Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun 17;16(12):2135.
doi: 10.3390/ijerph16122135.

Evidence of Nicotine Dependence in Adolescents Who Use Juul and Similar Pod Devices

Rachel Boykan  1 , Maciej L Goniewicz  2 , Catherine R Messina  3
Affiliations

Evidence of Nicotine Dependence in Adolescents Who Use Juul and Similar Pod Devices

Rachel Boykan et al. Int J Environ Res Public Health. .

Abstract

Background: The use of high-nicotine content e-cigarettes (so-called pods, such as Juul) among adolescents raises concerns about early onset of nicotine addiction. Methods: In this analysis of adolescents surveyed from April 2017-April 2018, we compare survey responses and urinary cotinine of pod vs. non-pod using past-week e-cigarette users aged 12-21. Results: More pod users categorized themselves as daily users compared to non-pod users (63.0% vs. 11.0%; p = 0.001); more pod than non-pod users had used e-cigarettes within the past day (76.2% vs. 29.6%; p = 0.001). More pod users responded affirmatively to nicotine dependence questions (21.4% vs. 7.1%; p = 0.04). Urinary cotinine levels were compared among those responding positively and negatively to dependence questions: those with positive responses had significantly higher urinary cotinine levels than those responding negatively. Conclusions: Adolescents who used pod products showed more signs of nicotine dependence than non-pod users. Pediatricians should be vigilant in identifying dependence symptoms in their patients who use e-cigarettes, particularly in those using pod devices.

Keywords: dependence; e-cigarette; nicotine; tobacco.

PubMed Disclaimer

Conflict of interest statement

M.L.G. received a research grant from Pfizer and served as an advisory board member to Johnson & Johnson, pharmaceutical companies that manufacture smoking cessation medications. The other authors have no conflicts of interest to report.

References

    1. Cullen K.A., Ambrose B.K., Gentzke A.S., Apelberg B.J., Jamal A., King B.A. 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. doi: 10.15585/mmwr.mm6745a5. - DOI - PMC - PubMed
    1. Goniewicz M.L., Boykan R., Messina C.R., Eliscu A., Tolentino J. High exposure to nicotine among adolescents who use Juul and other vape pod systems (‘pods’) Tobacco Control. 2018 doi: 10.1136/tobaccocontrol-2018-054565. - DOI - PMC - PubMed
    1. Boykan R., Messina C.R., Chateau G., Eliscu A., Tolentino J., Goniewicz M.L. Self-Reported Use of Tobacco, E-cigarettes, and Marijuana Versus Urinary Biomarkers. Pediatrics. 2019 doi: 10.1542/peds.2018-3531. - DOI - PubMed
    1. Wheeler K.C., Fletcher K.E., Wellman R.J., Difranza J.R. Screening adolescents for nicotine dependence: The Hooked On Nicotine Checklist. J. Adolesc. Health. 2004;35:225–230. doi: 10.1016/S1054-139X(03)00531-7. - DOI - PubMed
    1. McKelvey K., Baiocchi M., Halpern-Felsher B. Adolescents’ and Young Adults’ Use and Perceptions of Pod-Based Electronic Cigarettes. JAMA Netw. Open. 2018;1:e183535. doi: 10.1001/jamanetworkopen.2018.3535. - DOI - PMC - PubMed

Publication types