The rise of e-cigarettes, pod mod devices, and JUUL among youth: Factors influencing use, health implications, and downstream effects

Abstract

Background: Electronic cigarettes (e-cigarettes) were first introduced in the U.S. market in 2006, with the more recent evolution of "pod-mod" e-cigarettes such as JUUL introduced in 2015. Although marketed as a smoking cessation tool, e-cigarettes are rarely used for this purpose in youth. This review aims to synthesize the literature regarding e-cigarette use among youth, and provides a resource for clinicians, educators, and families that helps answer commonly asked questions about e-cigarettes. Methods: PubMed, Scopus, and PsycINFO search was performed using search terms "Electronic Nicotine Delivery Systems," "e cigarettes," "e-cigarettes," "electronic cigarettes," "vaping," "JUUL," "e-cigs," and "vape pens." Search results were filtered to only include those related to adolescents and young adults. Results: E-cigarette use among youth is common, with rates of use increasing from 1.5% in 2011 to 20.8% in 2018. Pod mod devices such as JUUL have gained favor among youth for their sleek design, user-friendly function, desirable flavors, and ability to be used discreetly in places where smoking is forbidden. Adolescents are often uninformed about the constituents of ecigarettes, and little is known about the long-term effects of e-cigarettes. Studies have suggested a "gateway" effect for combustible cigarettes and cannabis use. Conclusions: E-cigarette use is becoming increasingly common among youth, leading to a myriad of questions and concerns from providers, educators, and family members. More research is needed to determine the ultimate public health impact of e-cigarette use. The authors provide a summary table of frequently asked questions in order to help clarify these common concerns.

Electronic cigarette and moist snuff product characteristics independently associated with youth tobacco product perceptions

“…Pod-type e-cigarettes, such as market-leading brand JUUL, have become the most popular type of e-cigarette among US youth 21 . Independent of nicotine content and flavor, participants in the present study viewed pod devices with more curiosity and as easier to use than other device types but not necessarily as less dangerous.…”

Sistemas electrónicos de administración de nicotina: ¿una amenaza para el neurodesarrollo de los adolescentes?

“…Al aumentar la concentración de la nicotina en el líquido E, aumenta la concentración máxima en la sangre bajo una relación linear (16,17). Y aunque estos se suelen tener menor cantidad de sustancias toxicas, persiste un número importante de carcinógenos susceptibles de ser inhalados (18). Esto último es ambiguo, y no hay consenso acerca de los efectos de los CE en los pacientes con cáncer (19).…”

The Impact of “Vaping” Electronic Cigarettes on Spine Health

“…Electronic cigarettes (e-cigarettes) were first designed by a Chinese pharmacist in 2003 [1]. In 2006, e-cigarettes were introduced to the United States market as a smoking cessation tool marketed as a safer alternative to traditional cigarettes [2]. According to a recent study of U.S. adults, 95% of those interviewed believed e-cigarettes to be "cleaner and healthier" than conventional products, suggesting the validity of introductory claims were widely accepted by the general public [3].…”

“…The JUUL® was introduced in 2015, and immediately gained popularity amongst the youth due to its sleek design, desirable flavors, and the ability to smoke discreetly in prohibited locations [2]. The usage of ENDS has increased in young adults from 1.5% in 2011 to 20.8% in 2018 [2].…”