf tobacco … Pod mods may deliver an addictive dose of nicotine without an aversive user experience or other tobacco-related deterrents— which may be one reason why 80% of 15-24 year

• lds who try JUUL continue using the product

(Willett et al 2018) and why social media posts saying “addicted to my JUUL” are common (Kavaluru et al 2018).”

JUUL’s rise was accompanied by unprecedented social media promotion

“While marketing expenditures for JUUL were moderate, the sales growth of JUUL was accompanied by a variety of innovative, engaging and wide-reaching campaigns on Twitter, Instagram and YouTube, conducted by JUUL and its affiliated marketers.”

JUUL-related social media posts featured interpersonal communication that could normalize use

“The most prevalent topic was Person Tagging at 20.48% . . . The topic of Quit Smoking was rare at 0.29%”

Initial research findings highlight several issues

Terms “JUULs” and “JUULing” could affect reporting Discrete, easy to use in places like schools High concentrations of nicotine, low awareness Experimenters continue to use them Marketing on social media is correlated with sales,

exposes young audiences to promotional content

The complex marketing of JUUL

• n social media

JUUL’s official marketing content is aligned with public health objectives

In contrast, JUUL is also being promoted by retailers, affiliate marketers, and users

Celebrity influence on social media doesn’t need to be paid endorsement

The broad reach of social media platforms could enhance normalization of JUUL use

JUUL inspires users to produce and engage with organic content on social media

Social media provides opportunities for users to brand experiences with the JUUL brand

Challenges and next steps

Addressing youth use

• f pod mods is challenging

Surveillance surveys need updating to effectively capture

use of JUUL and other novel products

We know little about product design and formulation

characteristics that appeal to youth or enhance addictiveness

Need to develop evidence-based interventions for

addressing youth pod mod use

Affiliate and organic product promotion is difficult to

regulate

Continued research on JUUL and other pod mods is needed to address challenges

Continue tracking sales data, new brands & products Surveys of youth and adults

– Are youth underreporting when asked about “e-cigarette” use

because they do not include JUULs?

– Will knowledge about the nicotine content of JUULs improve over

time? Is knowledge associated with ad exposure?

– Do youth believe they are addicted to JUUL? – How many of those who try JUUL continue to use? Why?

Experimental studies

– What are the effects of ad exposure on behaviors, beliefs, and

attitudes?

– What product characteristics enhance appeal and addictiveness,

especially among youth?

Continued research on JUUL and other pod mods is needed to address challenges

Social media studies

– Who is generating promotional content (affiliate marketers,

brand ambassadors, users)?

– Are youth exposed to vaping company marketing on social

media?

– Are youth exposed to indirect marketing on social media?

More Information

Youn Ok Lee, PhD Social Scientist Center for Health Policy Science and Tobacco Research RTI International younlee@rti.org

References

1 Barrington-Trimis JL, Leventhal AM. Adolescents’ use of “Pod Mod” e-cigarettes—

Urgent Concerns. New England Journal of Medicine. 2018 Aug 22. DOI: 10.1056/NEJMp1805758.

2 Huang J, Duan Z, Kwok J, Binns S, Vera LE, Kim Y, Szczypka G, Emery SL. Vaping

versus JUULing: how the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market. Tob Control. 2018 May 31. pii: tobaccocontrol-2018-054382. [Epub ahead of print].

3 Willett JG, Bennett M, Hair EC, Xiao H, Greenberg MS, Harvey E, Cantrell J, Vallone D.

Recognition, use and perceptions of JUUL among youth and young adults. Tob Control. 2018 Apr 18. pii: tobaccocontrol-2018-054273. [Epub ahead of print].

4 Kavuluru R, Han S, Hahn EJ. On the popularity of the USB flash drive-shaped electronic

cigarette Juul. Tob Control. 2018 Apr 13. pii: tobaccocontrol-2018-054259. [Epub ahead

• f print].

5 Allem JP, Dharmapuri L, Unger JB, Cruz TB. Characterizing JUUL-related posts on

• Twitter. Drug Alcohol Depend. 2018 Sep 1;190:1-5. doi:

10.1016/j.drugalcdep.2018.05.018. [Epub ahead of print].

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