E-cigarettes could be as addictive as smoking

US researchers found that one brand of e-cigarette delivered roughly the same amount of nicotine as a traditional cigarette.

Published: November 15, 2019 at 4:36 pm

A certain brand of e-cigarettes are probably as addictive as smoking, researchers believe.

JUUL’s pod-based vaping devices can deliver users more nicotine at a faster rate than most other types, according to a US study.

Researchers from Penn State College of Medicine found that concentrations of nicotine in blood was almost three times as high in people who used the brand compared to most of the other vaping devices.

One of the authors, Jessica Yingst, said: “The JUUL users we studied obtained blood nicotine concentrations almost three times as high as most of the e-cigarette users we previously studied. JUUL’s nicotine delivery is very similar to that of cigarettes.”

Read more about e-cigarettes:

Co-author Jonathan Foulds, a professor of public health sciences, added: “In previous studies, we found that e-cigarette users were less addicted than smokers. However, the high nicotine delivery of the product and the scores on this study suggest that JUUL is probably as addictive as cigarettes.”

They asked six regular JUUL users to puff on their device 30 times – once every 20 seconds.Blood samples were collected during and after, and then the results were compared with more than 3,000 long-term users of other electronic cigarettes.

Users of the JUUL pod-based vapes had an average nicotine boost of 28.6 ng/mL in 8.7 minutes.Other devices delivered an average of 1.8 ng/mL in 10 minutes and an average of 10.8 ng/mL in 12.1 minutes, when puffing at the same rate.

In previous research they found that JUUL delivered lower levels of some harmful chemicals than cigarettes and some other e-cigarettes.

What does the current research say about e-cigarettes?

"They aren’t new. They’ve been around for 15 years; they’ve been in widespread use in the UK for about seven years. There’s been no appreciable reported adverse effects, with use by millions of people. So, if that was a drug, you’d be pretty confident that there are no major adverse short-term effects.

Long-term, because you’re inhaling a hot vapour which has got foreign materials in it into your lungs, it is likely that there will be some lung damage from it. But, if you look at the levels of these things, you will see that the levels are a fraction of those of tobacco smoke.

So on the one hand, it’s completely barmy, for non-smoking, non-nicotine users, to start using e-cigarettes. But if you’re a smoker, it’s a no-brainer. You should switch."

Read more of what Professor John Britton, director of the UK Centre for Tobacco & Alcohol Studies at the University of Nottingham, has to say.

They say the results pose a dilemma for public health experts, with the need to weigh up the “high addiction potential” of e-cigarettes versus them being a way for smokers to consume nicotine in a less harmful way.

Prof Foulds said: “This type of product is likely addictive and is attractive to teenagers. But those same qualities that make it addictive may enable it to help adult smokers switch to a much less harmful form of nicotine consumption.”

The authors said the small sample size was a limitation.

The findings are published in JAMA Open Network.

Updated 18/11/19:

A JUUL Labs spokesperson has provided the following comment:

"The JUUL device and e-liquid were designed to convert adult smokers off of cigarettes. With this goal in mind, the JUUL team sought to create a nicotine-based e-liquid that mimicked the nicotine experience associated with cigarette use.

Providing a similar nicotine experience was a priority given the fact that early generation e-cigarettes had failed in this respect and, as a result, did not convert a significant number of adult smokers from cigarettes.

Through testing the JUUL Labs team found that a vaporized salt-based formulation resembled the nicotine absorption in blood during initial uptake of a combustible cigarette. In addition, the JUUL device is purpose-built to deliver this proprietary nicotine salt e-liquid while maintaining a low temperature regulation system designed to minimize combustion.

In terms of actual nicotine absorption, our clinical studies have consistently shown that JUUL use at 5 per cent strengths results in a nicotine uptake similar to, but lower in concentration than, a reference combustible cigarette. Our significant switch rates among adult smokers to JUUL products demonstrate the importance of these design and product choices.

Behavioral studies of tens of thousands of JUUL users demonstrate approximately half of adult smokers who purchase and use JUUL products switch completely from smoking cigarettes within six months at their follow-up assessment.”