Nicotine delivery and relief of craving after consumption of European JUUL e-cigarettes prior and after pod modification

Abstract

The emergence of e-cigarettes on the consumer market led to a tremendous rise in e-cigarette consumption among adolescents in the United States. The success of JUUL and other pod systems was linked to its high nicotine delivery capacity. In compliance with the European Tobacco Product directive, liquid nicotine contents in the European JUUL variants are limited to 20 mg/mL or below. A short time after launching the initial version in Europe, JUUL pods have been modified in terms of the wick material used. This modification has been demonstrated previously to lead to an elevated aerosol generation, consequently, to a larger amount of nicotine per puff generated. The present study was designed to assess whether the mentioned differences between the “initial” and “modified” JUUL versions may cause a significant difference during consumption, and how nicotine delivery compares with tobacco cigarettes. In this single-center three-arm study, nicotine pharmacokinetics and influence on urge to smoke/vape were compared for tobacco cigarettes, the “initial” version of the European JUUL, and the “modified” version of the European JUUL. Participants, 15 active smokers and 17 active e-cigarette users, were instructed to consume their study product according to a pre-directed puffing protocol. Venous blood was sampled for nicotine analysis to cover the acute phase and the first 30 min after starting. Nicotine delivery and the reduction of urge to smoke/vape upon usage of both European JUUL variants were lower in comparison to tobacco cigarettes. This suggests a lower addictive potential. Modification of the pod design did not result in significant differences at the first ten puffs, as confirmed by a vaping machine experiment. Apparently, the limitations by the initially used wick material only come into effect after longer usage time.

Toward Better Characterization of a Free-Base Nicotine Fraction in e-Liquids and Aerosols

“…The addictiveness of tobacco products depends both on the nicotine dose and the rapidity of nicotine delivery. − In Europe, the limitation of nicotine to 20 mg/mL imposed by the European Tobacco Product Directive may mitigate the craving satisfaction experienced by users for nicotine content superior to 18 mg/mL but also may suggest a lower addiction potential. , Still, nicotine salts may considerably modify nicotine pharmacokinetics, thus addictiveness, even at lower doses through other mechanisms such as (1) a change of nicotine cellular uptake induced by protonated form compared to free-base form, (2) a modification in the gas/particle repartition of nicotine in the aerosol because the gaseous state or dissolved in a droplet of nicotine is a possible important factor of nicotine pharmacokinetics, and (3) the throat hit suppression/reduction enable deeper lung inhalation of the aerosol and a better aerosol deposition in the alveolar region favoring a more rapid or greater systemic passage. Additionally, NicH + could directly impact lung biological integrity.…”

Cardiovascular functions and arterial stiffness after JUUL use

“…Baseline characteristics for all 32 participants are presented in Table 1 and the flow of participants through the study is shown in Figure 1. The nicotine levels for the three groups with the corresponding numbers of participants are shown in Figure 2 36 .…”

Usage Pattern and Nicotine Delivery during Ad Libitum Consumption of Pod E-Cigarettes and Heated Tobacco Products

“…Reasons for this were discussed and include the social media marketing strategy, the selection of appealing flavors, product features, and the high nicotine delivery of the US version [ 16 , 17 , 18 , 19 , 20 ]. While we have showed that the European version delivers much less nicotine than a conventional cigarette in a study applying a pre-directed puffing protocol [ 21 ], it is unclear what nicotine levels are reached when consumers use the products in their own pattern. It was hypothesized that pod e-cigs may be used differently than known for older generation e-cigs.…”