The longitudinal study found that after accounting for key factors such as demographics and smoking history, rates of switching away from combustible cigarettes among adult smokers in the United States and Canada, where JUUL products are available in 59 mg/mL, were higher than in the United Kingdom, where the highest concentration available is 18 mg/mL. Researchers posited that heavier and more dependent smokers in particular may require the greater nicotine delivery of the higher nicotine concentration JUULpods (59 mg/mL) in order to successfully transition away from cigarettes.

Providing a satisfying nicotine effect and experience compared to combustible cigarettes is critical to facilitate an adult smoker’s transition from cigarettes to a potentially less harmful alternative nicotine-delivery product. Under the Tobacco Products Directive (TPD) regulatory framework in the European Union, the current maximum allowable concentration of nicotine in e-cigarettes is 20 mg/mL. Existing research suggests that these nicotine limits on e-cigarettes may reduce the ability of such products to switch adult smokers off of combustible cigarettes in the EU.

Notably, in both the US/Canada and the United Kingdom, more than 82% of participants reported using the highest JUUL nicotine concentration available (18 mg/mL in the United Kingdom and 59 mg/mL in the US/Canada).

The results from this study suggest that the availability of JUUL products (and other e-cigarettes) in a variety of nicotine concentrations — some greater than 20 mg/mL — may be associated with increased switching among adult smokers.

“When considering laws and regulations governing nicotine concentration in ENDS, policymakers should bear in mind that the availability of a variety of alternative nicotine products may facilitate even more smokers transitioning away from cigarettes,” said Mark Rubinstein, Vice President of Global Scientific Affairs at Juul Labs.

To be clear, JUUL products are not intended to be used for smoking cessation or other therapeutic purposes.

The study, entitled “Differences in Switching Away from Smoking among Adult Smokers using JUUL Products in Regions with Different Maximum Nicotine Concentrations: North America and the United Kingdom” was published in the journal Nicotine & Tobacco Research.

Juul Labs is fully committed to the Premarket Tobacco Product Application (PMTA) process in the United States, and to that end has built a robust scientific research program to help assess the harm-reduction potential of JUUL products, including their impact on the individual user, their ability to move adult smokers away from combustible cigarettes, and the net-population impact on public health.

We are committed to working cooperatively with regulators, public health officials, and other stakeholders to preserve the historic opportunity to transition adult smokers away from combustible cigarettes, while combating underage use.

Juul Labs will continue to share results from its science and research program transparently with the public health community as it works to support the scientific basis for the category, as well as future regulatory filings.

About the Study

A total of 10,082 adult established smokers in the United Kingdom, the United States and Canada who newly purchased JUUL products were recruited into a longitudinal study (UK: N=1,247; US/Canada: N=8,835). Complete switching (defined as no smoking, not even a puff, for more than 30 days) was assessed 1, 3, and 6 months after purchase. Propensity score matching and logistic regression compared switching after adjusting for baseline characteristics.

In both the United States/Canada and the United Kingdom, ≥82% of participants reported using the highest JUUL nicotine concentration available in that region. Rates were significantly higher in the United States/Canada (compared to the United Kingdom) at 3 and 6 months. After adjusting for factors such as demographics and smoking history, rates were significantly higher in the United States and Canada (compared to the United Kingdom) at 3 months and 6 months.

About Juul Labs

Juul Labs’ mission is to transition the world’s billion adult smokers away from combustible cigarettes, eliminate their use, and combat underage usage of our products. We believe that vapor products can offer adult smokers an alternative to combustible cigarettes and, in so doing, reduce the harm associated with tobacco. Nicotine is addictive and can potentially be harmful. It would be best if no one used any nicotine product. Anyone who smokes should quit. Adult smokers who have not successfully quit should completely switch to potentially less harmful alternative nicotine products. Juul Labs does not want any non-nicotine users, especially those underage, to try our products, as they exist only to transition adult smokers away from combustible cigarettes. JUUL products are not intended to be used for smoking cessation or other therapeutic purposes.

For the general public and policymakers looking for more information about the company, please visit www.juullabs.com.

For scientists, members of the public health community, regulators and policymakers looking to learn more about Juul Labs’ scientific research, please visit www.juullabsscience.com.

We are proud to have submitted a Premarket Tobacco Product Application (PMTA) to the US FDA in 2020 for the JUUL System, which contains over 110 original scientific studies and 125,000+ pages of data, including information about our products’ impact on the individual user, their ability to help adult smokers transition away from combustible cigarettes, and the net-population impact on public health.

Following the PMTA filing last summer, our Regulatory team turned their attention to publishing some of the key research underlying our application through peer-reviewed manuscripts. While FDA is ultimately responsible for analyzing the scientific evidence about our products and making a determination regarding their public health impact, we also appreciate that the scientific and public health community have an interest in better understanding the harm reduction potential of vapor products, including JUUL products.

This month we celebrate a significant milestone in those efforts with the publication of 11 peer-reviewed studies in a monograph edition of the American Journal of Health Behavior (AJHB). The monograph focuses on the centerpiece of our behavioral research program: the Adult JUUL User Switching and Smoking Trajectories (ADJUSST) study, which sought to understand patterns of tobacco product use among adult JUUL Product purchasers. The ADJUSST study collected data on over 55,000 current, former, and never smokers who bought a JUUL Starter Kit for the first time, and followed them over the course of a year.

These articles, and the data they reflect, represent a significant portion of our research portfolio and address many of the key topics of public health concern and interest. Our hope is that the AJHB monograph published this month helps to further the necessary scientific dialogue about the harm reduction potential of our products, and the role they may play in reducing the smoking-related death and disease which kills almost half a million Americans each year.

We look forward to continuing to share results from our science and research program as we work to support the scientific basis for the category and help advance the Agency’s Comprehensive Plan.

Below is a full list of articles in the monograph publication:

• Prevalence of ENDS and JUUL Use, by Smoking Status, in National Samples of Young Adults and Older Adults in the U.S.
• The Adult JUUL Switching and Smoking Trajectories (ADJUSST) Study: Methods and Analysis of Loss-to-Follow-Up
• Switching away from Cigarettes across 12 Months among Adult Smokers Purchasing the JUUL System
• Dual Use of Cigarettes and JUUL: Trajectory and Cigarette Consumption
• Switching away from Cigarette Smoking with JUUL: Populations of Special Interest
• Cigarette Smoking Trajectories in Adult Former Smokers Using the JUUL System
• Smoking Trajectories of Adult Never Smokers 12 Months after First Purchase of a JUUL Starter Kit
• Transitions in Smoking among Adults Newly Purchasing the JUUL System
• Changes in Dependence as Smokers Switch from Cigarettes to JUUL in Two Nicotine Concentrations
• Improving Retailer Compliance for Tobacco Purchases: Pilot Study Findings Modeling the Population Health Impact of ENDS in the U.S.