Pod-based e-cigarettes may be more addictive than other tobacco products, according to an analysis published Monday by JAMA Pediatrics.
JUUL pods and other similar products deliver nearly 60 percent more nicotine than conventional cigarettes, researchers found in the review of existing studies on vaping devices.
The pod-based devices are designed to deliver high doses of nicotine in a low pH form, which is less harsh compared to the higher pH nicotine found in most other e-cigarette brands, thus encouraging deeper inhalation, the researchers added.
“We found that pod-based e-cigarettes have a higher potential to get youth and young adults addicted than other devices,” co-author Stella Lee, assistant professor at Konkuk University in South Korea, said in a press release.
“To prevent this from happening, we need stronger health communication messages that alert people to these findings,” she added.
JUUL and similar pod-based replaceable e-cigarettes have been popular with teenagers and young adults since they became available in 2015. The devices are sleekly designed and easy to conceal, Lee and her colleagues noted.
Recent research has shown that e-cigarette use in adolescents has increased substantially since the introduction of pod-based e-cigarettes, prompting the U.S. Surgeon General to declare youth vaping an epidemic.
For the study, Lee and her colleagues reviewed recent peer-reviewed scientific literature on pod-based e-cigarettes. They identified 35 English-language articles that presented primary data on pod-based e-cigarettes from June 2015 to June 2019.
These studies looked at product design and biological effects, marketing and social media messaging, and population use and perception.
Although the products may contain lower levels of harmful ingredients than conventional cigarettes, the level of nicotine exposure in adolescents appears to be higher. The level of nicotine seen in JUUL and other pod-based e-cigarette users, based on urinary cotinine levels, was 245 nanograms per milliliter, compared to 155 nanograms per milliliter in users of traditional cigarettes, the researchers found.
Researchers also noted that pod-based e-cigarette social media marketing campaigns have targeted youth and young adults more than campaigns for other e-cigarette devices. These messages focused less on use of these products as smoking cessation devices and more on ease of use and lifestyle appeal.
Additionally, the study showed that adolescents using pod-based e-cigarettes were more likely than other e-cigarette users to vape daily and to have symptoms of nicotine dependence, the authors observed.
“Learning parents’ perspectives and their information needs around pod-based e-cigarettes is important to address the vaping epidemic among young people … because we will then be able to empower parents with accurate information and tools to communicate with their children that pod-based e-cigarettes are extremely addictive, and to avoid using these products,” said Andy Tan, assistant professor of social and behavioral sciences at Harvard T.H. Chan School of Public Health.