Differences in switching away from cigarettes and JUUL use characteristics among adult menthol and nonmenthol smokers who purchased the JUUL System.

Introduction:
This text presents the results of a one-year longitudinal study examining if menthol (vs. nonmenthol) smokers differ in switching away from cigarettes and JUUL use characteristics, including preferred flavor. The study is focused on adult established smokers who purchased the JUUL Starter Kit.

Key Points:

* The study included adult established smokers with data on menthol cigarette preference at baseline and smoking data at ≥1 follow-up.
* Participants were recruited from retail stores or online and were invited to complete 1-, 2-, 3-, 6-, 9- and 12-month follow-ups.
* Smokers with a regular cigarette brand were asked if their brand was flavored to taste like menthol or mint, and past-30-day switching was operationalized as a "No" response to the question "In the past 30 days, have you smoked a cigarette, even one or two puffs?"
* Covariates associated with menthol smoking and cessation were included in the analysis, such as cigarette dependence, planning to quit smoking, and ENDS use in the past 30 days.
* JUUL use characteristics, including number of days used JUUL in the past 30 days, daily quantity of JUUL use, JUUL dependence, and primary JUULpod flavor, were assessed at each follow-up.
* Menthol smokers (41.2% of the sample) were more likely to switch than nonmenthol smokers (38.8%).
* More menthol smokers primarily used Menthol/Mint-flavored JUULpods (53.8%) than nonmenthol smokers (22.9%).

Main Message:
The main message of this study is that adult menthol smokers using JUUL were more likely to switch away from cigarettes compared to nonmenthol smokers. The study also found that more menthol smokers primarily used Menthol/Mint-flavored JUULpods, while nonmenthol smokers were more likely to use Tobacco-flavored JUULpods. These findings suggest that the availability of ENDS in menthol flavors may be particularly important for menthol smokers, but may also benefit some nonmenthol smokers. However, the study was conducted prior to federal restriction of cartridge-based ENDS to only tobacco and menthol flavors, and additional research is needed to assess use of ENDS among menthol and nonmenthol smokers following this regulation.

Goldenson NI, Augustson EM, Shiffman S. Differences in switching away from cigarettes and JUUL use characteristics among adult menthol and nonmenthol smokers who purchased the JUUL System. Drug and alcohol dependence. 2022;231:109238. doi:10.1016/j.drugalcdep.2021.109238