The rise of e-cigarettes, pod mod devices, and JUUL among youth: Factors influencing use, health implications, and downstream effects

• Published in: Drug and alcohol dependence 2019-08, Vol.201, p.85-93
• Main Authors: Fadus, Matthew C., Smith, Tracy T., Squeglia, Lindsay M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Age Factors; Cannabis; Cigarette smoking; Cigarettes; Drug addiction; E-cigarette; Electronic cigarettes; Electronic Nicotine Delivery Systems - statistics & numerical data; Female; Flammability; Flavoring Agents; Health care delivery; Humans; JUUL; Long term; Long-term effects; Male; Marijuana; Nicotine; Pod mod; Public health; Questions; Relatives; Searching; Smoking; Smoking - adverse effects; Smoking Cessation; Socioeconomic Factors; Vaping; Young Adult; Young adults; Youth
• ISSN: 0376-8716; 1879-0046; 1879-0046
• DOI: 10.1016/j.drugalcdep.2019.04.011

•E-cigarette use (vaping) is increasingly common among youth.•“Pod mod” e-cigarettes, like JUUL, are the most common devices used by youth.•Clinicians and families are often unsure about how to discuss vaping with youth.•Answers to common questions regarding e-cigarettes and JUUL are provided. Electronic cigarettes (e-cigarettes) were first introduced in the U.S. market in 2006, with the more recent evolution of "pod-mod" e-cigarettes such as JUUL introduced in 2015. Although marketed as a smoking cessation tool, e-cigarettes are rarely used for this purpose in youth. This review aims to synthesize the literature regarding e-cigarette use among youth, and provides a resource for clinicians, educators, and families that helps answer commonly asked questions about e-cigarettes. PubMed, Scopus, and PsycINFO search was performed using search terms "Electronic Nicotine Delivery Systems," "e cigarettes," "e-cigarettes," "electronic cigarettes," "vaping," "JUUL," "e-cigs," and "vape pens." Search results were filtered to only include those related to adolescents and young adults. E-cigarette use among youth is common, with rates of use increasing from 1.5% in 2011 to 20.8% in 2018. Pod mod devices such as JUUL have gained favor among youth for their sleek design, user-friendly function, desirable flavors, and ability to be used discreetly in places where smoking is forbidden. Adolescents are often uninformed about the constituents of e-cigarettes, and little is known about the long-term effects of e-cigarettes. Studies have suggested a "gateway" effect for combustible cigarettes and cannabis use. E-cigarette use is becoming increasingly common among youth, leading to a myriad of questions and concerns from providers, educators, and family members. More research is needed to determine the ultimate public health impact of e-cigarette use. The authors provide a summary table of frequently asked questions in order to help clarify these common concerns.