BACKGROUND

JUUL is the fastest growing and highest selling brand of e-cigarette/vapor products in the USA. Assessing the effect of JUUL vapor products on adult smokers' use of conventional tobacco cigarettes can help inform the potential population health impact of these products.

METHODS

Online surveys assessed past 30-day use of conventional cigarettes, JUUL vapor products, and other e-cigarettes/vapor products, monthly for 3 months, in a non-probabilistic sample of 15,456 US adults (21+ years). Participants were established current smokers of conventional cigarettes and recruited at their first purchase of a JUUL Starter Kit in a retail store or through JUUL's website. Logistic regression models examined factors associated with participants' odds of reporting past 30-day abstinence from cigarette smoking at the 3-months assessment.

RESULTS

Past 30-day smoking abstinence at the 3-months assessment was reported by 28.3% of the intent-to-treat (ITT) sample (n = 15,456) and 47.1% of an efficacy subset sample that completed the 3-months assessment (n = 9272). Covariate-adjusted odds for reporting past 30-day smoking abstinence at the 3-months assessment were significantly higher among participants who primarily used Mint or Mango flavored JUULpods (versus Virginia Tobacco flavor) in the past 30 days; exclusively used JUULpods in characterizing flavors (versus tobacco flavors) in the past 30 days; used a JUUL vaporizer on all 30 of the past 30 days; purchased their first JUUL vaporizer in a retail store (versus online); and first purchased a JUUL Starter Kit to help quit smoking completely. Odds for reporting past 30-day smoking abstinence were significantly lower among participants who, at study enrolment, had smoked regularly for ≥ 20 years, smoked ≥ 20 cigarettes per day, and smoked on all 30 of the previous 30 days.

CONCLUSIONS

At least 28.3% of adult smokers had quit smoking cigarettes completely after using a JUUL vaporizer for 3 months. More frequent use of a JUUL vaporizer and primary use of JUULpods containing characterizing flavors, particularly Mint and Mango, appears to be important to new JUUL users' chances of quitting smoking. The impact of banning retail sales of flavored JUULpods on adult smokers' likelihood of quitting should be closely assessed.