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Observational Study
. 2023 Feb 9;25(3):498-504.
doi: 10.1093/ntr/ntac211.

Comparing POD and MOD ENDS Users' Product Characteristics, Use Behaviors, and Nicotine Exposure

Nicholas J Felicione  1 , Lisa Kaiser  1 , Noel J Leigh  1 , Michelle K Page  1 , Ashleigh C Block  1 , Bradley E Schurr  1 , Richard J O'Connor  1 , Maciej L Goniewicz  1
Affiliations
Observational Study

Comparing POD and MOD ENDS Users' Product Characteristics, Use Behaviors, and Nicotine Exposure

Nicholas J Felicione et al. Nicotine Tob Res. .

Abstract

Introduction: POD electronic nicotine delivery systems (ENDS), often containing high concentrations of nicotine salts, have replaced MODs (ie, open/modifiable devices) as the most popular devices. The purpose of this study was to compare device/liquid characteristics, use behavior, and nicotine exposure between POD and MOD users.

Methods: Data from the initial visit of a prospective observational study of exclusive ENDS users compared MOD (n = 48) and POD (n = 37) users. Participants completed questionnaires on demographic characteristics, patterns of ENDS use, and ENDS features. A urine sample was collected to test for cotinine and an ENDS liquid sample was collected to test for nicotine and salts. Puff topography was captured during an ad libitum bout at the end of the session.

Results: MOD and POD users did not differ on demographic characteristics. MOD users reported purchasing more liquid in the past month than POD users (180.4 ± 28.0 vs. 50.9 ± 9.0 ml, p < .001). Differences in characteristics of devices used by MOD and POD users included flavor type (p = .029), nicotine concentration (liquids used by MOD users contained less nicotine than those used by POD users: 8.9 ± 2.0 vs. 41.6 ± 3.2 mg/ml, p < .001), and presence of the nicotine salt (fewer MOD liquids had salts present than POD liquids: 11.9% vs. 77.4%, p < .001). User groups did not differ on urinary cotinine levels or puff topography (ps > .05).

Conclusions: Despite different characteristics of MOD and POD ENDS, users of those products are exposed to similar amounts of nicotine, likely due to using more liquid among MOD users.

Implications: This study directly compares ENDS product characteristics, user behavior, and nicotine exposure between MOD and POD ENDS users. Although POD products contained higher nicotine concentrations compared to MOD products, users of PODs reported consuming less liquid than MOD users. Ultimately, MOD and POD users were exposed to similar levels of nicotine, suggesting users behaviorally compensate for differences in product characteristics.

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Figures

Figure 1.
Figure 1.
Comparison of average nicotine concentration measured in liquids extracted from MOD and POD ENDS devices (mg/ml; Panel A); average volume of liquid purchased in past month by MOD and POD ENDS users (ml; Panel B), and average cotinine concentration measured in urine samples collected from MOD and POD ENDS users (ng/ml; Panel C). Error bars represent standard error of the mean.
See this image and copyright information in PMC

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