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Evidence of Nicotine Dependence in Adolescents Who Use Juul and Similar Pod Devices

Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(12), 2135;
Received: 15 May 2019 / Revised: 13 June 2019 / Accepted: 14 June 2019 / Published: 17 June 2019
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
Background: The use of high-nicotine content e-cigarettes (so-called pods, such as Juul) among adolescents raises concerns about early onset of nicotine addiction. Methods: In this analysis of adolescents surveyed from April 2017–April 2018, we compare survey responses and urinary cotinine of pod vs. non-pod using past-week e-cigarette users aged 12–21. Results: More pod users categorized themselves as daily users compared to non-pod users (63.0% vs. 11.0%; p = 0.001); more pod than non-pod users had used e-cigarettes within the past day (76.2% vs. 29.6%; p = 0.001). More pod users responded affirmatively to nicotine dependence questions (21.4% vs. 7.1%; p = 0.04). Urinary cotinine levels were compared among those responding positively and negatively to dependence questions: those with positive responses had significantly higher urinary cotinine levels than those responding negatively. Conclusions: Adolescents who used pod products showed more signs of nicotine dependence than non-pod users. Pediatricians should be vigilant in identifying dependence symptoms in their patients who use e-cigarettes, particularly in those using pod devices. View Full-Text
Keywords: e-cigarette; nicotine; dependence; tobacco e-cigarette; nicotine; dependence; tobacco
MDPI and ACS Style

Boykan, R.; Goniewicz, M.L.; Messina, C.R. Evidence of Nicotine Dependence in Adolescents Who Use Juul and Similar Pod Devices. Int. J. Environ. Res. Public Health 2019, 16, 2135.

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