Comparing the Effects of the EU- Versus the US-JUUL Pod in a Sample of UK Smokers: Nicotine absorption, Satisfaction, and Other Nicotine-Related Subjective Effects.

Introduction:
This manuscript reports a study that compares the effects of the EU and US versions of the JUUL pod vaping device on daily smokers’ subjective experiences, craving relief, and blood nicotine delivery. The study also examines whether the lower EU-compliant nicotine concentration is associated with more intensive puffing. The results of this study provide important insights into the regulatory restrictions imposed by the European Union Tobacco Products Directive (EU-TPD) on nicotine concentration and its impact on user experiences and nicotine delivery.

Key Points:

* The study used a double-blind, counterbalanced within-subjects design, with 19 daily smokers completing two experimental sessions approximately 7 days apart, one with the EU TPD-compliant (18mg/mL) and the other with the EU TPD non-compliant (59mg/mL) JUUL pods.
* The primary outcomes included subjective effects (satisfaction, nicotine hit, pleasant, liking, acceptability), craving and withdrawal symptoms (WS) measured using the Mood and Physical Symptoms Scale (MPSS), nicotine boost, and adverse effects (aE).
* The results showed no significant differences in satisfaction, nicotine hit, craving, and WS reduction between the two conditions. however, there was a significant interaction between Time and Nicotine concentration for Nicotine hit, with mean self-report increasing under the use of the 59mg/mL from 10 to 60 minutes and decreasing under the 18mg/mL.
* Participants reported higher Throat hit following use of the 59mg/mL (p=.017). There were no differences in other subjective effects, including craving, WS relief (ps>.05).
* Liquid consumption was doubled under the 18 versus the 59mg/mL (p=.001), and nicotine boost was significantly higher in the 59mg/mL at all time points (p≤.001).

Main Message:
The study findings suggest that the EU-JUUL is as satisfying and acceptable for UK smokers as the US-JUUL containing 59mg/mL. however, the EU-JUUL is associated with greater consumption of liquid aerosol compared to the US-JUUL, indicative of compensatory puffing. These results highlight the importance of considering the impact of regulatory restrictions on nicotine concentration and user experiences when designing and implementing tobacco control policies. It is crucial to balance the need to reduce nicotine exposure with the potential unintended consequences of compensatory puffing and the risk of relapse to cigarette smoking.

Kimber C, Zaidell L, hunter S, Cox S, Notley C, Dawkins L. Comparing the Effects of the EU- Versus the US-JUUL Pod in a Sample of UK Smokers: Nicotine absorption, Satisfaction, and Other Nicotine-Related Subjective Effects. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2023;25(6):1109-1115. doi:10.1093/ntr/ntac289