Trends in e-cigarette brands, devices and the nicotine profile of products used by youth in England, Canada and the USa: 2017-2019.

Introduction:
This text provides an analysis of the use of e-cigarettes among youth in Canada, England, and the USa, with a focus on the trends in e-cigarette brands, devices, and nicotine content from 2017 to 2019. The study highlights the shift towards higher nicotine concentration and salt-based products, such as JUUL, and their implications for youth vaping.

Key Points:

* The study used repeat cross-sectional online surveys in 2017, 2018, and 2019 with national samples of youth aged 16-19 years in Canada, England, and the USa.
* The study found that the use of pod-style e-cigarettes, high-nicotine, and salt-based products was greater in Canada and the USa than in England.
* In 2019, self-reported use of products with higher nicotine concentration was associated with significantly greater frequency of vaping and symptoms of dependence.
* JUUL and other higher-nicotine brands were more likely to be used by youth who reported greater symptoms of dependence.
* The study also found that greater use of high-nicotine salt-based products may account for recent increases in the frequency of vaping among youth in Canada and the USa.
* The study notes that several Canadian provinces are adopting similar nicotine limits, which will provide an opportunity to examine the impact of these hNSB product restrictions on youth vaping.
* The study highlights the importance of other hNSB brands, which were associated with equal or even greater symptoms of dependence compared with JUUL.

Main Message:
The study emphasizes the need for continued monitoring and regulation of e-cigarette products, particularly those with higher nicotine concentration and salt-based products, to prevent their use among youth. The study suggests that the restrictions on e-cigarette products with high nicotine concentrations may help reduce the frequency of vaping among youth. The study also highlights the importance of considering the broader market shift towards hNSB products, which are now available in a wide range of brands and device styles, in developing regulatory actions.

hammond D, Reid JL, Burkhalter R, et al. Trends in e-cigarette brands, devices and the nicotine profile of products used by youth in England, Canada and the USa: 2017-2019. Tobacco control. 2023;32(1):19-29. doi:10.1136/tobaccocontrol-2020-056371