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Nicotine levels of young Juul users higher than traditional cigarette users

Patients aged 12 to 21 years who used Juul and other recently developed pod electronic cigarette devices that resemble USB flash drives had levels of nicotine in their urine that were higher than those from combustible, traditional cigarettes, according to data published in Tobacco Control.

“Pods are compact, lightweight, ultraportable and easy to use inconspicuously. Popularity of these devices has increased in the past year, most notably, one brand, Juul,” Maciej Lukasz Goniewicz, PhD, of the Roswell Park Comprehensive Cancer Center in New York, and colleagues wrote. “However, to date, there are no data on nicotine exposure among youth who use pod systems.”

Researchers analyzed urine samples of 38 patients who said they currently used pods. Goniewicz and colleagues found the median urinary cotinine concentration was 244.8 ng/mL (interquartile range [IQR], 8.4-1,255.8), which they said was higher than the previously reported 155.2 ng/mL (IQR, 68.8-579.2) in 55 adolescents aged 13 to 19 years who said they smoked traditional tobacco cigarettes regularly.

“Clinicians must be aware of and educate their patients about the potential for long-term sequelae of using e-cigarettes, especially pods. Public health advocates and regulatory agencies must act now to restrict youth access to e-cigarettes before decades of progress in tobacco control is undone,” researchers wrote.

Patients aged 12 to 21 years who used Juul and other recently developed pod electronic cigarette devices that resemble USB flash drives had levels of nicotine in their urine that were higher than those from combustible, traditional cigarettes.

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The growing trend in the use of Juul and electronic nicotine delivery systems by underage smokers has also caught the attention of the FDA and Scott Gottlieb, MD, commissioner of the FDA, who in April announced the agency plans a large-scale undercover crackdown on the sale of these products in both retail and online stores, as well as request documents on marketing and research conducted by manufacturers. – by Janel Miller

Disclosures: Goniewicz reports receiving fees for serving on an advisory board to Johnson & Johnson and research grant support from Pfizer, serving as a member of the National Academies of Science, Engineering and Medicine Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems and contributed to the writing of that committee’s report. The other authors report no relevant financial disclosures.